The Pulse

This 74-year-old woman was referred to a skilled nursing facility for rehabilitation services with severe debility, decreased functional mobility, increased urinary frequency, and anxiety following hospitalization for acute cystitis (inflammation of the bladder). She has a long standing history of COPD and emphysema with requirement of oxygen supplementation of 4L/min. Prior to hospitalization, she lived independently. This woman’s goal is to be able to get to the bathroom on her own again.

Breathing impacts everything we do from bed mobility, transfers and gait to ADLs and IADLs. Incorporating patient-specific breathing strategies into a comprehensive rehab program not only addresses breathing impairment due to cardiopulmonary compromise, but also positively impacts pain, balance, function, and ADL performance.

Galek, K.E., Bice, E.M., Allen, K. (2023). The Influence of Three Feedback Conditions on Performing a Swallow Motor Pattern in Healthy Adults. Folia Phoniatrica et Logopaedica (Karger). doi.org/10.1159/000525634  

This 66-year-old gentleman was referred to a skilled nursing facility for rehabilitation services due to right-sided weakness and general debility. He was hospitalized after a stroke which required thrombectomy (procedure to remove blood clot). Prior to his stroke, he was living with his spouse in a home with a 3-step entry, was independent with all functional mobility, and walked with a rolling walker.

According to the CDC, coronary artery disease (CAD) is the most common type of heart disease in the US. It is caused by plaque build-up in the coronary arteries which slows blood flow. The most common symptom of CAD is chest pain. However, many people don’t have symptoms and only find out they have CAD after they suffer a heart attack.

Improving Speech Using Breathing Therapy with Biofeedback

Speech Therapy: (3x/week x 11 weeks)
OmniFlow® Breathing Therapy Biofeedback
• Airway clearance – The Dandelion
• Forced expiration – Prehistoric Contest
• Respiratory muscle training – Starry Road

This 71-year-old woman was referred to a skilled nursing facility for rehabilitation services due to requiring increased assistance with all functional tasks after a five-day hospitalization due to nine falls in one week and diagnosis of a urinary tract infection. Prior to hospitalization she lived with her grandchildren in a single story home with four steps at the entry and was independent with ambulation and all functional activities including meal prep.

Pain is common in the geriatric population leading to a rapid decline in cognition and function with the eventual need for assistance and potential institutionalization. While opioids are often used to treat pain, their side effects are now well established. In therapy, multimodal non-pharmacologic pain management interventions are effective at improving clinical outcomes.

This 81-year-old woman was admitted to a skilled nursing facility following hospitalization for acute respiratory failure. She was intubated (tube inserted in airway to assist with breathing), had pneumonia caused by aspiration (material entering the lungs), and oropharyngeal dysphagia (difficulty chewing and swallowing). As a result, she was referred for speech language pathology (SLP) services. Although she had a history of dysphagia from previous spinal surgery, she was able to consume a diet of regular food and thin liquids prior to this hospitalization.