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Medically Complex
Case Study
59-year-old female DIRECTLY admitted to Lawrence Rehabilitation and Healthcare Center from home. She was recently at Capital Health Medical Center – Hopewell, where she initially presented with bilateral lower extremity erythema and drainage. Patient found to have sepsis due to bilateral lower extremity cellulitis. Patient was started on broad spectrum antibiotics. Past medical history significant for lymphedema, anemia, pneumonia, CHF and wheelchair bound at baseline. Patient was transferred to Lawrence Rehab for therapy services and wound care.
Interventions:
Ensure Adequate Nutrition to promote wound healing, tolerating regular diet with Ensure Plus daily and Liquid Protein BID
Wound Management – patient with multiple wounds upon admission including stage 3 to sacrum and heel, skin tear, arterial wounds and venous wounds. She was followed closely by the wound care team and wound care was performed daily. At the time of discharge, many of her wounds were resolved with the remaining improving without complication.
Therapy Interventions:
Initial Evaluation: Upon admission, she required Mod A for rolling. She required set-up assistance for feeding and grooming. She was required total dependence for bathing and dressing.
Interventions: An individualized therapy plan was developed consisting of physical and occupational therapy and she actively participated in therapy.
Discharge Evaluation: At discharge, she made gains with mobility. She advanced to contact guard for bed mobility and Mod A for transfer. She also regained her independence with self-care including being independent for feeding and grooming. She required contact guard assistance for toileting, set-up assistance for upper body dressing and Mod A for bathing and lower body dressing.
After a successful stay in short term rehab, the patient returned home with support from Bayada Home Care.
