The Pulse

Patient Information: Female, Age 64

Diagnosis: Acute Respiratory Failure / COVID-19 / Chronic Obstructive Pulmonary Disease (COPD)

History:
This woman was referred to a skilled nursing facility due to severe debility following a seven week hospitalization due to COVID-19. Her condition was complicated by diabetes, COPD, and pulmonary fibrosis. At the time of hospital discharge, she required 8 liters per minute of supplemental oxygen to maintain oxygen saturation level. Prior to hospitalization she lived with her family in a 2-story home, was independent with walking and all self-care, and worked as a construction supervisor.

Patient Information: Female, Age 80

Diagnosis: Subluxed Humerus / Pain

History:
This woman, a long-term care resident of a skilled nursing facility, was referred for rehabilitation services to address pain, decreased strength, and impaired motion of the left shoulder after experiencing a fall which caused her left shoulder to become partially dislocated (subluxed). Prior to her fall, she was able to dress independently.

Patient Information: Female, Age 64

Diagnosis: Acute Respiratory Failure / COVID-19 / Chronic Obstructive Pulmonary Disease (COPD)

Patient Information: Male, Age 71

Diagnosis: Subdural Hematoma / Oropharyngeal Dysphagia

History:
This gentleman was admitted to a skilled nursing facility for rehabilitation services following hospitalization due to a fall, which resulted in a traumatic subdural hematoma (bleeding between the skull and brain). He was then diagnosed with encephalopathy (damage to the brain) and oropharyngeal dysphagia (difficulty swallowing), with a feeding tube placed during his hospitalization to provide nutrition and hydration. Prior to his accident, this gentleman consumed a regular diet and drank thin liquids.

Patient Information: Female, Age 78

Diagnosis: Oral Cancer / Dysarthria / Oropharyngeal Dysphagia

History: This woman, a long-term care resident of a skilled nursing facility, has a history of oral cancer four years ago. At that time, she underwent removal of 50% of her tongue, tissue grafting for her palate, and has resultant decreased jaw movement, oropharyngeal dysphagia (difficulty swallowing), and dysarthria (difficulty with speech production). Additionally, she underwent a tracheostomy (tube inserted into the trachea to assist with breathing) and a feeding tube was placed to provide nutrition due to her inability to eat and drink by mouth. She has received intermittent speech-language pathology services over the four years. Prior to her cancer, this woman had no limitations in eating, drinking, and speaking.

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.