Case Study: The Grove at Valhalla Rehabilitation & Nursing Center (March 2018)

Patients Age: 70
Admission Date: 8/2/2017
Admitted From: Burke Hospital
Discharge Date: 3/30/2018
Discharged To: Home-Peru
Length of Stay: 8 months
Reason for Stay: CVA (Cerebrovascular Accident) – Stroke

Details of Experience:

More than healing a patient’s physical condition is also helping a patient’s dream life. But what happens when a medical setback nearly destroys your dream retirement? Here at The Grove we are committed to both physical and emotional healing – providing the medical recovery, psychological strength and spiritual confidence needed to continue living life on your own terms.

In 1968 Maria moved from Lima, Peru to the U.S. A few years later she gave birth to Marisol. Maria worked for many years as a nurse’s assistant in a nursing home until her recent retirement. Together with her devoted partner of 30 years, Louise, they finalized plans to return to their homeland, Peru. The target month was April, 2017. They loved America but it was not home.

In March, 2017, Maria collapsed and was airlifted to Greenwich Hospital. Maria suffered a massive stroke. Once medically stable she was transferred to Burke Hospital for further treatment and intense rehab and then later was transferred to us, The Grove, for further rehab and care, in the beginning of Aug, 2017.

The stroke did too much damage. A complete recovery would seem medically impossible and returning to Peru would have been financially impossible (in the condition she was in a medical flight would have cost well over a hundred thousand dollars). As a retired nurse’s assistant, a woman who devoted her entire career to helping nursing home residents, she and her partner did not have that money. Their retirement fund was air marked for their new home in Peru and the cost to retire. But what she did have was a new extended family – hospital and nursing home staff members – who were going to honor her wish and return the favor. We owed it to her.

The goal was to help Maria regain the strength, balance and coordination needed for her partner Louise to continue caring for her with minimal assistance and to stabilize her condition to the point where she would be cleared to fly a commercial flight home with the company of a nurse. When she first arrived, Maria needed maximum assistance with all her daily activities and it required two people to transfer her and care for her. Maria appeared agitated and depressed. Although her communication was poor and her level of comprehension questionable, it was quite clear that she recognized and felt the pain of her loss and condition.

Although at first Maria presented with fear during her sessions, she quickly warmed up to her therapists. Maria began to make steady small gains and with her beginning success her mood reflected one of hope and courage. The first few weeks were focused on improving her comfort and positioning in her wheelchair by strengthening her right side (the side that was impacted by the stroke) and her core strength. This also helped prevent skin breakdown and improve quality of live. Soon after we helped Maria with strengthening her lower and upper body and improve balance and coordination. For Maria to return safely home, she would need to be able to stand and transfer with only one person assisting.

Maria’s insurance would exhaust before completing the therapy needed, but not her spirits and not our commitment. Marisol her daughter, worked closely and tirelessly with our Finance/Medicaid/Insurance coordinator, Veronica Gordon, in obtaining the resources and insurance needed for Maria to receive all the help, care and therapy she was eligible for throughout her eight months’ stay.

When Maria’s therapeutic gains began to plateau we all recognized that the focus would now shift on maintaining and stabilizing her condition. If Maria can demonstrate stable condition for an extended period of time than spending the rest of her life in the company of those closest to her, at home, would no longer be a dream, but a reality. In her final two months’ our staff helped train Louise how to safely care for her. Maria held strong and stable and her mood and confidence was continuously improving.

In the last weeks, our social worker, Christine Martinez worked closely with Marisol in helping navigate the logistics of the flight. A nurse from an outside home care agency and Marisol were trained by our nursing and rehab staff how to safely care for Maria throughout the journey. Louise went ahead of time to arrange the home and hire a local nurse to help in the beginning for a few hours a day.

On March 30, 2018 at 2:30pm, Maria together with a nurse and her daughter, Marisol, boarded a United Airlines flight home. Louise was there to greet them.

