Case Study: The Paramount at Somers Rehabilitation and Nursing Center (March 2021)

Short Term Rehabilitation Following Hemiarthroplasty Hip Surgery

Concierge: Julie Lavadhi
Patients Age: 77-years-old
Admission Date: 1/6/21
Admitted From: Northern Westchester Hospital
Discharge Date: 03/10/21
Length of Stay: 63 days
Discharged To: Home
Reason for Stay: Skilled PT/ OT Hip replacement surgery
How did this patient hear about the The Paramount at Somers Rehabilitation and Nursing Center? Hospital Case Worker

Details of Experience:
Mr. Steven is a 77-year-old gentleman welcomed to The Paramount at Somers Rehabilitation and Nursing Center for short-term subacute rehab, following his hospital stay at Northern Westchester Hospital Center. He had been admitted following a fall at home and hospitalization, requiring Hemiarthroplasty surgery to repair his fractured hip.

Before admission, Steven resided alone in a co-op apartment with ramps to enter and an elevator inside. He was independent with all activities of daily living (ADL’s) and did not use Assistive Device (AD) for functional mobility.

Upon admission into the community, Steven was greeted by the Paramount staff, immediately assessed, and made comfortable. The community worked hard to develop a plan of action to support Steven’s independent return home.

Upon initial physical and occupational therapy evaluations, Steven was assessed as unable to care for himself or perform any of his activities of daily living independently without skilled care assistance. Due to the nature of his injuries, he had a great deal of weakness, decreased functional activity tolerance, reduced Activities of Daily Living (ADL) performance, and needed increased assistance for balance. Also, he was considered to be at high risk for falls.

Mr. Steven worked diligently with his Physical and Occupational Therapists on strengthening his leg muscles, range of motion, transfers, and all his ADLs. At the end of this period, he improved his endurance and tolerance for pain. He was instructed on safety techniques, body awareness, and compensatory strategies.

Steven’s main goal was “to get his strength back and go home.” While his focus was rehab, Steven enjoyed independent pursuits such as watching TV and surfing the web (as he is a collector), and reading. Therapeutic Recreation provided a tabletop activity packet to use at his leisure. Also, the concierge provided 1:1 visits to increase socialization and provide extra support.

Steven continued to stay focused. He improved his strength and endurance, progressing from needing maximum assistance to moderate assistance. He could increase his balance, and the duration of persistence doubled during this phase of treatment. Steven began to tolerate weight bearing on his affected leg and balance exercises and functional activities. He progressed from moderate to minimum assistance with dressing, transfers. Although he had pain initially when he began to bear weight on his affected leg, his pain tolerance improved.

He continued to progress in his balance and pain tolerance. He was able to walk short distances with PT/ OT up to 150 feet and went from moderate assistance to minimum assistance up to a distance of 75 feet. His improved balance and endurance helped him progress from minimum assistance to contact guard assistance with dressing and ADLs.

Steven progressed in ambulation from minimum assistance to contact guard assistance up to 150 feet. His balance and endurance improved when he transferred and dressed with only supervision.
During this final phase of treatment, Steven turned a corner and entered an independent level of functioning for all of his ADLs and transfers. His walking increased from 150 feet to 350 feet for indoor and outdoor ambulation. He had excellent safety awareness, improved his functional capacity, improved balance and strengthening of his lower extremities, and most importantly, a lower risk of future falls.

In conclusion, Steven could have potentially spiraled downward with the many deficits he had due to his broken hip. However, he had a great motivation to get better and a desire to succeed. He longed to return to his vibrant independent lifestyle at home and to enjoy his family, his friends, and his many hobbies. Thank you for putting your trust in The Paramount at Somers to provide you the unparalleled rehabilitation and skilled nursing care.

The team at the Paramount is proud to have been a part of his therapy recovery journey. Good Luck!