Case Study: The Paramount at Somers Rehabilitation and Nursing Center (March 2019)

Patient’s Age: 81-years-old
Admission Date: 03/13/19
Admitted From: Clara Maas Medical Center
Discharge Date: 03/23/19
Discharge To: Home
Length of Stay: 24
Reason for Stay: Patient needs to improve functional independence and ambulation status post orthopedic surgery following left shoulder surgery.
How did this patient hear about The Paramount at Somers? Hospital Referral.

Details of Experience:

Day 1
Mrs. Carol Cofone was admitted to Clara Maas Medical Center on March 7, 2019, for a shoulder surgery resulting from a rotator cuff tear. Before her hospitalization, she was living alone at home and functioning independently. She was referred by the hospital case manager to The Paramount at Somers Rehabilitation and Nursing Center for rehabilitation therapy. The focus of her therapy would be to improve functional independence ambulation and strength so she can return home independently.

Overall Clinical Observation: Over the course of her 4-week stay at the Paramount, she had a successful recovery. When her Physical Therapist (PT) first evaluated her she Moderate Assistance in completing bed mobility, sit to stand and stand pivot transfers and walking only 10 feet moderate assistance using a rolling walker. She progressed over the 4-week course to modified independence in all of the above areas. During her OT evaluation, the patient exhibited weakness and shortness of breath and was unable to complete her ADLs without taking small breaks and needing more assistance than ever. She required moderate assistance with hygiene and grooming (brushing hair, brushing teeth, applying makeup, washing and drying her face), moderate assistance with toileting and bathroom transfers.

Week 1 (3/13-3/20)
With PT, Carol worked on bed mobility, transfers and walking. At the beginning of the week, she was able to walk 10’ and improved to 25’ with minimum assistance. In OT, she continued with weakness and needed to take rests between ADL and toileting tasks.

Week 2 (3/21-3/27)
During this time, Carol’s PT improved from moderate assistance to minimum assistance in all areas to moderate assistance for bed mobility and transfers. Her walking progressed from 25’ at minimum assistance to 75’ with contact guard assistance. She also made progress in OT progressing from moderate to minimum assistance for bathroom transfers and ADL’s. Carol was noted to take less rests in between OT exercises.

Week 3 (3/28-4/4)
Carol made more progress in PT in bed mobility and transfers moving from Minimum assistance to Modified Independence. Her walking improved from 75’ contact guard assistance to 175’ and with only a wheelchair follow. In OT, Carol improved with bathroom transfers from minimum to contact guard assistance. In addition, she had greater endurance for walking and functional tasks.

Week 4 (4/5-4/8)
Carol improved in PT with bed mobility, standing, transfers and walking from moderate independence at 175’ to walking 250’ with standby assistance. In OT, Carol has steadily made progress in all areas including activities of daily living as well as endurance and tolerance for activities.

In conclusion, Carol had a very successful recovery with her rehabilitation. She admitted as a patient who required moderate assistance with PT and OT. During her first week here, Carol stated: “I didn’t realize how weak I was until I started with therapy.” Upon following up with her after she returned home, we were pleased to hear that she was doing great and continued to mention how pleased she was with her rehab services and staff. Carol is a perfect example for other patients to live up to. She never gave up and persevered in reaching her goals.