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

Patients Age: 72
Admission Date: 5/10/18
Admitted From: Burke
Discharge Date: 7/22/18
Discharged To: Home
Length of Stay: 2.5 Months
Reason for Stay: Malignant Neoplasm of Cerebellum (Metastatic Brain Cancer)

Details of Experience:

“You’ll need to use a sliding board to transfer for the rest of your life.” That was the conclusion of many of Dorothy’s physicians and therapists. After months of undergoing treatment for her brain cancer and intense therapy at Burke Rehabilitation Hospital, it seemed that Dorothy’s chances to walk again were unrealistic. Dorothy received outstanding treatment from her oncologists, surgeons, and therapists. Both she and her husband enjoyed fulfilling and successful careers and were well-connected to top healthcare providers. However, Dorothy had a long, challenging journey ahead of her.

Once she completed the acute rehab program at Burke, she decided to keep moving forward and asked to be transferred to sub-acute for further rehabilitation and treatment. When Dorothy arrived at The Grove, she was close to flawless with the transfer board. If she would want to continue remaining under sub-acute care, new goals would have to be put in place. On the surface, one can mistake Dorothy’s easy going and pleasant nature as “giving up or being lazy.” Behind her passive demeanor, there was a force of stoicism and hopeful spirit, that with continuous therapy and care, would overcome the side effects of brain cancer. Dorothy was determined to fight.

Therapeutic success isn’t measured by the number of steps one can take or the time frame needed to complete the goals. We measure success against the unique challenges one faces. For the first few weeks, Dorothy required the use of a standing frame machine to support her lower body and knees, allowing her to begin bearing weight in her legs. After a few weeks of committed and consistent therapy, Dorothy was able to be on the machine for a continuous half hour. She then upgraded to the light gait machine, a device that uses a harness to support the lower body, removing one’s weight when walking. This helped her develop elasticity and movement in her lower body and begin building more muscles in her legs.

The turning point for Dorothy was when she was succeeding at the floor mat exercises. Combined with improved core and lower body strength, Dorothy was to able hold a bridge position and other difficult positions for an impressive amount of time. The small gains boosted her spirits and faith that perpetual hard work, commitment, and training can in-fact beat the odds. Dorothy was also given exercises to help improve her upper body strength, which she often did on her own and with the help and support of family. In her final month, Dorothy was walking with the support of her therapist and was later gifted with a walker.

Dorothy was constantly surrounded by loving family and community members, and her staff served as her coaches and cheerleaders. Dorothy’s spirit and stoicism spoke louder than words and her results reflected two and a half months of intense and continuous therapy. With a humbling smile and upright back, Dorothy walked out of The Grove.

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

Patients Age: 76
Admission Date: 3/13/18
Admitted From: Burke
Discharge Date: 6/23/18
Discharged To: Home
Length of Stay: 3 Months
Reason for Stay: Tracheostomy, Heart Failure, Presence of Heart Assistance Device – Left Ventricular Assist Device, End Stage Renal Disease (Acute Kidney Failure)

Details of Experience:

On March 7th, Diana arrived at The Grove for a tour. She was impressed with the new beautiful renovations, cheeriness of the staff, and the state-of-the-art gym with the most up-to-date equipment. But her primary questions revolved around the ability of our medical, nursing, and rehabilitation departments to address the complicated medical needs of her father, Charles, a left ventricular assist device (LVAD) patient.

At the young age of twenty, Charles immigrated from Europe to the United States. Within a surprising few short years, he built for himself a lucrative construction company. By the age of thirty, he was married with four children. Charles spoke one language – dedication and grit. Providing for his family and earning an honest living was his life and nothing could stop him. But he did have to slow down, at age sixty, he suffered a massive heart attack. His medical condition required him to change his lifestyle, but not his attitude. This was another challenge and obstacle life presented to him that he was determined to beat. If a failing heart is not challenging enough, Charles also required dialysis treatment three times a week as his kidneys failed him too.

When Charles arrived at The Grove, he was already fifteen years into his battle, a fight against a failing heart. In 2016, Charles had a left ventricular assist device inserted into his heart (LVAD); his heart cannot function on its own. It’s very common for patients with an LVAD to display feelings of depression and grief, the dependency on an electrical device to survive can feel demoralizing and hopeless. But Charles is different. His family is different.

Charles is well-known at Westchester Medical Center’s cardiac unit. He’s been receiving medical treatment there for over a dozen years. Despite the years of needing treatment, he made it clear from the first day, “I’m not a patient, I’m a father and business owner and I will return home.”