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Case Study: The Grove at Valhalla Rehabilitation & Nursing Center (February 2018)

Patients Age: 89
Admission Date: 12/14/2017
Admitted From: White Plains Hospital
Discharge Date: 2/14/2018
Discharged To: Home
Length of Stay: 2 months
Reason for Stay: Urinary Tract Infection

Details of Experience:

Urinary Tract Infections, commonly known as UTI’s are one of the most common infections, especially amongst the senior population. Women are more likely than men in contracting the infection. Symptoms can include infrequent or frequent urination, burning sensation while urinating, abdominal pains and muscle aches, to name a few. While most UTI’s can be treated with antibiotics and if addressed early on the treatment and recovery process can be quick (2-3 days). Unfortunately, Diana, is of the 20% that have recurring UTI’s. Her last UTI was not the non-serious UTI’s that she typically experiences.

On December 10, Diana was rushed to the emergency room by her daughter, Eva. The urinary infection she contracted was a “bad one”, requiring her to be hospitalized for a few days. Receiving the necessary treatment and ruling out the possibility of other contributing diagnoses, she was transferred to The Grove. Diana has been to our rehabilitation center two times in the past two years, for muscle weakness and difficulty in walking. Under better conditions would have been a preferred reunion, but we were happy to have the opportunity to care for and help her get back on her feet.

Diana returned to the same unit and nursing staff that had treated her in the past. She was warmly greeted by the familiar smiles and happy faces. Her immediate expression was, “Yes, it’s me, I’m back, and like before, I’ll recover.” Diana was in weak condition from her stay in the hospital coupled with her Parkinson’s disease. Prior to the hospital she required minimal supervision when ambulating. Now, she required maximum assistance with even the simpler tasks.

Diana, not surprising to the staff who knew her fighting spirit, was not disappointed or discouraged that she was in her third rodeo. The need to receive rehab services three times in two years seemed to inspire and push her to work even harder. Unlike her previous two stays here, which were respectively three months and over, Diana made a relatively fast recovery.

In the two months that she was here, Diana learned how to recognize signs of UTI, methods in preventing it and build the necessary strength to reduce further muscle aches. The nursing staff closely monitored and treated her infection and the rehab department helped her help herself get back on her feet. The friendly and supportive environment enabled her to feel confident about herself and her accomplished goal — returning home safely to her husband!

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Case Study: The Grove at Valhalla Rehabilitation & Nursing Center (January 2018)

Patients Age: 84
Admission Date: 11/08/2017
Admitted From: Westchester Medical Center
Discharge Date: 1/10/2018
Discharged To: Home
Length of Stay: 2 months
Reason for Stay: Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, multiple fractures of ribs, cognitive communication deficit, mixed receptive-expressive language disorder and muscle weakness.

Details of Experience:

We treat every patient as a success story, helping and supporting all our patients achieve the therapeutic goals they set. Some come to us with milder physical challenges while others are very advanced in age and nearing the end of life. Helping them obtain the results or the comfort and meaning they wish for in this phase in life is our goal. But some stories have a more noticeable success, as in the case with Mr. Robert P.

On October 19, 2017, Robert, an avid photographer, was out strolling in the community when unexpectedly a vehicle lost control and struck Robert on the side of the road. His head struck the windshield of the vehicle causing a starburst crack to the glass. Robert was immediately transferred to the ICU unit where he was intubated and held for a number of days, until he was able to transfer to a less acute unit. Robert made great results in the hospital and was considered medically stable three weeks later, but the brain damage he suffered and the poor physical condition (broken shoulder and ribs) — was another battle he would have to engage should he want to fully recover.

When Robert arrived at The Grove for short term rehab, it was very apparent the amount of steps he would need to take to recover. Due to his neurological deficit and confusion, Robert was combative, requiring constant supervision. Robert’s wife and family were instrumental in helping Robert settle in at The Grove. It wasn’t until weeks after did Robert only first begin recognizing his nurses and therapists and recall the traumatic accident. Progress was very slow in his first few weeks here. The neurological damage caused by the brain injury made it difficult to know if Robert would ever be able to properly communicate, swallow whole foods and be physically independent, let alone his ability to be cognitively sound.

Robert’s road to recovery is a testament that rigorous work, a resilient spirit, outstanding care and therapy and the unconditional love and support from family can heal a much wounded brain and body.

Robert’s strong motivation and support from family and staff helped him ignore the depression and discouragement he felt when recognizing how compromised he was. Through repetitive exercises and activities Robert began seeing results, although minimal at first. As his swallowing and memory process began to improve along with his ability to communicate and make rehabilitative gains, his confidence and spirit grew. The results he gained in the first five weeks
proved that patience and persistence will prevail.

