Case Study: Sans Souci Rehabilitation & Nursing Center (November 2017)

Patients Age: 81
Admission Date: 8/1/2017
Admitted From: St. John’s Riverside Hospital
Discharge Date: 11/17/17
Discharged To: Home
Length of Stay 109 days
Reason for Stay: Cerebrovascular Accident (Stroke)
How did this patient hear about Sans Souci Rehabilitation and Nursing Center? Social Work department in Hospital

Mr. Keith Fields is an 81-year-old male who was admitted to Sans Souci Rehabilitation and Nursing Center on 8/1/17 after suffering a stroke. At the initial swallow evaluation, he required the use of a PEG tube and was unable to tolerate food by mouth. He received an MBS (modified barium swallow study) and FEES (Fiberoptic endoscopic swallowing test) to assess his swallowing abilities in real-time to determine the best treatment approach. Both the MBS and FEES tests displayed a moderate silent aspiration.

In order to improve Mr. Fields’ swallowing abilities and allow him to have regular-consistency foods, an intensive dysphagia treatment approach was used. Mr. Fields received speech therapy five days a week for 60 minutes each. During the treatment session, various techniques were used to improve his swallow initiation time and effectiveness, sensation, pharyngeal clearance and bolus formation. Thermal tactile stimulation (sour/cold ice chips), NMES (neuromuscular electrical stimulation), oral motor exercises, effortful swallows, Masako and Shaker maneuvers/exercises, and continuous trials with liquids and solids were among the various treatment techniques used to improve his swallowing abilities.

Within a few weeks, Mr. Fields was demonstrating improvements and was able to begin eating by mouth. He was then upgraded to honey-thick liquids and puree consistency. With continuous intensive dysphagia treatment and family education, Mr. Fields was safely upgraded to nectar thick and thin liquids and soft chopped foods. Mr. Fields and his family were educated on a daily basis regarding diet consistency and his strategies to prevent any decline. Their goal was to improve his swallowing abilities before Thanksgiving in order to enjoy this holiday with his family. With great family support and motivation, Mr. Fields was upgraded from NPO (nothing by mouth) to safely eating soft chopped food and nectar thick and thin liquids. We were so excited to see him return home in time for Thanksgiving to enjoy the holiday with his loving wife and family! The team here at Sans Souci wishes only the best of health and continued progress for Mr. Fields!