One can only admire his stubbornness and resilience. Charles has little pity for himself and does not need anyone else’s either. In his first month, Charles demonstrated great commitment in the gym and his therapists were pleased with the therapeutic progress he was making. His muscles and core were getting stronger, but his medical condition was beginning to decline. After one month, Charles had to be re-hospitalized. On top of a failing heart and kidney, Charles was having respiratory trouble. The attending physicians were worried, his lungs were failing, too. Charles was placed on a ventilator until he was stabilized, and his new tracheostomy would be left indefinitely.

Charles’s came back with a new set of challenges. He was our first patient to have an LVAD and a trach (and require dialysis). Having a successful therapeutic outcome with either, is astonishing, let along both. For the very first time, Charles asked himself, “Will I ever be able to return home?” Not accepting defeat, but reality. Both Charles and his family agreed that the question would have to be put on hold, the focus now was to get better as much as possible. The team of physical and occupational therapists along with the respiratory, nursing and medical team, revised his goals and care plans.

The initial goal was not whether he will be able to return home or not, but how long can he live? Will he ever be medically stable? Small goals are what we agreed to focus on. Physically, he was weak and couldn’t carry his own weight. He needed assistance with transfers and support while standing. Six days a week he received therapy and those were his happiest moments. Slowly, his strength and stability were increasing. For the following month, his therapists worked on his lower body strength and the medical team treated his respiratory needs and stabilizing his condition. As he was improving, he was slowly returning to himself and his commitment to “return home and live to see his first grandchild get married.”

Charles and his family revisited the conversation of the possibility of returning home. His children and wife couldn’t have been more supportive and understood, that returning home would require lifestyle changes on their end too. His wife would need to feel confident managing his care and assist with his tracheostomy care at home. In his final weeks, Charles was the happiest and hardest working man in the gym. His team of therapists tailored his exercises to functional and basic skills he’ll need to return home safely. The social worker coordinated the home care services, equipment and the additional nursing care he would require, while the medical and nursing team helped train his wife on tracheostomy care. It was the first time we succeeded in discharging a patient with a tracheostomy (either we succeed in weaning the patient off the trach or the patient ends up requiring long-term care).

Never have we seen a patient leave with such triumph and pride, “I told you I will return home.” That was the biggest “thank you” the staff could ever hear. We knew that his return home was truly the collective efforts of the entire team here at The Grove and the hospital along with his wife and family and his inner strength and commitment to live life at his own terms.

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

Patients Age: 73
Admission Date: 4/23/2017
Admitted From: White Plains Hospital
Discharge Date: 5/14/2018
Discharged To: Home
Length of Stay: 3 weeks
Reason for Stay: Strain of Right Quadriceps Muscle

Details of Experience:

In mid-April, Scott had a total knee replacement. He opted to go home after the surgery. He fell and tore his right quadricep muscle a few days after the surgery. He returned to the hospital for further treatment. Scott had two relatives who were patients at The Grove, so when the physician at the hospital encouraged Scott to transfer to a subacute setting for further treatment and therapy, he confidently chose a community he was familiar with.

Although he knew many of the staff by first name, being a patient at The Grove was not something he expected to happen. We knew Scott well and his preferences, so in the few days leading up to his arrival, the staff prepared his private room with the equipment he will need to have a comfortable and clinically optimized experience with us.
Scott’s fall damaged more than his quadricep. It forced him to acknowledge the challenges and difficulties of aging. He had to be patient with the recovery process as Scott was in a lot of pain. When he first arrived, he was not bearing any weight on the leg and he could not bend his knee. He was required to wear a brace on his knee and also suffered an infection from the incision – which required him to be on an extensive antibiotic regimen; he was weak and had poor endurance.

Scott’s therapy plan consisted of pain management, muscle strengthening, weight bearing, and range of motion of his knee. Scott was motivated to work hard and return home. After two weeks of rehab he gained weight bearing status, but was still not able to bend his knee. During his last week of rehab, the staff worked with him on flexibly and range of motion of his knee. After a short three weeks of rehab, Scott was able to return home safely. He gained the strength and endurance needed to live independently. He returned home with a walker to use for temporary support, a device he initially never thought he would need, “but it’s much better than having to be in wheelchair.”

We are extremely proud of Scott’s rehabilitation process. We here at The Grove strive to meet the needs and expectations of our residents. Through hard work and dedication while working with the team here at The Grove, Scott reached his goals.