Robert’s last few weeks of rehab were focused on his functional abilities and mobility. He began ambulating and transferring, and his confusion and forgetfulness was quickly disappearing. His devoted wife was no longer to be the sole decisions maker, “I am now able to decide for myself,” he confidently claimed while holding his wife’s hand, “but I still need you as ever before,” he concluded.

“Someone of his age and medical condition to make a full comeback is simply incredible,” Brian Cook our Speech Pathologist reported, “we knew he was ready to go because he knew he was ready to go.” It took eight weeks, a supportive but aggressive team of physical/occupational therapists, nurses, physician and psychiatrist along with a loving family and fighting spirit to help Robert make the full recovery. Allowing him to safely return home, walking upright and proud of what he achieved.

Robert’s final words before leaving summarize his two months here at The Grove, “I honestly did not think I would be able to recover to the extant I did. The fact that I’m able to walk out after two months of rehab and care is a testament to the outstanding medical and therapeutic services of The Grove. In addition to having a clinically exceptional experience, staff made sure that my stay was comfortable and pleasant. If felt like a home away from home.”

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Case Study: The Grove at Valhalla Rehabilitation & Nursing Center (December 2017)

Patients Age: 91
Admission Date: 11/24/2017
Admitted From: White Plains Hospital
Discharge Date: 12/22/2017
Discharged To: Home
Length of Stay: Four Weeks
Reason for Stay: Dorsalgia, Muscle Weakness and Spinal Stenosis.

Details of Experience:

On November 21st Mr. T.’s lower back pain became intolerable and brought himself to the White Plains Hospital emergency room. Mr. T. has a diagnosis of spinal stenosis and dorsalgia, a condition which is causing him a lot of lower back pain, numbness to his legs and severe limitation in ambulating. The medical team at the hospital and Mr. T. concluded that surgery would not be in his best interest and decided on a pain management and rehab treatment. When the hospital helped reduce his back pain to a tolerable level, they highly recommended he go to inpatient therapy. Going back home was not a safe option in the condition he was in.

When arriving at The Grove on a late Friday morning, Mr. T. was not shy of his intentions and feelings, “I’m here to get stronger and go home.” The staff helped him settle in and reassured him that with that conviction and courage, going home will happen sooner than later. Within a few hours, Mr. T.’s personality and optimism started to shine. He was very warm and outgoing with all the staff and greatly appreciated the services offered. Although he preferred minimal interaction with other residents, he wasn’t alone or lonely. He responded favorably to the staff’s friendship and had a close relationship with a number of his nurses, and especially, his therapists.

Mr. Higgins had a very positive and happy spirit and the therapist greatly enjoyed working with him.
When first arriving, he was only able to walk thirty feet and required much contact support: he required others to support him while walking. Not uncommon, but the first week, minimum progress was earned.

Due to his condition, his muscles were very weak and the pain in his back severely limited his mobility and balance. First, we needed to help reduce the pain by muscle building and stretching. Once sufficient strength was acquired his therapy sessions were focused on functional skill and ambulation. We are proud to say that in less than a month, Mr. Higgins was able to return home safely. He was able to walk with a walker without the assistance of others and gained the strength and functional skills to enjoy and engage in activities that were once considered questionable. His positive nature was noticeably more expressed on the morning he was picked up by his son in-law, and The Grove is forever a little brighter by his smile.

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Case Study: The Grove at Valhalla Rehabilitation & Nursing Center (November 2017)

Patients Age: 84
Admission Date: 10/25/2017
Admitted From: White Plains Hospital
Discharge Date: 11/27/2017
Discharged To: Home
Length of Stay: Four Weeks
Reason for Stay: Fluid Overload, Muscle Weakness, Hypertension, Obesity, Chronic Obstructive Pulmonary Disease, Chronic Kidney Disease, Obstructive Sleep Apnea and type 2 diabetes.

Details of Experience:

Prior to her hospitalization, Mrs. D. lived at home requiring assistance with some of her activities of daily living and could only ambulate with contact support and her need for increase oxygen was dramatically increasing. To put it simply, Mrs. D. was not in great shape. She was physically weak, short of breath and her spirits were beginning to reflect the poor health she was in. Mrs. D.’s primary medical challenge is physical weakness due to shortness of breath. The hospital helped stabilize her breathing, but recommended short term rehab to help her regain her strength and improve her breathing.

