Case Study: St. James Rehabilitation & Healthcare Center (Q3 2023)

Concierge: Ashley Valentin

Patient’s Age: 81 years old

Admission Date: 6/22/2023

Discharge Date: 9/18/2023

Discharged to: Home

Length of Stay: 90 days

Reason for Stay: Fall with acute subdural hematoma (SDH)

How did this patient hear about St. James? She heard positive things about St James


Details of Experience:

Ms. G had a fall and, thankfully, was found by her neighbor. She was then airlifted to Stony Brook University Hospital (SBUH). EMS intubated her, and as soon as she was at the hospital, they called a trauma team. They did a pan scan and found that she had a (SDH) subdural hematoma and had to get an urgent craniotomy. They inserted a tracheotomy and a feeding tube. A tracheotomy is a procedure to help air and oxygen reach the lungs. They also found she had a fractured clavicle and small fractures throughout her body. Ms.G was treated at the hospital for over a month, recovering and becoming stable for the next level of care. She and her brother heard good things about St. James and decided to come here for the next stage of her recovery.

When Ms. G came to the facility, she was evaluated by a speech and respiratory therapist. These two therapists were key parts of the patient’s care team and were vital in assisting the rest of the care team with her tracheotomy tube and feeding tube. The respiratory therapist worked with Ms. G on her breathing techniques and oxygen levels, along with monitoring and evaluating air and oxygen levels. She also required significant assistance from the nursing team. Her speech therapist monitored how well she swallowed along with her speech. She used techniques and education to reach the goal of eventually removing Ms. G’s feeding tube. The respiratory and speech therapist both worked with her continually throughout her stay. With these two therapies, along with physical therapy, occupational therapy, and nursing, along with the primary care doctor in the community, they could take Ms. G off of the tracheotomy and feeding tube.

In addition to working with respiratory and speech therapy, she was also working with physical therapy and occupational therapy. Before her fall, Ms.G was completely independent. After her fall, she needed complete assistance with all of her levels of care, such as toileting, dressing, walking, standing, etc. She was slowly making progress, such as needing fifty percent assistance with standing for two minutes, along with needing fifty percent assistance with walking for twenty feet. She went from needing fifty perfect assistance to almost no assistance with walking or standing.

While all this was taking place, her case manager was working with Ms.G and her family on steps to make a safe return home. The case manager provided Ms.G’s brother with companies that provide stair lifts and private hire aides for her. Along with that, the case manager also ordered equipment. Ms. G needed a hospital bed, a walker, a commode, and a wheelchair, as well as a home care agency with physical therapy, occupational therapy, and speech therapy to continue getting stronger at home.

With her entire care team from Saint James and the determination of Ms.G, we were able to meet her goals and return home.