Concierge: Misty Billingsley
Patient Name: Patricia Riester
Patient Age: 70 days
Admission Date: 01/05/2024
From: Vanderbilt Medical Center
Discharge Date: 03/15/2024
Length of Stay: 70 days
Reason for Stay: Open reduction internal fixation right humorous, Parkinson’s

Details of Experience:

The Lebanon Center for Rehabilitation and Healing team welcomed 71-year-old Patricia “Pat” Riester to our community on January 5th, 2024, after a short stay at Vanderbilt University Medical Center in Nashville, Tennessee. Pat had a fall on her porch, resulting in a right humeral fracture and ultimately a successful orthopedic surgery, after which she needed inpatient therapy services to strengthen and retrain the muscles of her right upper extremity. Pat, unfortunately, experienced a delay in transfer out of the hospital due to difficulty finding her placement, as reported by her transferring case manager.

In addition to a post-surgical arm and subsequent pain, Pat was also suffering from an exacerbation of her Parkinson’s disease as well as obvious tardive dyskinesia that affected her speech, ability to eat, communicate, and meet her own needs as she could prior. Pat now requires substantial to maximum staff assistance to complete all daily activities. After settling into the community, Pat immediately became an active and eager participant in physical, occupational, and speech therapy, performing at only 25% of her prior level of function. Pat was welcomed by the clinical team led by Carolyn Bond, NP, under the supervision of Dr. Bernard Sy, medical director of the community. She was immediately seen to ensure adequate pain control to optimize participation in therapy services and minimize the mental strain experienced in lieu of uncontrolled pain.

After two weeks of rehabilitation therapy, Pat had made little to no progress due to very limiting symptoms of tardive dyskinesia in conjunction with her Parkinson’s disease and still required too much hands-on assistance to change levels of care. Pat was referred to our mental health provider, Herneschia Woods, PMHNPBC, who helped to support and treat Pat’s symptoms in this challenging time. Pat had no children, lived independently before arrival to the community, and needed medication from her home. After social services director Christy Buono, with the assistance of the director of concierge services Misty Billingsly, helped to reconnect Pat with a supportive family member, we were able to retrieve the crucial, non-formulary medication from her home that had traditionally controlled her TD symptoms.

Pat had an excellent attitude and performed all the tasks asked of her in therapy services to the best of her day-to-day ability. Pat experienced mild pain in her right arm that was well controlled with a dual-modality method, allowing her to push herself to reach goals without being limited by pain. Pat was welcomed to the wound care crew led by Cierra Minter, LPN, and Dr. Diane Lusas, MD, who rounded on her surgical incision weekly to ensure positive progress. By February 1st, 2024, Pat had 13 sutures removed and a perfectly healed surgical incision without unnecessary antibiotics and had nearly gained full range of motion back to her right arm.

After the initiation of her TD medication and her continued hard work with therapy, Pat sailed through her speech therapy goals and completed them all by early March! Pat’s insatiable and snacky appetite returned to full force, and she could feed herself independently and communicate clearly with staff and other residents in no time. Pat developed a companion-like relationship with all kitchen team members, and she loved their cooking! Pat learned and demonstrated swallowing safety techniques routinely and remained compliant with her diet throughout her stay. Pat regained her self-confidence, and her symptoms are now controlled. She began participating daily in activities and group therapy sessions, enjoying all the sweet treats she could get her hands on. Pat went from being shy and somewhat introverted to quite the social butterfly and enjoyed the company of many other residents and staff at the facility in between therapy sessions.

By the end of her time in our community, she had met 85% of all goals set across all therapy disciplines and was ready to transition to a lower level of care. Pat could now perform all activities of daily living independently or with supervision and with only the occasional need for safety cueing. Social services secured a bed at The Saphire at Music City, an assisted living community in Nashville, TN, for Pat’s transition. On March 15th, she was discharged with support in place from Suncrest Home Health, as well as a connection with an Austedo drug representative to ensure she would not go without her tardive dyskinesia medication ever again!

In a very short two months, Patricia became one the most drastically improved and dearly beloved residents to ever become a part of our community and she will be dearly missed! The team at Lebanon Center is so proud and incredibly blessed to have gotten to know and love you, and we wish you the best of luck, love, health, and abundance of life in all your future endeavors.