WVTherapy's Blog

WV Veteran’s Nursing Facility

wvtherapy — Tue, 20 Dec 2011 21:22:03 +0000

BREAKING NEWS: WV Therapy Services received official word today that they have won the bid for the therapy services at the WV Veteran’s Nursing Facility in Clarksburg, WV. WVTS has been providing service in the VA facility for over 3 years and is very excited to have an opportunity to continue this realtionship.

WVHCA E-News Update

wvtherapy — Mon, 19 Dec 2011 15:17:42 +0000

http://newsmanager.commpartners.com/wvhca/issues/2011-12-16/email.html

WVHCA E-news update

wvtherapy — Tue, 13 Dec 2011 15:43:02 +0000

WVHCA E-news update

This is a weekly E-news update provided by the WV Health Care Association. They do a great job keeping the LTC community up to date on all of the news throughout WV. If you would like to receive this newsletter, you can subscribe at the bottom of the letter.

Feature in Brickstreet

wvtherapy — Mon, 12 Dec 2011 19:42:06 +0000

WVTS will be featured in the Winter issue of the Brickstreet Quarterly Magazine. The article will talk about WV Therapy, their successes and growth over the past 6 years and also the great relationship they have with Brickstreet and the wonderful people they have working there. BrickStreet is a mutual company owned by its policyholders, and is among the largest writers of workers’ compensation coverage in the nation. BrickStreet provides a variety of tools to help employers provide a safe work environment for their employees and minimize losses – including on-site support from our safety specialists, a library of safety resources and ongoing programs, such as our Deductible Program, that can help manage costs. Brickstreet uses Charles Ryan Associates out of Charleston, WV to produce and publish the magazine and they recently held the photo shoot for this article at CareHaven of Pleasants in Belmont, WV. CareHaven is owned by Stonerise Healthcare and is one of the many great partners that WV Therapy works with to provide therapy throughout the LTC community in WV. Look for pictures from this photo shoot soon.

Mike Dotson

VP of Sales

www.wvtherapy.com

https://www.brickstreet.com/Pages/BrickStreetHome.aspx

http://www.charlesryan.com/

http://stonerisehealthcare.com/

Patient Success Story

wvtherapy — Tue, 06 Dec 2011 18:38:58 +0000

Our resident is a 61 year old male who came to Carehaven in February after suffering a stroke with right side deficits. This Resident had been living alone at home able to complete all ADL’s independently and was even driving (or riding his motorcycle) on a regular basis prior to hospitalization. Upon admission to our facility, the resident had spent 2 weeks in a transitional care unit and was only able to ambulated 20 feet with moderate assist, had poor dynamic balance, 3/5 LE strength and required Moderate assist for all transfers. Resident required a mechanical soft diet with nectar thick liquids with impairs language, problem solving, sequencing, and memory. Resident also needed moderate assist with dressing and completing ADL’s.

The residents therapy services included physical, occupational and speech therapies. Resident was receiving strengthening to both LE and UE including the use of modalities such as the omnicycle and e-stim strengthening and neuro. re-ed. protocols to promote muscle strength and re-education to facilitate proper gait sequencing and mobility. He also completed standing balance activities to improve loss of balance recovery. With our speech therapist, the resident was treated with vital stem to improve swallowing and worked on word finding, problem solving, activity sequencing and memory recovery.

Upon re-evaluation in mid-March the resident was able to ambulate 120’ with a straight cane and minimal assist with 4-/5 LE strength, Fair balance and required only stand by assist for transfers. Resident was also able to complete dressing and ADLs with SBA. Resident was also on regular diet and liquid trials and progressing well with all speech and language deficits.

This resident has made remarkable progress since March and is now completely independent in the facility and outdoors using a front wheeled walker due to his own preference, completing all daily activities on his own and consuming a regular diet and liquids without incident. The resident was physically and medically ready to return home in mid May, however financial limitations prevented him from doing so at that time. All limitations have now been resolved and he is scheduled to return to his prior living situation on June 9^th with only one change, he can no longer ride his two-wheeled Harley.

However, his riding brothers have traded it in on a nice three wheeled Harley Trike for his safety and riding pleasure!

