Case Study: Gallatin Center for Rehabilitation and Healing (March 2021)

Long Term Rehabilitation Following Pulmonary Hypertension

Director of Concierge: Ladeshia Norman
Patient’s Name: Donna C.
Patient’s Age: 74
Admission Date: 8/21/20
Admitted From: Sumner County Regional Medical Center
Discharge Date: 3/16/21
Discharged To: Gallatin Center for Rehabilitation and Healing
Length of Stay: Approximately 7 ½ months
Reason for Stay: Suspected Pulmonary Hypertension and acute, chronic systolic CHF exacerbation
How did this patient hear about Gallatin Center for Rehabilitation and Healing? Discharge planner at the hospital

Details of Experience:
Ms. Donna arrived at the Gallatin Center on August 21st, 2020, from Sumner Regional Hospital in Gallatin, Tennessee. Donna’s recent hospital stay was due to complaints of chest pain and increased fluid in both of her lower legs. One day, Donna was at home and decided to feed her cats from the neighborhood. She walked to the back door and felt some numbness in her lower legs, noticing that she had some pain in the right side of her chest. While she was washing her hands in the bathroom, she fell to the floor. She called the emergency service number, and an ambulance arrived to take her to Tristar Skyline Medical Center in Nashville. Her stay at Skyline was short, and she transferred to the Waters of Gallatin Rehabilitation Center. Donna stayed at The Waters of Gallatin for about two weeks before moving to the Sumner Regional Medical Center. After being evaluated by the clinicians, she was diagnosed with suspected pulmonary hypertension and acute, chronic systolic CHF.

Donna was admitted to the hospital with volume overload, UTI, and non-ST segment elevation myocardial infarction. She began taking medication to help eliminate the excess fluid from her body and other medications to help her recover. Donna participated in inpatient therapy services and discussed with the therapist goals she wanted to accomplish to get back to her home. Donna was active in therapy and required total assist x2 while seated at the edge of the bed using a draw sheet. She also needed complete assistance to put on her shoes and back brace. She was able to stand at the bedside with total assistance and stood up from being seated on the bed to the rolling walker three times with maximum assistance of 2 people for 10 seconds each time. Donna put in a lot of effort while working with the therapist at Sumner Regional Medical Center. Soon, the therapists decided that it was time for Donna to transfer to a skilled nursing facility for further therapy services.

On August 21st, 2020, Donna was admitted to Gallatin Center for Rehabilitation and Healing. She was greeted by the Nursing, Social Services, Dietary, Billing Department, Concierge, Activities, and Therapy. Each department discussed its role and how they may assist her during her stay. After being evaluated by the Therapy Department, she created goals with the therapists to help her be more independent after discharging into her home environment. Donna required total assistance with all of her bathing and dressing tasks. She shared with the therapists that she didn’t think she could make it like this due to her lower leg pain. Before their therapy sessions, the therapists ensured that she received adequate pain medication to tolerate her therapy sessions without discomfort.

The next couple of months of Donna’s journey were challenging, and her progress was slow due to pain and pre-existing conditions. On September 4th, she was able to sit in her wheelchair, supported for 4 hours, before she needed to lay back into her bed, and that was something that she was unable to do before. On September 18th, she made progress dressing her upper body from requiring moderate assistance to set up. On September 13th, she made progress from being unable to stand to being able to stand with support for > 3 to 5 minutes. She also increased walking with her rolling walker from 0 feet to 50 feet with minimal assistance on September 23rd. After a month of continued therapy, her distance walking with a rolling walker increased to 350 feet with stand-by assistance on October 20th. She slowly progressed with her bathing and dressing tasks and still required maximum assistance for bathing tasks and standing from a seated position. Donna transitioned to long-term care and continued her therapy services until they were discontinued on October 30th.

Donna began therapy services again on December 3rd to help her transition from long-term care back to her home independently. Donna said, “I’m trying to keep my spirits up. If I lose my spirit, then I’m gone.” This leg of her therapy journey focused on her bathing and dressing, balance, transfers, and walking with her rolling walker. On January 20th, she required minimum assistance to put on her shoes and back brace, and by March 4th, she had reached her goal of modified independence. She showed progress with the balance from fair -, meaning she needed minimum assistance or upper body support to stand without loss of balance to fair, meaning she was able to maintain balance while standing 1 to 2 minutes without loss of balance or upper body support. Donna also worked on transfers and showed progress from requiring moderate assistance to transfer from the side of the bed to the wheelchair to modified independence. The most impressive part of her therapy was walking with her walker 125 feet with minimal assistance on December 3rd to an unlimited distance with no assistance using her rolling walker on February 8th. She could be seen strolling the halls with her rolling walker visiting the other patients in her unit while getting her exercise in multiple times a day.

The time had come for Donna to start planning for her discharge home with the discharge planner. She would have home health care set up to make the transition easier. She shared with the concierge that she would recommend the Gallatin Center to anyone. “Robert, in the therapy department, is remarkable! He is like a relative to me. His fiancée, Amanda, is nice too and a good person,” Donna said. She also shared that everyone at the facility had a good attitude, she didn’t receive any negative remarks, and everyone just told her things that she needed to hear for her to be the best”. Donna’s journey took about seven months total, and she was able to stay motivated until she reached her goal of going back to her home alone.

Gallatin Center wants to congratulate Donna Cherry for showing that resilience, hard work, and focus can help you work through obstacles to make the impossible possible!