The Pulse

Part 1: Ethics and Considerations in Patient and Caregiver Perspectives

According to the CDC, falls are common among older adults with 36 million occurring each year and more than 8 million requiring medical attention. Among those with Parkinson’s disease, diabetes, stroke, and those experiencing impaired strength, coordination, and balance after prolonged hospitalization falls are also common. Individuals with or recovering from COVID-19 may also have these impairments and are at an increased risk of falls.

Collaboration to provide ability to monitor, manage and analyze vital signs from post-acute care patients

RENO, Nev. – Dec. 1, 2020 – Accelerated Care Plus (ACP), a Hanger, Inc. (NYSE: HNGR) company, today announced a partnership with Current Health, a global leader in remote healthcare delivery. ACP, the nation’s leading provider of specialized rehabilitation technologies and evidence-based clinical solutions for post-acute providers, will distribute Current Health’s remote monitoring platform, co-branded as OmniVitals Powered by Current Health, to the post-acute care market through ACP’s network of more than 7,000 post-acute care facilities.

According to the National Institute of Nursing Research (NINR), five million Americans are affected by chronic wounds each year. Chronic wounds are those that do not show measurable progress in wound healing with standard nursing care in 30 days. Individuals with diabetes, disability, and the elderly are among those at highest risk.

Patient Information: Male, Age 75

Patient Information: Male, Age 81

Diagnosis: COVID-19 / Acute Hypoxemic Respiratory Failure

History: This gentleman was referred to a skilled nursing facility for rehabilitation services due to severe debility and confusion after hospitalization for COVID-19. During hospitalization, he was found to have acute hypoxemic respiratory failure (not enough oxygen in the blood), as a result of COVID-19, and was intubated (placement of an artificial airway into the trachea) and placed on a ventilator (life support to assist breathing). During treatment he received convalescent plasma which led to removal of mechanical ventilation, but he required oxygen supplementation of three liters. Prior to his diagnosis of COVID-19, he lived at home with his wife and walked independently, no oxygen supplementation was needed.

Muscle strength decline is associated with normal aging and may be accelerated by illness, disease, or injury. Decreased physical activity resulting from COVID-19 mitigation efforts is exacerbating the incidence of muscle disuse atrophy in older adults. Strength declines may lead to functional and mobility deficits with increased risk of falls, injury, or death. According to the CDC, each year three million adults are treated in emergency departments for injuries related to falls. By 2030 fall deaths are anticipated to rise to seven per hour. Accurate assessment of strength using validated tests and objective measures is crucial to creating an appropriate treatment plan and achieving outcomes that reduce fall risk.

Speech-language pathologists (SLPs) are commonly involved in the rehabilitation of patients with cardiopulmonary disorders. Patients hospitalized with respiratory diseases such as COPD and heart failure (HF) are identified as at risk for development of oropharyngeal dysphagia. Additionally, patients who experience prolonged endotracheal intubation have an increased risk of developing dysphagia. (Malandraki et al., 2016) This is often seen in patients hospitalized for COVID-19.