JOBST Stockings

wvtherapy — Fri, 04 Nov 2011 13:23:02 +0000

My name is Robb McLeod and I have been a PTA for nine (9) years. Physical Therapy has been a part of my life since I was young. My father was a Physical Therapist who began his career in 1965. He recently retired in Jan of 2010. My father is the one who first introduced me to Jobst stockings. He has been an advocate of the stockings since the 1980s when he had participated in a class in Toledo Ohio where he toured the place where the stockings were made. He even met the owner of the company! Jobst stockings are specifically designed to address edema caused by venous insufficiency. The design of the stockings is as such that it will provide the most pressure at the ankle and foot and will progressively decrease as the stocking goes up the calf. This will help push the fluid back towards the heart and hopefully help the body eliminate the excess fluid normally. Many doctors will prescribe Thrombo Embolic Deterrent (TED) Hose to help relieve swelling; however, the pressure that the TED Hose provides is the same from foot to calf which will not be effective in pushing the fluid up towards the leg. In all my years working in physical therapy I have never witnessed TED Hose relieving swelling in the lower extremities of the person wearing them, but, I have had good success with Jobst stockings. To measure someone for the Jobst stockings, measure around the smallest part of the ankle and the largest part of the calf. The measurements will fall within a range that corresponds to sizes small, medium, large, extra-large, and so on. One pair will cost $35.00-$40.00 dollars. To clean they must be washed in cold water and should be air-dried, as directed by the manufacturer. They can be difficult to apply, but an able-bodied person or caregiver should be able to apply appropriately. All Healthcare workers are also good patient advocates; so, if you have a client with persistent swelling in the lower extremities, AND they have good skin, AND, they do not have Congestive Heart Failure (CHF,) consider getting some Jobst stockings, as they may help.

Robb McLeod LPTA

Attitude Determines Outcome

wvtherapy — Mon, 31 Oct 2011 15:58:08 +0000

I’ve worked in the nursing home setting as a PTA for the past six years. The average age group I provide therapy for is around 75 years of age and older. However, sometimes we receive outliners that do not fit the norm. “Sue”, for confidentiality reasons, was an atypical patient; she was 58 years of age. Sue was admitted to the nursing facility for an overall general decline. The biggest culprit for her admittance to the nursing facility was end stage kidney disease. End stage kidney disease sounds bad, but it is manageable through dialysis. Although dialysis helps extend the life of the kidneys, it takes a toll on the physical and mental well-being of the patients. A typical dialysis patient takes treatment three times a week for four to six hours a day.

My first therapy session with Sue was short. She wasn’t able to roll over and wouldn’t allow me to exercise or get her out of bed. Toward the end of the first week the only thing she would let me do was assistive exercises bedside on her back. Every day was the same conversation with Sue; “I’m so tired, I feel sick, what’s the point.” By the end of week two Sue had made little to no progress with therapy, while spending about twenty hours a day in bed. At this time it was up to me to give Sue an ultimatum. She could remain in the condition she is in or take therapy seriously.

Sue knew I was motivated to help her, but she wasn’t motivated to help herself. She had the mentality that this was the end of the line for her since she was in a nursing home. But, she wasn’t looking at what she had outside of the nursing home such as a loving family, her dog, and a house. These are the things that ultimately changed Sue’s attitude and motivated her. I made a deal with Sue. I informed her that she would have the possibility of going back home with her family and dog if she did what I asked of her.

First thing every morning I would go to Sue’s room and remind her of how many days we had left until her projected go home date. As the weeks went on Sue’s attitude became more positive and she became stronger and more independent with therapy. Sue went from week one of dependence with everything, to week twelve of ambulation to and from therapy with an independent exercise program. By week fourteen arrangements were made with Sue’s family and she was discharged home.

Sue had the ability from day one, but lacked the self motivation because of her negative attitude. Former college football champion coach Lou Holtz once said, “Ability is what you’re capable of doing. Motivation determines what you do. Attitude determines how well you do it.” As therapists we build knowledge through school, our experiences, and fellow employees. But, the knowledge we acquire is useless if we can’t motivate, educate, and encourage our patients to reach their potential.

Patient Success Story

wvtherapy — Thu, 06 Oct 2011 13:09:59 +0000

We had a patient ( 66yr old male) admitted here at NCNR w/ the diagnosis of dysphagia, and status post CVA, COPD, Respiratory MRSA. He was dehydrated and receiving G-tube feedings. He had not been out of bed in weeks and had not been walking so he had an abnormal gait and was extremely weak.

The therapy department went in for evals and we thought “prognosis negative”.

He was not motivated and did not want to participate in therapy.

As a speech therapist, I would begin therapy sessions with oral care to stimulate the oral cavity for sensory purposes to encourage the need to swallow and for education on good oral hygiene. The residents mouth was showing signs of dehydration and his tongue was actually cracking and peeling. The resident was not willing to eat or drink at all at this time. Nursing administered swish and swallow as the resident developed thrush. I encouraged small sips of thin water as the resident had not shown any signs or symptoms of outward aspiration. If the resident was willing to participate, I would have him complete Oral Motor exercises for strengthening of labial and lingual musculature as well as laryngeal elevation exercises. As the resident became more willing to participate and was tolerating thin water and cold puree bolus’, I recommended a MBSS to be completed to determine the current status of swallowing. Once completed the resident was cleared for PO intake of thin liquids and a slow restart of foods (all liquid, puree, mech. soft, regular). Nursing and staff were educated on residents swallowing status at his point. Due to lack of PO intake the resident continued to need encouragement to eat a PO diet and also for attention to tasks due to some continued orientation deficits due to the CVA and MRSA infection. I continued to encourage PO intake, use of compensatory skills (safe swallow techniques) and attention to task to include: time of day, as He would say I have already ate. SLowly he improved and as deemed appropriate his diet was upgraded. The residents MRSA slowly cleared and the resident was safe to participate in a Rehab dining setting. This seemed to really motivate him to want to eat and be able to participate in every day activities once more.

