The Pulse

I am often surprised to learn that terms and concepts I use on a regular basis are different than
I thought. A common term that I have misunderstood for many years is “aspiration pneumonia.”
Recent reading has led me to a new understanding of this term.

What do you do in your free time?
I pride myself in being a family man. My wife, 2 boys (ages 1 and 4), and Golden Retriever Nacho, are blessed to have both sets of grandparents nearby to us in New Jersey. As the boys get older, I look forward to getting back into and sharing my love of tennis, basketball, soccer, and movies with them. I love hosting parties and watching everyone enjoy themselves. We make a big deal out of every birthday, anniversary, and milestone, so the house stays busy with positive energy. My favorite time is during the holidays when family, friends, food, and good spirits feels just perfect.

Patient Information: Male, Age 80

Diagnosis: Muscle Weakness / Falls

History: This gentleman, a long-term skilled nursing facility resident, was referred to therapy by nursing due to generalized weakness, risk of falls, and a significant decline in his ability to bathe, dress himself and use the bathroom independently over the previous few weeks. Prior to this decline he was able to walk 100 feet with a rolling walker with close supervision and required minimal (25%) assistance for toileting.

According to the CDC, falls are not only a serious health risk, they carry a high economic burden as well. For older adults in the US, fall mortality rates have increased by 30% from 2007 to 2016. In 2015, the total medical cost for falls was more than $50 billion with Medicare and Medicaid accounting for 75% of these costs. The statistics related to falls are astounding. Each year:¹

• Three million older adults are treated in emergency departments for fall injuries
• 800,000+ patients are hospitalized due to a fall-related injury, most often head injury or hip fracture
• A typical nursing home with 100 residents reports about 100-200 falls
         – 35% of injuries due to falls occur in residents who do not ambulate
• 24% (most common cause) of falls among elderly nursing home residents are due to muscle weakness and gait problems, whereas 16-27%, on average, are due to environmental hazards

Patient Information: Male, Age 94

Diagnosis: Chronic Kidney Disease / Generalized Weakness

History: Following hospitalization related to chronic kidney disease, this gentleman, a long-term skilled nursing facility resident, was referred to occupational therapy to address severely decreased range of motion (ROM) in his right hand which limited his ability to feed himself. Prior to the hospitalization, he was able to feed himself independently.

Patient Information: Male, Age 66

Diagnosis: Fall-Related Trauma / Multiple Fractures

History: This gentleman was admitted to a skilled nursing facility for rehabilitation services after being hospitalized for two and a half months due to a fall at home while climbing a ladder, resulting in multiple fractures to the left side of his body. While in the hospital he suffered respiratory failure due to a pneumothorax (collapsed lung). Prior to his fall he was living at home, independent with all activities, and worked full-time in the field of construction.

Patient Information: Male, Age 73

Diagnosis: Chronic Obstructive Pulmonary Disease (COPD) exacerbation

History: This gentleman was referred to a skilled nursing facility for rehabilitation services to address significant weakness and functional decline after an exacerbation of  COPD.

What do you do in your free time? 

My husband, Ross, and I love watching our kids (Eliza, 11 and Charlie, 7) play sports, particularly soccer as we both grew up playing ourselves. Eliza and Charlie also both have high blue belts in Taekwondo. This has been a new and interesting experience for us to watch as they learn the sport and work through the belt ranks. Needless to say, we are in full-fledged taxi mode, carting the kids to their various activities on a daily basis! I’ve gotten into Spartan Racing recently and enjoy spending “me time” working out at the crack of dawn every morning.  Ross and I typically sign up for one or two trail running races each year as well.

Proper trunk positioning is an essential component of optimal aerobic capacity training. Poor positioning of the head, neck, shoulders, trunk, and pelvis during aerobic exercise may compromise an individual’s ability to reach optimal functional outcomes.

Patient Information: Female, Age 85

Diagnosis: Fractured ribs / CHF / Generalized weakness

History: This woman was hospitalized after falling and fracturing seven ribs. During her
hospitalization, she began having complications from chronic heart failure which resulted in an
extended stay of almost a month. By the time she was discharged from the hospital, her function had declined as a result of generalized weakness and pain in her low back and upper shoulders. She was referred to therapy to recover her function, treat her pain, and improve her activities of daily living.