The Pulse

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.

Patient Information: Female, Age 72

Diagnosis: Cardiac Arrest / Pulmonary Embolism

History: This woman was referred to a skilled nursing facility for rehabilitation services due to severe weakness and debility following hospitalization. She had a pulmonary embolism (blood clot in the lungs) which required intubation and life support with extracorporeal membrane oxygen – ECMO (blood pumped outside the body to a heart and lung machine to remove carbon dioxide and send oxygenated blood back to the body). Prior to hospitalization, she lived at home and was independent with all mobility and self-care.

Patient Information: Female, Age 76

Diagnosis: Chronic Heart Failure / Generalized Muscle Weakness / Shoulder Pain

History: This woman was admitted to the hospital to address multiple medical issues. Following hospitalization, she was referred to a skilled nursing facility for rehabilitation to address her limitations in strength and mobility, with a goal to return home alone at her prior level of function, independent with all mobility.