Patients Age: 91
Admission Date: 12/18/2017
Admitted From: Good Samaritan Hospital
Discharge Date: 2/3/18
Discharged To: Home
Length of Stay: 48 Days
Reason for Stay: Congestive Heart Failure
How did this patient hear about Ramapo Manor? Lives in the area

Details of Experience:

Joseph Ciaccio is a 91-year-old male who was admitted to The Willows at RamapoRehabilitation and Nursing center on December 18, 2017. He was transferred from Good Samaritan Hospital where he was being treated for congestive heart failure. He also has a past medical history of sepsis, pneumonia, and bilateral pleural effusion.

Upon admission to The Willows, he was on 4L of oxygen, which contributed to his low activity tolerance and energy levels during daily activities. He was also on a modified diet, which included nectar thick liquids, for which he was being seen by speech therapy.

Joseph self reported his prior level of function to be modified independent in all functional transfers, mobility and self care categories. This was confirmed to be accurate following discussion with his son. He was expected to ambulate up to 200 feet, as well as be able to negotiate 13 stairs twice per day with his son’s close supervision. His goal for therapy was to return him back to this prior level of function with the least restrictive adaptive
equipment and ambulatory device.

Upon evaluation, Joseph presented with minimal assistance for bed mobility, transfers and ambulation using a front wheeled walker of approximately 50 feet. During ambulation and transfers Joseph exhibited knee instability secondary to underlying paresis and heel-floor angle. Stairs were not evaluated at that time.

Joseph’s physical therapy treatment consisted of resistive exercise to the bilateral lower extremities, aerobic exercise to improve activity tolerance and wean off the oxygen, with the help of respiratory therapy. In addition, Joseph participated in dynamic sitting and standing balance activities, and functional mobility training, to increase postural stability during activities. Occupational therapy worked on underlying skills of strength, and balance to improve his level of independence during self care, ie: dressing, toileting and bathing. Overtime, Joseph continued to improve incrementally, and by discharge home, he was performing ambulation and transfers at his prior level of function of modified independence. Despite still requiring supervision for stair negotiation and self care, Joseph eagerly returned home with his son and home care to further facilitate the gains he made during his stay. Joseph wanted to give a shutout to Joe, his physical therapist, and Chris from respiratory, who helped him throughout his journey here at The Willows.