Concierge: Julie Lavadhi
Patients Age: 59-years-old
Admission Date: 4/1/21
Admitted From: Putnam Hospital Center
Discharge Date: 5/6/21
Length of Stay: 36 days
Discharged To: Home
Reason for Stay: Post Total Hip Arthroplasty
How did this patient hear about the The Paramount at Somers Rehabilitation and Nursing Center? His mom worked here 25 years ago, and he also knew people from here.

Details of Experience:
William M. is a 59-year-old male admitted to The Paramount at Somers for short-term rehabilitation from Putnam Hospital Centers (PHC) post Total Hip Arthroplasty (THA) on 3/30/21. The patient’s past medical history includes right knee reconstructive surgery, left foot fusion, hypertension, and shortness of breath (SOB).  Before the surgical intervention, Bill lived alone in a private residence with ten steps inside and was independent in bed mobility, transfers, ambulation, and stair negotiation. 

Upon admission into the community, Bill was greeted and welcomed by The Paramount staff and immediately comfortable.  The team worked hard to develop a plan of action to support Bill’s goals of returning home to his normal activities of daily living and that he would be able to return to work. 

Bill was evaluated for physical therapy and occupational therapy.  At the evaluation time, Bill was weight-bearing as tolerated (WBAT) on the left lower extremity (LLE). He complained of sharp pain with movement 6/10 around the area of the incision. William presented with Maximum assistance with bed mobility, total dependence with transfers, ambulated 5 feet with total dependence (TD) using a front wheeled walker (FWW), and was unable to negotiate stairs. 

Rehabilitation sessions increased endurance using the nustep bike and improved standing tolerance while ambulating using a Front Wheeled Walker. In addition, Bill was given an exercise program that he began within two weeks, as soon as it was safe for him to complete it independently. Bill was performing in the hallway, with the assistance of the guard rails – side-stepping, hip marching to 90 degrees of flexion, heel raises, sit to stand, and hip abduction on bilateral sides. The patient began to progress quickly with intervention.  

Bill did continue to suffer from hip pain but was given cryotherapy, which he enjoyed and expressed relief post-treatments. He quickly increased distance with GAIT training, ambulating approximately 200 ft by mid-April with a front-wheeled walker. At this time, Bill started to GAIT train using a straight cane (SC), which he would use at home. He began stair negotiation training with rehab therapists, stairs using bilateral handrails, graduating to facility stairs within two weeks. He was trained to use the straight cane to mimic his stairs at home.

During OT sessions, rehab focused on increasing sitting out of bed tolerance due to pain, increasing UE strength to assist with transfers, ambulation, and Activities of Daily Living. Bill was educated on hip precautions and provided with adaptive dressing devices. He was educated and trained on how to increase independence and safety during tasks, increasing standing tolerance, ability to weight shift to increase the ability to participate in upper body tasks, and lower body dressing tasks with increased independence and safety. Bill had poor functional task endurance, and endurance training and strengthening were necessary to increase safety for his return home. 

Bill was highly motivated during his therapy. He used a rolling walker and was able to progress to a cane at times. He trained on walking on uneven surfaces, transferring to multiple surfaces and heights to ensure hip precautions will be maintained when he returns home. Bill had a supportive family and friends whom he often spoke to on his phone. His independent pursuits included watching TV, reading, and being on his phone.  

Recreation staff has provided a tabletop packet to work on independently, at his leisure, while in the confines of his room.  Bill’s focus was to get better and to get his strength back so he can return to work and also to be able to travel to Texas.  

Upon discharge, Bill was independent with bed mobility, modified independence (MI) with functional transfers, using a straight cane, able to ambulate 300 ft with a straight cane (SC) with Modified Independence, and was able to ascend/descend 12 steps with SC using a step-to method. He demonstrated good safety awareness and was able to maintain hip precautions at all times. 

He was encouraged to continue with physical and occupational therapy with either home services or outpatient. Bill’s goal is to return to work in a hardware store early this summer.  Upon discharge evaluation, Bill shared that he was very happy with the stay and that the staff was very friendly and helpful.  

We are very grateful to our patients for choosing The Paramount for Rehabilitation and Nursing Care. 

From everyone here at The Paramount, we wish you good luck!