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Posted - 2024-02-21
← Back to News and MediaBackground: Patient P is an 80-year-old female admitted from the hospital with a history of peripheral vascular disease status post angioplasty to the left lower leg, multiple sclerosis, emphysema, hypertension, and anxiety. She presented with acute onset right lower leg pain and swelling, associated with an unsteady gait, and was diagnosed with cellulitis and exacerbation of emphysema with hypoxia.
SNF Course of Stay: Patient P’s rehabilitation stay was complicated by anxiety which significantly interfered with her participation and progress in rehabilitation therapy, and a new diagnosis of mild COVID-19 that occurred within two days of arrival. She received a consultation and recommendations from behavioral health that included adjustments to her anxiety medication. Rehabilitation and nursing staff collaborated with the patient on a medication schedule that led to improved therapy participation and progress. Additional support was provided by nursing, social services, and the medical team to address patient concerns underlying her anxiety. Her cellulitis was treated with oral antibiotics and her Covid resolved.
Functional Status: Prior to her hospitalization, Patient P was modified independent with most functional activities, using a three-wheeled walker for ambulation. She lived in a one-story home with family members. Upon admission to Harbor House, Patient P was quite decompensated and required mod/max assist with most activities. She received physical and occupational therapy throughout her stay and made significant progress to where she could perform most functional activities with supervision.
Discharge Plan and Outcome: Patient P made outstanding gains and was discharged to her home environment after four weeks. Home health services were arranged for continued rehabilitation and monitoring. A follow-up phone call to ensure services were received and a schedule of appointments with her cardiologist and PCP were provided upon discharge.
This case emphasizes the importance of a multidisciplinary approach to facilitate positive outcomes. Psychosocial needs that initially inhibited progress were appropriately addressed and the plan of care adjusted accordingly. Despite having a complicated medical history and superimposing anxiety, she made significant progress during her stay at Harbor House. With a combination of medical care, behavioral health services, social services, physical therapy, family support, and home health services, she was able to discharge safely with improved function and quality of life.