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

Patients Age: 84
Admission Date: 3/15/2017
Admitted From: White Plains Hospital
Discharge Date: 4/23/2018
Discharged To: The Bristal Assisted Living
Length of Stay: 5 weeks
Reason for Stay: Lateral Hip Replacement

Details of Experience:

The short version of this story can be told as follows: the man fell, required hip surgery and regained his strength. From a clinical standpoint, that is correct, as it’s reported on his medical records. But healing isn’t isolated to the nuances of one’s hip and adjoining muscles. The individual’s emotional state, psychological strength and family and communal support systems are critical players in the recovery process just as the biological causes of a fall.

Ted is a retired IBM executive. A company he worked for starting from the day after he graduated from college. Commitment and excellence are practices he demonstrated his entire life. Two years ago, his wife, his partner of close to sixty years, died. Although his four children live in four different states, their commitment to each other and to their father is exemplary. Ted was physically active all his life, a strong squash player until the late age of 82.

On March 9th, Ted tripped in his large home. It was a bad fall. When 22 hours lapsed without hearing from their dad or being able to reach him, Wendy, his eldest daughter, went to check on him. He sustained a hip fracture. At White Plains Hospital, the surgery performed was a lateral hip replacement, where they enter from the front, as opposed to the more common posterior approach – from the back. The benefit of this approach is the reduced chance for the hip to dislocate, but the process for recovery is longer, with more hip precautions.

Ted’s initial 24 hours at The Grove went smoothly. He was recovering from the surgery and surrounded by his family. A day later he had an awakening, “I’m in a nursing home for rehab, what is this place? I’ve never been in this environment before.” The staff succeeded in helping Ted adjust and make him feel as comfortable and at home as possible. He appreciated the attentive and concerned response from the staff, but it was a major adjustment for him, both emotionally and physically.

Claire, PT and Kaitlyn, OT, were his assigned therapists. The rehab phase consisted of building the leg muscles by contracting the muscles in the leg without moving the hips and glutes. Much of these exercises took place in his room. Ted was in a lot of pain. A week in, he was able to continue his exercise and muscle strengthening in the gym. His pain was still severe which prevented him from putting any weight on his legs. Through the exercises and pain management, the pain eventually reduced, which then allowed him to sit up on the edge of his bed, transfer out of bed and increase his independence.

Ted’s ability to perform more arduous exercises increased, as his endurance level increased and his pain reduced. He was able to remain on the bike for longer periods and began ambulating. His competitive and resilient character began to shine. Observing the progress he was making encouraged and gave him the confidence to continue exercising outside his sessions. Ted would perform exercises in his room and was encouraged to ambulate and transfer independently. Ted’s athletic history helped him recover faster. After three weeks he was able to begin walking longer distances and his endurance level continued to rise.

There was much going on in Ted’s life as his hip was healing and his lower body was becoming stronger. It became apparent that living alone was not the healthiest option for him. Although reluctant at first, and understandably, the discussion of moving to an assisted living was introduced. This was even a greater challenge and accomplishment on his end than recovering from a hip replacement. His entire life, Ted was the provider, the leader. He led a very successful life both at work and at home. The manner in which he recognized his limitations and the inevitable process of aging was impressive. He was stoic and realistic.

His time at The Grove prepared him for his next phase in life. As he became more physically independent, he began befriending and socializing with some of the other patients. He appreciated the sense of community and camaraderie that was offered. He visited the Bristal Assisted Living during his stay with us. He enjoyed what he saw, but most importantly, they allowed him to bring his piano. Ted is an incredible pianist, an activity he enjoyed throughout his stay at The Grove, not to mention the appreciation of all the staff and patients he performed for. Shy by nature, he wasn’t searching for the attention. The relationships and connections his playing created between him and others strengthened his interest in choosing to live in a community as opposed to living alone.

Ted’s story exemplifies the healing that can only come from the community. Beginning with his devoted children to the committed staff at White Plains Hospital, The Grove, and now at The Bristal, all were happily and positively helping Ted find the meaning and healing that can be found in aging.

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Historic Ribbon Cutting Celebration

Our community is so proud to share the unveiling of our state-of-the-art healing center, providing our patients with unparalleled resources to inspire healing and ReNEWal! The Grove at Valhalla’s mission is to provide those that we serve with an opulent healing environment, fulfilling the expressed and unexpressed wishes of our patients and families!

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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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