Concierge Director: Mayya Burlakova
Patient Name: Alter Barbara
Admission Date: 12/4/2023
Admitted From: Acute Care/Short Term West Boca Medical Center
Discharge Date: 02/28/2024
Discharge To: Home
Length of Stay: 93 days
Reason for Stay: Fracture of right femur, subsequent encounter for closed fracture with routine healing. History of falling
How did this patient hear about The Legacy: From her Humana case manager

Details of experience:

Barbara is an 85-year-old woman who came to the Legacy in December 2023 from West Boca Medical Center. Her Humana case manager highly recommended this facility. From the family’s visit to our community and their research, they liked that the community is located at the heart of Boca Raton. The family found our community clean and well-maintained. Each room has individual refrigerators, TVs, and views of exotic landscapes surrounding a lake, making for incredible window views. The community has two gyms: an occupational therapy gym and a physical therapy gym, both well equipped. There are outdoor patios where patients and residents can chat with each other and their loved ones all year round. They heard that The Legacy has an excellent reputation and outstanding physical therapy with dedicated, caring nursing staff and activities that make resident’s day more enjoyable. Concierge services are a great addition to the community. Residents enjoy snacks between meals, live music three times a week, birthdays, pizza and seasonal parties, bingo, and various classes. First, she was scared and felt she was in the wrong place. Upon her arrival, our staff welcomed Barbara to the community. She felt like she was greeting old friends. When she opened her eyes in the morning on the day after admission, she fell in love with the outdoor surroundings, especially our outdoor patio. From the beginning, Barbara was determined to regain her independence. She has a powerful spirit. First, she was evaluated by nursing therapists, followed by physical and occupational therapists. According to her Physical Therapist, Barbara arrived as dependent with transfers and bed mobility(to roll left to right, Sit to lying, Lying to sitting on the side of the bed). She walked 10 feet with substantial or maximal assistance. Because of medical conditions and safety concerns, she did not attempt to walk 50 feet with two turns. Her Gait Distance was five feet using Parallel bars. By performing Gain Pattern or Deviations patients, she exhibits abnormalities in posture, absent push-off, absent loading response, antalgic gait, decreased cadence, decreased step length(15’), excessive hip and knee flexion, muscle instability, and compensatory deviation for problems elsewhere. Her Mobility Function Score (range from 0-12) was 0. When she was admitted to our community, Barbara was dependent on full help for Hygiene/Grooming, Toileting, and low-body dressing. Our staff developed an individual plan of recovery and renewal. The final goal for Barbara was to return home and be self-sufficient with family help. She lives with her daughter. All the goals were in place so Brbara could safely regain her independence. During recovery, the patient demonstrated good rehab potential, as evidenced by cognitive functioning, supportive families, and motivation to participate. Skilled treatment interventions included instructing and training the patient using assistive devices, proper body mechanics, safe transfer techniques, and energy conservation techniques to increase tolerance and prolong ambulation on level or unlevel surfaces with assistance. The Patient made consistent progress throughout her Plan of Treatment. During weeks one through four, the Patient improved her ability to safely transfer from sitting on the side of the bed to lying flat on the bed from dependent to with partial or moderate assistance. Barbara improved her ability to transfer from a bed to a chair from dependent to substantial assistance. She improved her ability to transfer to and from a bed to chair and sit or stand with independent ability to right self to achieve balance from dependent to Substantial assistance. Now, she ambulates uneven surfaces 200 feet using the least restrictive device and level surfaces 30 feet using a walker with Partial moderate assistance. In four weeks, she needed partial or moderate assistance with low-body dressing, toilet transfer, and toilet hygiene. During weeks four through eight of the patient’s stay, Barbara continued to improve the ability to transfer from a bed to a chair from Substantial assistance to Supervision or touching assistance. She improved the ability to transfer to and from a bed to chair and sit or stand with independent ability to right self to achieve balance from Substantial assistance to Supervision or touching assistance. She also improves her ability to ambulate uneven surfaces 200 feet using the least restrictive device and level surfaces 30 feet by using a walker. Now, residents are doing it with Supervision or touching assistance. In eight weeks, she just required supervision or touching assistance for Low Body dressing, for toilet transfer, and toileting hygiene. By discharge, according to the Physical Therapist, she independently transfers herself from sitting on the side of the bed to lying flat on the bed. Barbara transfers herself from chair/bed to chair and sit or stand with Setup or Clean-up Assistance with the ability to right self to achieve and maintain balance with setup or clean-up assistance. She ambulated on level 30 feet using a two-wheeled walker with adequate weight acceptance, continuous steps with even step length, functional dynamic balance, functional loading response, functional posture, functional push-off, and functional speed and amplitude with Setup or clean-up assistance. She ambulated on uneven 200 feet using the least restrictive device with Independence, adequate weight acceptance, continuous steps, even step length, functional dynamic balance, functional loading response, functional posture, push-off, speed, and amplitude, and Setup or clean-up assistance. According to her Occupational therapist, she needed supervision or touching assistance with Hygiene /Grooming, Toileting, and Low Body Dressing with Supervision. During recovery, Barbara made consistent progress throughout the Plan of Treatment. After her workout, she liked watching TV and spending time outside on the patio. Her prognosis for maintaining her current level of function was good. Barbara was discharged at home with support and assistance from her family. Before she left, Barbara shared her experience: “For 2-month Legacy at Boca Raton became my home, and staff treated me as my family. I came here completely dependent on my aid and nurses. They always being nice and caring. My occupational and physical therapists, Rick and Daniela, were encouraging and professional. My recovery is teamwork. The staff here works so well together, and they all have a goal of helping their patients become healthy again. I would like to say thank you to all of them. I highly recommend The Legacy at Boca Raton”. She promised to visit us and recommend everyone she knows in our community. After discharge, she will continue physical and occupational therapy at home. She will receive services from “Better at Home” home health care services (nurse and aid visitation). Our social worker Veronica ordered her wheelchair with leg rest and cushion, rolling walker, shower chair, commode, and grab bars. She was delighted. We all were amazed at her progress. We wish Barbara a healthy rest of the 2024 year.