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

Concierge Director: Daniel Mayer
Patient’s Age: 80 years old
Admission Date: 2/5/21
Admitted From: Parker Jewish Health Systems
Discharge Date: 4/16/21
Discharged To: Long Term Care setting
Length of Stay: 71 days
Reason for Stay: Rehabilitation
How Did the Patient Hear About Glengariff? She was referred to our rehabilitation facility by her case manager at the hospital.


Details of Experience:
Mrs. Arlene Scholer was admitted to the Glengariff Nursing and Rehabilitation on February 5, 2021. Prior to being admitted to Glengariff, she was admitted to Parker Jewish because she had a diagnosis of decreased mobility.  She had been admitted on 6/2020 and struggled with a decubitis ulcer on 8/2020.  Mrs. Scholer was admitted to Glengariff due to new onset of decreased strength, decreased mobility, and reduced ADL participation.   At the subacute rehab service at the hospital, they recommended subacute, short-term rehabilitation.  Her case manager at the hospital indicated that Glengariff had top-quality rehab staff.  Due to Covid-19, no tour was feasible, but instead, the patient chose our community, and arrangements were made for Arlene to be transferred to Glengariff. 

When Arlene arrived at Glengariff, she was concerned about her lack of balance, mobility, and strength.  She had previously secured an assisted living private apartment with independent living. Still, she was worried about her ability to manage the two steps at the entry and her wheeled walker once she was in the apartment.  Arlene could not walk by herself, and she did not know if she would be able to do so for more than five steps on a flat service. Moreover, there were no handrails in all locations inside her home.  Further complicating Arlene’s health picture were a host of other medical conditions, including a propensity for fractures, UTI’s and Type 1 Diabetes.  These conditions created an additional need for medical management.  

Shortly after arriving in Glengariff, Arlene felt her motion too restricted to begin making strides, both figuratively and literally.  She could not climb stairs and could walk only five steps when she was first admitted.  Even standing still was only done with tremendous strain and assistance from the rehab team.  She was at high risk for falls.  She was also wearing a soft collar due to cervical issues, which reflected overall weakness.

However, her strength improved with time and training, and her steps improved, from initial moves to pivot from lying supine to sitting up, standing from a seated position, and attempting dynamic standing.  After just one week, she was able to walk 30 feet using her rollator walker and moderate assistance.  Still, she could not successfully ascend or descend any stairs at all.  After two weeks in rehab, her distance walking (with the walker) rose to 50 feet, nearly doubling her previous accomplishment.  She was still at substantial risk for falls due to her persistent poor balance and spatial awareness.  She still could not navigate stairs.  As the therapy continued, Arlene’s goals were reset again, establishing new benchmarks for her to achieve.

With the staff coming to provide intensive physical therapy and the Concierge team keeping Mrs. Scholer busy, she got stronger with each passing day.  She was relieved by this clinical and emotional support, which helped her feel calm and optimistic.  She could now focus on getting better and improving her technique at maneuvering, sitting up in bed, toileting and bathing. After three weeks of participating in rigorous rehabilitation therapy, Arlene was able to get out of bed on her own with only minimal supervision. She was improving in performing the basic activities of daily living.  Her progress, though not rapid, was encouraging.  She was now walking 75 feet on flat surfaces.  Stairs, however, continued to be a challenge.

She could not climb any stairs when she was admitted and was at high risk for falls.  But within nearly 4 weeks of her stay, she was walking 100 feet unassisted!  After five and one-half weeks, Arlene was walking 125 feet and counting.  By this time, she was much steadier on her feet but was not climbing steps yet.  She had been reassessed as having a risk of falls but had been down-graded from high risk.  She was making progress and headed toward the finish line! 

New goals were set for Arlene, and she pursued these with gusto too.  Within another three weeks of rehab, she was walking 150 feet.  She had also achieved near-full independence with her ADLs and was able to set up her surroundings for bed transfer and sit-to-stand situations almost entirely without even verbal cues. After four more weeks, she was mounting stairs!

Arlene was wheeled out on her day of discharge on May 16, 2021, confident that she would make a strong transition to her independent living setting.  She was able to mount and descend 4 stairs at a time.  This fact alone put her much more at ease.  She had achieved a 21 out of 28 scores on her decreased risk of falls rating.

 

Throughout her stay, until her departure nearly three months later, Arlene was pleased with our staff and how they cared for her.  Arlene could still recall those who had worked with her to advance her progress toward rehabilitation from multiple departments.  Of particular note, during her extended stay, it was identified that she had a deep affinity for fresh fruit, particularly pears. The Concierge reached out to her close friends and suggested that perhaps a gift package could be arranged for Arlene.  Arlene was understandably a bit saddened that both Covid restrictions, and her compromised physical condition, made it impossible for her to go home to enjoy her independence.  Within days, her dear friends arranged for a shipment of 16 hand-wrapped gourmet pears!  The Concierge brought her custom gift to her bedside, and her eyes went wild with delight!  She had gently inquired if the Concierge could arrange for some “fresh fruit once in a while.”  He said he would “see what he could do.”  Both staff and loved ones had rallied to provide high-level care and top-notch customer service.

This singular sensitivity and effort particularly touched Arlene.  Arlene was also grateful that the team mobilized to provide her with a bed that served her comfort and continuing care needs.  Not a day between the first delivery of pears and the day of her discharge passed without the Concierge popping in for a short visit and asking Arlene, “Have you had a fresh gourmet pear today?  They’re really rather delicious!”

Arlene attributes her terrific progress and healing to the care and commitment of the team.  Another success story of hard work and dedication created from the bond between patient and care team at Glengariff!