Case Study: Glengariff Rehabilitation and Healthcare Center (January 2021)

Patient’s Age: 81 years old
Admission Date: 11/04/20
Admitted From: Plainview Hospital
Discharge Date: 01/07/21
Discharged to: Home
Length of Stay: 64 days
Reason for Stay: Rehabilitation
How did this patient hear about Glengariff Rehabilitation & Nursing Center? Hospital referral

Details of Experience:
Mrs. Schnitzler was admitted to the Glengariff on November 4th, 2020. Prior to being admitted to Glengariff, she was admitted to Plainview Hospital, due to increased lower back pain prompted by spinal stenosis of the lumbar region. This impeded her ability to walk. She also suffers from substantial pain, decreased range of motion, decreases in strength, and reduced balance. At the hospital, they recommended subacute, short-term rehabilitation due to a decrease in strength and functional mobility, reduced ability to safely ambulate, reduced functional activity tolerance, and ADL participation.

Mrs. Schnitzler lives at home with her husband, who is totally dependent on her. They live in a home with four steps up to the doorway and access to bedrooms without handrails. She has a walk-in shower. She was made aware of Glengariff and our reputation for rehabilitation by the hospital staff.

When Mrs. Schnitzler arrived at Glengariff, she was highly concerned about her lack of balance, mobility, and strength. The slightest movements would prompt excruciating pain and she exhibited little interest in her own rehabilitation. She hoped that rehab would strengthen her, but she was concerned about her ability to manage stairs and to be able to care for herself and her dependent spouse and his most basic needs. Mrs. Schnitzler was only able to walk with contact guard assistance for 40 feet, slide or roll from side to side in her bed with help 50% of the time. She could not support herself standing for long periods of time. She did not know if she would ever be able to climb any stairs. She attempted to climb stairs when she came and was unsuccessful. How would she gain access to her home? How would she care for her frail and infirm spouse? Sitting up erect in bed created additional experiences of imbalance, acute pain, and overexertion. Activities in the bathroom involved complete dependence on the staff and required a Hoyer lift with two staff to assist. Mrs. Schnitzler was at risk for recurrent falls.

Within a month after her arrival, Mrs. Schnitzler started to make ‘strides’ in certain areas of mobility. Her strength improved, and she was able to attempt transfers from bed with substantial assistance. She was able to take 10 steps up the stairs, but she was training to do more. She progressed from not being able to climb stairs at all, to doing so with maximum assistance. The length of her standing was very short, however. As the therapy continued, Mrs. Schnitzler’s goals were reset again, establishing new short-term and long-term goals for her to achieve.

With the staff coming to provide both intensive physical therapy and the Concierge team keeping Mrs. Schnitzler content with chats about her family she got stronger and abler with each passing day. She was making improvements in her functioning every day. She was so encouraged by this clinical and emotional support, which helped her feel confident and hopeful. She could focus on getting better and improving her techniques at maneuvering, sitting up in bed, toileting and bathing. Her functional mobility during ADL’s also improved from maximum assist to minimal assistance over the continuing month. Still, there was much work to do and she could see the horizon of independence in the distance!

When she was admitted, Mrs. Schnitzler could not muster the strength or balance to climb any stairs and was at high risk for falls. But by the conclusion of the second month of her stay, Mrs. Schnitzler was able to achieve mobility tasks with mere supervision and no actual assistance. Rolling from side to side in bed and using handrails was also an achievement that month. Mrs. Schnitzler was able to push herself up from the arms of her chair with moderate assistance and sit up erect with no supervision. She was heartened when she was able to stand with support for 1-3 minutes in place! She went for a walk and progressed to over 100 feet. She looked behind herself and was stunned!

Mrs. Schnitzler advanced in the capacity she now had for completing ADLs. She could perform lower body dressing with only “Contact Guard” help up from maximum assistance just 30 days before. Her functional mobility during ADLs and his ability to transfer from bed went from minimal assist to mere Set-Up assistance.

By the third month of her stay, Mrs. Schnitzler was able to sit supinely without any assistance, push arm from his arms in a chair, rise to a standing position with moderate assistance, stand unsupported in place for just three minutes and walk up to 200 feet.
Gertrude had made such incredible progress that all categories of PT were switched to minimal intervention or supervised only. She was ready for the final threshold – a discharge plan and date! Mrs. Schnitzler was able to climb 15 stairs in a row, after waiting 3 months to climb even one. She was walking 225 feet at a clip and she was feeling confident about helping her ailing spouse.

Throughout her stay, until her departure over 3 months later, Mrs. Schnitzler was pleased with the staff and how they cared for her. She described them as “wonderful and compassionate.” Though there were few opportunities to receive care packages, she still got “care packages” from the Concierge who was able to cheer her up. “I could never have done it without the people at Glengariff.

I feel like I got my life back.” She is a graduate of the Glengariff Rehabilitation and Healthcare Center.