Case Study: The Enclave at Port Chester Rehabilitation and Nursing Center (June 2017)

Patients Age: 62
Admission Date: 3/17/17
Admitted From: Phelps Memorial Hospital
Discharge Date: 6/27/17
Discharged To: Home
Length of Stay: 100 days
Reason for Stay: Severely Sprained ankle, general de-conditioning, history of multiple sclerosis, Bipolar disorder and schizophrenia
How did this patient hear about the Enclave? Phelps Memorial Hospital

Details of Experience:

Shirley came to The Enclave at Port Chester Rehabilitation and Nursing Center on March 17, 2017 from Phelps Memorial Hospital following an inpatient hospitalization for a sprained right ankle and general de-conditioning. Initially, it was discussed that Shirley would be a candidate for long term care. The staff focused on supporting Shirley and ensuring excellent outcomes with hopes of assisting her back home. Upon admission, she was evaluated as requiring extensive assist of two for bed mobility, toileting, personal hygiene and transfers, in addition to being non-ambulatory. During initial skilled physical therapy, her legs buckled. Due to her history of cognitive impairment, the staff strived to build a positive rapport with Shirley, comforting her so that she would be able to fully participate in therapy and not be hindered; this was an opportunity they were excited to embrace!

The entire team at The Enclave worked alongside Shirley to ensure her comfort. Kayla, her occupational therapist, began working on increasing her muscle strength, while the physical therapist worked on increasing her endurance and lower-body muscle strength. To address concerns of pain, the therapists introduced e-stim, diathermy and ultrasound modalities to complement her standard routine, which helped to alleviate a lot of her pain. With determination and patience, Shirley began to make noticeable progress.

The nursing team often went above and beyond to redirect Shirley in ensuring her personal safety. Our psychiatrist and psychologist also made themselves greatly available to Shirley so that she could share her thoughts on her course of treatment and care plan. With the support from the clinical team, Shirley was offered guidance and education as to the expected outcomes of her healing journey, enabling Shirley to relax and be more trusting of the staff.

In the beginning of May, an x-ray was performed on the right foot revealing no acute fracture, at which point her weight bearing status was upgraded to full-weight bearing. The positive news, along with all the encouragement from the team, improved Shirley’s demeanor and outlook. She became increasingly participatory and motivated to engage in therapy, responding well to redirection to maintain attention to task. By the end of May, her gait was significantly improved while ambulating supported by walker, due to her improved muscle strength. She could now perform transfers from different surfaces with stand by assist.

Despite being admitted for potential long term care, Shirley was able to return to her community after a three month stay! Upon discharge, her muscle strength returned to her baseline of 4+ for lower and upper body, she is now independent with hygiene, grooming and feeding, and can ambulate with a rolling walker independently for short distances; for long distances she requires light supervision. Debbie, her social worker, arranged for her to receive home care for ten hours a week to offer additional support services as she transitions back home. Shirley was sad to leave us but was grateful for the staff’s ability to return her back home. We wish her all the best!