Case Study: Sans Souci Rehabilitation and Nursing Center (May 2018)

Patient’s Age: 74
Admission Date: 3/13/18
Admitted From: NY Presbyterian
Discharge Date: 5/11/2018
Discharged To: Home
Length of Stay: 58 days
Reason for Stay: Dysphagia
How did this patient hear about Sans Souci? Another skilled nursing facility.

Details of Experience:

Ms. Bernice was admitted on March 13th with PEG feeding and the presence of a trach. She was unable to tolerate food or drink by mouth, and was in poor spirits due to her medical conditions. The projected plan of action was to enable Ms. Bernice to increase her capabilities functionally and with her feeding and respiratory needs; however, the eventual plan was to anticipate long term care, as she and her loving family felt she would need due to her extensive needs.

Upon evaluation, the speech language pathologist saw that she presented with the PEG tube, unable to eat or drink, and she had a trach. She had a severe case of oral thrush, which required thorough, daily oral care. She worked with Ms. Bernice to gradually introduce food. By increasing her oral hygiene significantly, she was able to perform an instrumental swallow study, called a Modified Barium Swallow, or MBS for short, and she displayed good oropharyngeal function, meaning that her muscular abilities in her throat improved significantly. With continuous speech therapy, she was able to safely tolerate regular diet consistency with no fear or signs of aspiration, and on 4/3/18 her PEG feedings were put on hold and a calorie count began. She was consuming 75% to 100% of her meals and feeding herself independently. She was then upgraded to a chopped consistency from puree, which allowed her to enjoy her food and the consistency to a greater extent. Her PEG tube was actually removed as she was able to eat entirely independently. With regard to her tracheostomy care, the speech therapist and respiratory therapist were gradually able to wean her off oxygen and tolerate decannulation.

Bernice was able to return home with her family which she was not expecting to do. She required minimal assistance, as she was eating and breathing by herself, and did not require the trach or PEG tube any longer. It was a highly emotional day at Sans Souci when we were able to see her return to her loving husband family and friends, functioning so much better than when she came in, and better than she ever thought she would! We wish only continued success and health for Bernice and her family!