Case Study: Palmetto Subacute Care Center (Q1 2022)

Concierge: Marialcira Hernandez
Patient’s Age: 77 years old
Admission Date: 11/13/2021
Discharge Date: 02/20/2022
Discharged to: Home
Reason for Stay: Lumbar stenosis with neurogenic claudication, urinary tract infection

Details of Experience:

Mr. Hernandez is a 77-year-old male who lives alone in a second-floor apartment. He was able to ambulate using a cane with moderate independence in the community and during household ambulation without a cane with moderate independence. He was able to perform his activities of daily living (ADLs) with independence and was an active driver. He had a past medical history significant for lumbar stenosis with neurogenic claudication and chronic back pain. He was referred to a Spine Surgery Doctor in the Neuroscience Institute in Baptist Hospital. Mr. Hernandez has been complaining of lower back pain since the beginning of 2020 that radiates to his bilateral posterior legs, 7/10 in intensity, worse when standing up from a sitting position or walking with significant claudication, and able to walk only a few steps due to the severity of the pain and numbness of both feet. He has been under treatment with a pain specialist and received epidural injections that helped with the pain for two months. He also reported some urinary incontinence for over a year. For many years he underwent multiple modalities of conservative management, including physical therapy, medication, injections, and lifestyle modifications, without any significant improvement.

Due to the intractable nature of the symptoms and progressive neurogenic claudication with weakness and chronic urinary incontinence, he was deemed to need surgery for multilevel lumbar spine decompression, which was made on November 10, 2021. He was at the hospital, after the surgery, until November 13, 2021, when he went to Palmetto Subacute Care Center for rehabilitation upon Doctor’s recommendation.

Upon admission, Mr. Hernandez was received by a multidisciplinary team that included the Unit nurse and assistant, Social Worker, Concierge, and Therapist. The team worked together to evaluate Mr. Hernandez and ensure he was comfortable and met all his needs. He was referred to Physical and Occupational Therapy due to decreased strength, decreased functional mobility requiring more assistance during bed mobility, transfer, and gait, poor endurance to activity, decreased static and dynamic balance, and decreased ADL participation.

At the first evaluation with the therapist, Mr. Hernandez discussed his goals and started his recovery journey right away with the team. His treatment included therapeutic exercises, neuromuscular reeducation, gait training therapy, therapeutic activities, and self-care management training. In the beginning, most of his ADL and activities were made with moderate independence. He was able to ambulate 150 feet using a rolling walker.

Mr. Hernandez was motivated and demonstrated good potential. He enjoyed his time in the community. He liked participating in activities and enjoyed playing dominoes, bingo, and board games. He made friends and put together a dominoes group, and played daily. After weeks of hard work, Mr. Hernandez has made consistent progress with the skilled interventions of the team. He improved his ability to perform all functional transfers with supervision, improved static standing, allowed him to tolerate higher levels of challenges, improved his gait pattern to 260 feet using a rolling walker with supervision, and he was able to perform ADLs with supervision.

Mr. Hernandez was discharged home on February 20, 2022, after reaching his maximum potential. He was pleased with the care and love he received during his stay at the facility. A few days after his discharge, Mr. Hernandez returned to the facility to visit his friends and the staff.

We were very happy and excited to see him again and fully recovered. We are very proud of him, and we wish him the best.