The Pulse

Patient Information: Female, Age 66

Diagnosis: Hemorrhagic Stroke / Oropharyngeal Dysphagia

History: This woman was admitted to a skilled nursing facility for rehabilitation services following hospitalization due to suffering a hemorrhagic stroke. As a result, she was diagnosed with altered mental status and oropharyngeal dysphagia (difficulty swallowing) and a feeding tube was placed to provide nutrition and hydration. Prior to her stroke, this woman ate a regular diet and drank thin liquids.

Patient Information: Female, Age 62

Diagnosis: Stroke / Oral Dysphagia (difficulty swallowing)

History: This woman was referred to outpatient speech therapy services due to continued deficits in her ability to speak, eat, and drink following a stroke seven months prior.

Patient Information: Female, Age 73

Diagnosis: Closed Head Injury / Intellectual Disability / Oropharyngeal Dysphagia

History: This woman, born with intellectual disability, was referred to a skilled nursing facility for rehabilitation services following hospitalization due to a fall at her group home, which resulted in a head injury and femur fracture. Prior to her fall, she lived in a group home with caregivers, was non-verbal, and consumed a regular diet with thin liquids. However, caregivers modified her diet to soft solids due to noted occasional difficulty in chewing and swallowing.

Patient Information: Female, Age 85

Diagnosis: Chronic Heart Failure (CHF) / Chronic Obstructive Pulmonary Disease (COPD) / Muscle Weakness

Patient Information: Male, Age 71

Diagnosis: Guillain-Barré Syndrome / Oropharyngeal Dysphagia

History: This gentleman was referred to a skilled nursing facility for rehabilitation services after a 3-month hospital stay. He was visiting his son in the United States from Venezuela when he began experiencing numbness in his legs. He was hospitalized and diagnosed with Guillain-Barré Syndrome (rare autoimmune disorder that causes rapid and unexpected muscle weakness). While hospitalized he experienced multiple complications including infection, being placed on a ventilator, and placement of a feeding tube. Prior to his hospitalization he lived independently and ate a regular diet.

Patient Information: Male, Age 91

Diagnosis: Parkinson’s Disease / Oropharyngeal Dysphagia /
COVID-19

History: This gentleman, a long-term resident of a skilled nursing facility, was diagnosed one and a half years ago with oropharyngeal dysphagia (difficulty swallowing), a complication of his Parkinson’s disease. Since that time he has had known aspiration (liquids entering the airway), altered diet, hospitalization for aspiration pneumonia, and COVID-19. Due to his complaint of his liquids being too thick, he requested to participate in swallowing therapy for possible return to thin liquids. As a result, swallowing evaluation and resultant therapy was initiated.

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.

Patient Information: Female, Age 77

Diagnosis: Left Knee Pain

History: This woman, a long-term care resident of a skilled nursing facility, was referred to therapy due to knee pain and a decline in functional activity and ambulation. Prior to this recent decline, she was independent with ambulation throughout the facility.