The Pulse

Patient Information: Female, Age 76

Diagnosis: Chronic Obstructive Pulmonary Disease (COPD) / Chronic Heart Failure (CHF) / Diabetic Neuropathy

History: This woman was referred to home health therapy services due to numerous falls, poor balance, and a decline in functional mobility. Over several months she became wheelchair-dependent in part due to fear of falling. Prior to this decline, she was independent with transfers and able to walk with a rolling walker to the dining room for meals in her assisted living facility.

Patient Information: Female, Age 70

Diagnosis: Left Femur Open Reduction Internal Fixation (ORIF) / Pain

History: This woman was admitted to a skilled nursing facility for rehabilitation services following hospitalization due to a fall at home resulting in a left femur fracture requiring surgical repair. Prior to her fall, she lived in a 2-story home with her husband and was independent with walking and all activities of daily living.

Patient Information: Male, Age 87 Diagnosis: Pressure Ulcer / Type II Diabetes

History: This gentleman was transferred to a skilled nursing facility for long-term care with a long standing pressure ulcer. Nursing referred him to therapy for wound care intervention due to this non-healing stage IV (full thickness) coccyx (base of the spine) pressure ulcer despite being treated weekly be a wound care doctor and receiving daily wound care by nursing for almost 2 years (643 days). He also has type II diabetes and poor sitting posture which contributed to his slow healing.

Patient Information: Female, Age 81

Diagnosis: Distal Femur Fracture / Fall Risk / Dementia

History: This woman was hospitalized for a surgical repair of her right femur, which she fractured in a fall. Following hospitalization, she was referred to a skilled nursing facility for rehabilitation to address decreased functional mobility and safety. Previously, she also had a hip and knee replacement on the same side. Prior to her fall she lived at home with her spouse and walked independently, including up and down four steps at the entrance of the home.

Patient Information: Male, Age 57

Diagnosis: Cognitive Communication Deficit / Chronic Obstructive Pulmonary Disease /
Chronic Heart Failure

History: This gentleman was admitted to a skilled nursing facility and referred to speech therapy for decreased cognitive function and failure to thrive following bilateral above knee amputations. Previously, the gentleman lived at home.

Patient Information: Female, Age 83

Diagnosis: Acute Encephalopathy / Chronic Heart Failure / Morbid Obesity

History: This woman was referred to a skilled nursing facility due to declining health, functional mobility, and ability to care for herself. Thirteen months prior, she was hospitalized due to encephalopathy and complications from chronic heart disease, she was then referred to a skilled nursing facility for rehabilitation. She had poor adherence and participation in therapy. At that time, her son and daughter-in-law took her home despite requiring assistance for all transfers, mobility, and most daily living activities. Once home, her activity level and health further declined and she was re-admitted to the hospital and subsequently back to the skilled nursing facility. Prior to initial hospitalization, she was able to propel herself in her wheelchair up to 100 feet and was able to assist with transfers and self-care.

Patient Information: Male, Age 71

Diagnosis: Stroke / Left Hemiparesis

History: This gentleman suffered a stroke causing hemiparesis (muscle weakness) to his left leg and arm. After spending a week and a half in the ICU and an additional three weeks in inpatient rehabilitation, he received six weeks of outpatient therapy. Prior to his stroke, this gentleman was independent with all mobility and worked full-time running a heavy equipment corporation.

Patient Information: Male, Age 79

Diagnosis: Wallenberg - Stroke / Dysphagia

History: This gentleman was admitted to a skilled nursing facility for rehabilitation services after hospitalization due to a stroke. A feeding tube was placed to address his dysphagia (difficulty swallowing). Prior to the stroke, he lived in his assisted living apartment and was able to eat a regular diet.

Patient Information: Female, Age 91

Diagnosis: Left Hip Pain / Spinal Stenosis / Difficulty Walking

History: This woman, a long-term skilled nursing facility resident, was referred to therapy due to a significant decline in functional mobility including bed mobility, transfers and walking. The decline was preceded by a fall while getting out of the car with her daughter, after which
she experienced increased pain in her left hip and back. Prior to this incident, she required minimal assistance with most functional tasks.

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.