After touring The Grove and meeting with the staff, Mrs. D.’s family felt confident that The Grove can help provide Mrs. D. with the rehabilitation, medical service and support she desperately needed. When Mrs. D. first arrived, she required a therapist to support her while walking and couldn’t climb any steps. She had a lot of pain in her knees and had extremely low endurance. Her first phase of therapy was focused on respiratory exercises and muscle strengthening. The nursing staff and social work department ensured that Mrs. D. was comfortable and well cared for, providing her with the level of service our staff is committed to.

Mrs. D.’s early therapeutic results proved that with effort and time, getting better and stronger is possible. Mrs. D. followed her routine exercises strictly, both in and out of sessions. As her lungs got stronger and her breathing improved, her need for external oxygen became less and her endurance increased – allowing her to participate in therapy sessions for longer and perform more rigorous exercises. Her lower body muscles became stronger, which in effect decreased the pain and pressure in her knees, Mrs. D. began walking for longer distances and transfer independently and the smile on her face was noticeably wider.

The day of discharge was a huge celebration and victory for Mrs. D. She was going back home walking with only the assistance of a walker, independent with her daily activities and completely off oxygen. She proudly walked to the nurse’s station with a box of chocolate in her hand, thanking each team member individually, assuring us all that “I’ll come back to visit and celebrate.”

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Case Study: The Grove at Valhalla Rehabilitation & Nursing Center (October 2017)

Patients Age: 92
Admission Date: 8/18/17
Admitted From: Phelps Medical Center
Discharge Date: 10/16/17
Discharged To: Home
Length of Stay: 2 months
Reason for Stay: Syncope and Collapse, General Muscle Weakness and Fracture of Vertebra due to Wedge Compression, with diagnosis of Benign Prostatic Hyperplasia and Hypertension.

Details of Experience:

When Mr. Lawrence arrived at The Grove from the hospital on a Wednesday evening in mid-August, he was warmly welcomed by the staff, but his mood and orientation was puzzling. He couldn’t recall the reason for being here or a contact person, he seemed very confused. Mr. Lawrence was in poor physical condition, he was not ambulatory and needed assistance with all his ADL’s (activities of daily living). Who he was a mystery to us, until the hospital provided his neighbor’s contact information.

Due to HIPAA regulations, Mr. Lawrence’s neighbor was not informed by the hospital where he was being transferred to for rehab, while at the hospital Mr. Lawrence was unable to indicate his recognition of the neighbor. After a few days at The Grove, he began recalling more of his personal life and his orientation improved. The social worker reached out to Mr. Lawrence’s neighbor, the neighbor was more than thrilled to hear where Mr. Lawrence was, another senior neighbor whom he looks out for was previously here, and immediately visited The Grove community. Mr. Lawrence was beyond ecstatic to see a familiar face and recognized the need to appoint his neighbor as his health care proxy.

Mr. Lawrence was a successful engineer and lived a very independent life. He would regularly dine out, “known to always wear a well-pressed shirt, car in pristine condition and was deeply admired by all the neighbors,” his friend shared. Mr. Lawrence lost his wife a few years ago and has no children or family. His recent accident was a big shock to him, his loss of consciousness (Syncope) caused him to fall and he sustained head trauma, which resulted in memory loss and temporary loss of physical independence and mobility.

After a few weeks of intense physical and occupational therapy, Mr. Lawrence regained significant strength and was making great recovery strides. He was determined to get well and fast. His warm and friendly character was well received by both staff and residents. However, his balance required continued improvement and his mildly impaired cognitive function put him at risk for another potential fall. As much as he had to learn how to be mobile again and perform his daily activities independently, he also had to learn his limitations – he will need devices to assist him in walking and a companion throughout the day. Understandably, this frustrated him, “I want to drive again, I may even buy an island and start a resort.” But with time, he stoically accepted his limitations and pushed harder in the gym.

Mr. Lawrence was able to return home in less than two months! It took an interdisciplinary team to usher incredible levels of recovery from all departments. We are so excited to hear from Mr. Lawrence’s neighbor that “He is acclimating really well back at home and is very receptive to his 24 hour companion!”

