Philip Calachino is a 79-year-old gentleman who suffered a fall down his basement steps resulting in a subdural hematoma, a subarachnoid hemorrhage, multiple skull fractures, a cervical fracture, rib fracture and sacral fracture. He required tracheostomy and PEG tube placement. Because of the extent of his injuries and the significant deficits in functional mobility, Philip was admitted to the Gardens at East Mountain on 7/19/19.
Upon admission, Philip required Respiratory, Physical, Occupational, and Speech Therapy as his goal was to return home to reside with his spouse. He was on a 28% trach collar and his diet level was puree and nectar thick liquids. He required Moderate Assistance for bed mobility, Maximal Assistance for transfers, and he was dependent for ambulation and stair climbing. He required up to Maximal Assistance for self-care and toileting.
Philip was seen by Respiratory Therapy daily to ween from trach collar. He did so well that he was transitioned to room air while in his room which then further progressed to while in therapy services. He was decannulated on 7/30/19. After a successful decannulation, Philip worked very hard with his breathing exercises throughout the rest of his stay.
Philip was seen in Speech Therapy services for dysphagia to assess and determine least restrictive diet with implementation of strategies to minimize aspiration risk as well as cognitive-communication strategies to maximize safety. Prior to DC, he progressed to a mechanical soft diet and thin liquids.
Physical Therapy focused on improving Phillip’s functional mobility. He participated in a lower body strengthening program, balance programming, and transfer and gait training. He was able to progress his transfers from Maximum Assistance to Minimal Assistance and his walking improved from total dependence to the ability to walk 200 feet with a rolling walker and Minimal Assistance. Phillip now has to the ability to negotiate stairs with assistance.
Occupational Therapy focused their plan of care on improving Philips ability to perform self care. He improved his ability to perform self-care requiring
Maximum Assistance to performing upper body bathing and dressing with Minimal Assistance and lower body bathing and dressing with Moderate Assistance.
Philips’s family was very eager to have him home. So even though Philip required assistance prior to discharge, he progressed to a level of care that his family was able to provide. We are confident that Philip will continue to progress with home health therapy with a goal to reach his prior level of function and this makes him a true success story.