Short Term Occupational Therapy Following High Blood Pressure and Hemorrhage

Director Concierge: Deaven Golding
Patient Name: John
Patient Age: 76 years old
Admission Date: 2/25/21
Admitted From: St. Thomas-West
Discharge Date: TBD
Length of stay: 39+ Days
How did the patient hear about Bethany Center for Rehabilitation and Healing? This patient has stayed at Bethany before, and he shared with the case manager, “I wouldn’t want to stay anywhere else.”

Details of Experience:
John presented to St. Thomas-West Emergency room with confusion and a severe UTI. He was admitted and stayed in the hospital for nine nights before being admitted to Bethany Center. During his stay at the hospital, they administered IV fluids for the UTI. He showed signs of tachycardia and high blood pressure. A few weeks before, a CT scan showed a hemorrhage in the right thalamus from a previous hospital stay. He had a second CT scan during this stay at the hospital, and the results showed a decrease in the hemorrhage.

Upon admission to Bethany Center, John was greeted by the receptionist and the admissions team. Once he settled in his room and the nursing staff had completed their initial evaluation, the concierge came in to greet him and meet her initial review. He shared, “It is good to see everyone again; I just wish it wasn’t under these terms.”

The following day therapy came to greet John and determine his baseline. He will be participating in occupational therapy and physical therapy 5x a week. John will need treatment for weakness and impaired mobility. Some of his short-term goals include safely performing bed mobility tasks with assistance and use of side rails and cues for safety awareness, perform functional transfers with max assistance and cues for safety awareness and proper sequencing, and increase static sitting balance for more than 8 minutes. Long-term goals include: patient will demonstrate improved independence with all gross mobility tasks, as evidenced by improvement on the PMS to 25/45. The patient will demonstrate the ability to mobilize household distances using the best method.

John immediately started treatment and was to meet these goals by 3/18/2021. First, the most crucial goal was to learn how to transfer safely. He began with the bed to wheelchair and back, then moved to the bed to wheelchair to bathroom and back. On 2/27/2021, John would need two-person assistance, along with the help of side rails, to transfer safely. By 3/4/2021, he could do a lot by himself and only needed assistance from one other person. While learning how to transfer safely, he was also working on increasing his static sitting balance. John shared, “This takes a lot of core muscles, and I’ve never seemed to have those in my life.” His baseline rated him as “poor” on the scale, and his goal was to reach “good” or higher. By 3/4/2021, he was scored at a “good” rating, and by 3/11/2021, he had met most of his short-term goals and was able to transfer safely with minimal assistance. At this time, his static sitting balance had only increased to “fair.” They continued to work on it every day to improve it. By 3/18/2021, he had met all of his short-term goals! John shared, “I never thought I could do this, but with this amazing therapy team, I did it!”

As for his long-term goals, on 2/27/2021, his baseline on the physical mobility scale for improving independence with all gross mobility tasks was rated a 2/45. Therapy made it a plan for him to meet 25/45. By 3/4/2021, he was scored at a 4/45. He shows a deficit in upper and lower extremity movement, along with core strength. John continued to work on it every day and push himself to get better. By the time of his subsequent evaluation on 3/18/2021, he had reached a 19/45! As they continue to work on the sitting balance and maintaining the strength he has built up, they are preparing for his discharge soon.

John has come a long way, and the team is so proud of him!