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Cars for a Cause!

The Grove at Valhalla would like to thank everyone who attended our community car show: “Cars for a Cause!” The day was filled with legendary vehicles, great food and a lot of fun! The day was in support of our Music and Memory program, which provides our residents with the gift of music!

The Grove/Amputee Walking School CEU

The Grove at Valhalla Rehabilitation and Nursing Center, along with the Comprehensive Amputee Rehabilitation Program, were honored to host a CEU on Thursday, August 24th for professionals in the community. The informative CEU was  presented by Paralympic gold medalists, Todd Schaffhauser and Dennis Oehler, alongside representatives of The Grove at Valhalla. Thank you to all who attended!

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Case Study: The Grove at Valhalla Rehabilitation & Nursing Center (April 2017)

Patients Age: 87
Admission Date: 1/21/17
Admitted From: Lawrence Hospital
Discharge Date: 4/5/17
Discharged To: Home
Length of Stay: 2.5 months
Reason for Stay: Respiratory Failure/Pulmonary Edema from Congestive Heart Failure

Details of Experience:

Resident arrived to The Grove severely de-conditioned and in poor spirits. He had a complicated hospital stay- even a small stint in the ICU, from a severe upper GI bleed, flu, with complications, including hypovolemic shock and malena. This would be tough for anyone to handle, especially a formerly very active 86-year-old. To top it all off, this new resident had a recent hip fracture on his left side, which added much pain to movement and mobility as well as co-morbidities including knee degenerative joint disease, peptic ulcer disease and hypertension.

Much to the surprise of The Grove staff, the resident was all smiles and positive. He was very happy to be admitted to The Grove, and was prepared and ready for the incredible rehabilitation team to begin.

Upon admission, as per the team’s assessments, the resident required moderate assistance of performing bed mobility, transfers, ADLs, (Activities of Daily Living) and ambulation. Both the resident and his family understood the rehabilitation journey they were about to embark on, and assured the team that he was ready to roll up his sleeves and get started.

For the first month or so, he still had pain in his left hip, even with the pain management expertly overseen by the nursing and rehab staff; however, he worked hard every day with his physical and occupational therapists, making small gains. The positive reinforcement, smiles and encouragement from The Grove Staff fueled him to push harder than ever, and eventually, the pain started to subside, and he began to have an easier time with all tasks given by the therapists. Another surprising conversation he had with the team arised when he asked for “homework” exercises to be given to him, to do on his own time!

After two and a half months at The Grove, the resident was discharged back home! His status upon leaving was that he was able to walk over 200 feet with a walker, perform all ADLs on his own, and return to life as he loved it. Proper home care was arranged by his social worker, to assist with the transition back home.

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Case Study: The Grove at Valhalla Rehabilitation & Nursing Center (March 2017)

Patients Age: 80
Admission Date: 1/19/17
Admitted From: WPH
Discharge Date: 3/28/17
Discharged To: Home
Length of Stay: 3 months
Reason for Stay: Respiratory Failure/Pulmonary Edema from Congestive Heart Failure

Details of Experience:

Sara was admitted on 1/19/17 to The Grove at Valhalla from White Plains Hospital. She had been admitted due to Respiratory Failure and Pulmonary Edema, which caused de-conditioning and an increased need for assistance in performing activities of daily living (ADL) ambulation and transfers.
On admission, Sara required maximum assistance to perform bed mobility, transfers, ADLs, and ambulation. Resident was extremely motivated to return back home and worked very hard in therapy every day to do so. All staff and residents on the sub-acute unit enjoyed Sara’s knowledge, wit and sparkle in her eye, as she quickly became a member of The Grove family.

As time progressed, Sara showed slow but steady progress. She was severely reconditioned upon arrival, and summoning the strength to do rigorous therapy daily is not an easy task! Thankfully, with the supportive team by her side, she was able to push herself harder than she ever pushed herself before.

With a combination of supportive nutritional guidance, company, relaxation and rehabilitation, Sara’s future is looking very bright! We are proud to share that Sara is now able to perform ADLs with distant supervision for safety, and will be discharged from The Grove with only her walker!

During one of her final rehabilitation sessions, Sara told her therapist, “I appreciated all the hard work each person at The Grove did to ensure my recovery and return home!”

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