When given a lot of encouragement and dedication from the therapy department he started to improve and is now independent in the facility w/ a rolling walker and the G-tube is long gone!

Don’t Judge a Book by Its Cover!

Patient Success Story

wvtherapy — Wed, 21 Sep 2011 15:12:02 +0000

Patient was a 52 year old female admitted to skilled nursing facility
following a lengthy hospitalization for acute renal failure. Other diagnoses
included diabetes, morbid obesity, severe deconditioning, and bilateral foot
ulcers. Per patient she had not walked for over a year, but her goal was to
“walk again and return home.” She would begin physical and occupational therapy
to increase her strength, endurance, range of motion, and functional mobility to
work toward her goal of returning home.

At start of care patient was unable to transfer in and out of bed, therefore
required a mechanical lift. She required moderate assistance to roll in bed and
was unable to perform supine to sit. The first month of treatment focused on
upper and lower extremity strengthening, bed and chair positioning for comfort
and pressure relief, bed mobility, and sitting balance. She refused to attempt
standing due to fear of falling. By the end of the first month, she was able to
roll in bed independently using the side rails, perform supine to sit with only
supervision, and maintain sitting at edge of bed for 10 minutes. She still
required a mechanical lift to transfer to and from the bed and chair, however
was able to tolerate sitting in chair for 3 hours 3 times a week.

After 2 months, she was ready to stand. She performed sit to stand transfer with
moderate assistance of 1-2 therapists. She was able to stand in the parallel
bars for 1.5 minutes with contact guard assist. Although she was very
enthusiastic and proud of her progress, she required much encouragement and
praise to maintain her motivation to improve. She continued to be too fearful of
falling to attempt walking. An orthotic company was consulted to make
specialized shoes for her to aid in pressure relief and prevent future ulcers
while maintaining her safety during transfers and ambulation.

After just 3 months of therapy, she was able to perform sit to stand transfer
with only contact guard assist. She was able to perform a stand pivot transfer
from bed to chair using a front-wheeled walker with minimal assist. She
ambulated with a front-wheeled walker and minimal assist of 1-2 therapists, for
20′. This was the first time she had walked in over a year, and both therapists
were her loudest cheerleaders. This gave her the courage and motivation she
needed to continue with her treatment and reach her goal.

After 5 months of therapy, she was performing bed mobility independently without
side rails and was able to transfer in and out of bed and chair with a
front-wheeled walker and supervision. She was ambulating up to 50′ with the
front-wheeled walker and contact guard assist. She could stand with the walker
for 2.5 minutes and perform minimal-moderate activities with only contact guard
assist. Discharge planning began with facility staff, therapy staff, the
patient, and the patient’s family. Due to the family living a few hours away
from the nursing home, several conference calls were made with the social
worker, therapy staff and the patient’s family to discuss equipment
recommendations and alterations/additions to the patient’s house.

The patient was discharged from therapy following 5 months of treatment but
continued to work daily with restorative nursing on ambulation, transfers, and
upper and lower body strengthening. After 4 weeks with restorative nursing, she
was performing stand pivot transfers bed to chair independently with
front-wheeled walker and walking with only supervision up to 80′. After 6 months
in the nursing home, she finally went home to live with her family.

Home Assessments

wvtherapy — Wed, 31 Aug 2011 19:38:30 +0000

When a client has suffered an illness or injury that has resulted in a change in their functional mobility, their ability to perform activities of daily living, and/or their ability to reason out/manage home/self-care responsibilities safely and efficiently, a Home Evaluation may be warranted. Completing a Home Evaluation is a great way to truly assess how therapists can assist clients in returning to a safe and independent life at home. Home Evaluations are normally completed by either an Occupational or Physical therapist, but are most beneficial when Occupational, Physical, and Speech Therapies are directly involved. Clients who are on a therapeutic leave to home can meet with therapists who then assess their current level of functional abilities with the tasks most crucial to safe and maximum independent home living. Bathroom set-up, walking space, stairs within and outside of the home, fall hazards, and kitchen assess-ability are some of the critical areas to be assessed with actual client performance of activities. Some other, less obvious areas that are looked at are access and usability of lighting, power outlets, windows, door handles, and telephones, all of which are vital and can be easily altered to improve function and performance with individual client’s needs. All of these tasks should also be assessed with the caregiver and the client present, when applicable, to assess their performance together and then provide education and training tailored to individual client needs. After the assessment, therapists can set up treatment based on the home environment until the client is ready for discharge to home.