Case Study: Jupiter Rehabilitation and Healthcare Center (December 2019)

Patient’s Age: 72-years-old
Date of Admission: 09/09/19
Admitted From: Strong Memorial Hospital
Discharge Date: 11/23/19
Discharge To: Home
Length of stay: 74 days
Reason for stay: Therapy after a stroke
How did this patient hear about Jupiter Rehabilitation and Healthcare Center? Her daughter is the Director of Therapy at Jupiter.


Details of experience:
Our journey began on July 21st, while on vacation in Geneseo, New York. Mrs. Dater was found unresponsive in her bed at 10 am. Paramedics responded and took Mrs. Dater to Strong Memorial Hospital. The ride was over 25 minutes long, however, Strong is the trauma center for the area.

Mrs. Dater was put in the Neuro Intensive Care Unit. She was intubated and placed on a respirator that supported 50% of her breathing. They also inserted a Nasogastric tube (NG) to supply nutrients in combination with IV medications and hydration. Mrs. Dater was put into an induced coma. On Day three, doctors put in two shunts in her brain to relieve the pressure in her head from swelling and fluids. During this initial week, Mrs. Dater would occasionally lift her right arm to demonstrate she could hear people and to acknowledge understanding. Mrs. Dater’s brain bleed was on the right side of the brain and caused left-sided hemiparesis, left-sided hemianopsia. Mrs. Dater’s daughter Lisa sat in on the meeting of the doctors, as they rounded on the patients in NICU. Strong is also a teaching hospital for the University of Rochester.

It was on the 5th day that the NICU doctor told Lisa that her mother would probably pass in less than a week. To which her daughter responded, “You have never met my Mother.”

Although she does not remember this time, Sharon responded to yes and no answers by raising her arm or giving a thumbs up to yes and no questions. She also could raise her right leg and wiggle her toes. She would respond to voices. By the sixth day, she was opening her eyes. Also after two or three instances of no heartbeat the doctor’s put in a temporary pacemaker. By the seventh, day one of the shunts was removed. By the ninth day, the other shunt was removed and the pacemaker had kicked in three times. Sharon was given a Mickey Mouse Glove because she kept trying to pull out the trach tubes. She recognized her grandson’s, her sister, her brother, her husband, her best friends (Helen and Fayette), and even her favorite brother-in-law. Two weeks passed and Sharon began sitting in a geriatric chair in a reclined position. Doctors tried to remove the breathing tube and for 23 hours Sharon did great on her own but then her oxygen saturation began to wane, so they performed a tracheostomy. Once in place, this did 20% of the breathing for her, with intermittent times off for her to practice on her own. As the weeks passed, Sharon was able to have ice chips and then pudding and applesauce.

On August 17, Sharon was moved from the NICU to the inhouse therapy floor at Strong Memorial Hospital. She was positioned in a high back wheelchair. She was hoyer lifted from bed to chair to bed and sometimes to the therapy matt. Sharon began eating more foods, mash potatoes, chopped meat, pureed vegetables, and fruits. Sharon increased her time in the wheelchair and sitting balance.

Sharon increased her abilities to speak and to see more items on the left-hand side. She did some standing and weight shifting. By the first week of September, it was apparent that it was time for the Florida girl to come home, much to the chagrin of the hospital. So on September 6, 2019, Sharon’s daughter, Lisa, had to prove to the staff that she could indeed transfer her mother on and off multiple airplanes to get her back to Sunny South Florida. It was this weekend that Sharon really began to feel her legs underneath her. Sharon and Lisa spent the whole weekend working on transfers and standing balance and trunk stability. Then at 4:30 a.m. on September 9th, it was time to leave for the airport… two flights both first-row first class. Then, poof, they were all back in sunny South Florida. This is when Sharon became a member of the Jupiter Rehabilitation Family.

THE FLORIDA DAYS
Upon admission to Jupiter Rehabilitation, Sharon was supervision for eating and hygiene with a setup assist, Bathing required maximal assist for task completion, and dressing was dependent. With a poor for sitting balance during ADL activities. Sharon also had a flaccid arm and leg on the Left side.

Her Barthel Index score was 6/20. The left-arm also had a 10/10 pain secondary to tone and past poor positioning. Sharon required moderate assistance for bed mobility, and totally dependent on transferring with no ambulation. She had a tinetti score of 0/28.

Sharon was on a diet of nectar liquids and mechanical soft solids. She was oriented times three, however upper cognition tasks were very difficult for Sharon to manage. Sharon received PT/OT six times a week times eight weeks, and Speech therapy five times a week times eight weeks. Sharon also had a bunch of assistance from the many friends and family members who were here to support her and help her to be stronger than she ever realized she could be. Sharon progressed from a two-person assist with hemi walker to contact guard with one person and a quad cane. Sharon is able to bathe herself with SBA and set up. Sharon uses a three in one commode in the shower and is able to bathe herself with set up. Sharon is at home now. She lives with her husband, dog, and cat. Her husband John was trained before discharge and is able to assist Sharon with dressing, bathing, and ambulating in the house with a quad cane. Sharon is also able to go up and downstairs with John and likes to take quiet sunset golf cart rides around her community. Although Sharon is still requiring nectar thick liquids she is able to eat just about anything she wants. The left leg has great strength and even though the left arm is not yet functional it is much less painful, and Sharon completes AAROM with the arm daily.

Team Jupiter is so thrilled how well Sharon is doing at home and was honored to be able to help and see her progress and recovery and we wish her all the best!