Case Study: The Enclave at Rye Rehabilitation and Nursing Center (November 2017)

Patients Age: 69
Admission Date: 9/13/17
Admitted From: Greenwich Hospital
Discharge Date: 11/1/17
Discharged To: Home
Length of Stay: 7 weeks
Reason for Stay: Acute hypoxic respiratory failure, congestive heart failure
How did Patient hear about The Enclave at Rye? White Plains Hospital

Details of Experience:

Phil arrived at The Enclave at Rye Rehabilitation and Nursing Center on September 13th, 2017 following an inpatient hospitalization at White Plains Hospital due to acute hypoxic respiratory failure and congestive heart failure. The interdisciplinary team, including clinicians, therapists, social worker and administration, welcomed Phil within twenty four hours of his arrival assuring him that his care and well being were the highest priority of the team.

Phil presented with decreased strength and endurance impacting his functional mobility and ability to perform activities of daily living independently. His being on two liters of oxygen via nasal cannula and also requiring dialysis three times a week were challenges the team incorporated into his care plan. Therapy established short term goals of increasing upper and lower body strength to stand for 3-5 minutes in order to increase participation in ADL’s and transfers, as well as safely ambulating 75 feet. Long term goals were tasked to ambulate 350 feet independently and perform ADL’s with modified independence, using least restrictive assistive devices.

The nursing team, led by Liby, closely monitored Phil’s oxygen saturation to ensure his health while slowly attempting to wean him off the oxygen as much as possible as his strength increased. Concurrently, Marlene his physical therapist patiently scheduled his sessions to maximize his time here and not extend his stay more than necessary. Nearly one month into his stay, Phil’s lower body muscle strength increased from 3/5 to 4/5, he could ambulate 150 feet supervised, and could perform bed mobility with modified independence. Additionally, he could perform ADL’s standing for seven minutes with supervision.

Over the next three weeks, Phil made substantial progress on multiple fronts, allowing him to return back to living in the community independently. He could be off oxygen for extended periods without feeling short of breath, although he would still use it sporadically throughout the day. He could also stand unsupported for 20 minutes, which surpassed the goal initially set for him. He met the team’s goals which included: perform functional mobility during ADL’s with modified assist, including toileting, using a rollator walker, and could walk for 350 feet with his walker. Congratulations on your incredible progress, Phil!