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A Pair of Successes – By Sujith Abraham
Story 1
Mrs. B was admitted to St. Joseph's Villa October 31, 2007 following a fractured left hip. She was clear from day one that her goal was to return to her home. At the age of 84, she was highly motivated and kept her spirits high throughout her stay. Her motivation partly stemmed from the fact that her husband was also a resident at the Villa and although she was not ready to live here permanently, she did want to be independent enough to continue to visit her husband several times a week as she had prior to her hip fracture.
The physiotherapist first assessed Mrs. B in October 2007. She was generally weak and complaining of pain in the left hip. She was barely walking 25 feet with a two person assist. The objective measures reported were:
- Tinetti Balance and Gait - 7/28
- Three-minute walk test—25 feet with standard walker and two people assistance.
- Timed Up and Go (TUG) - not able to perform.
Mrs. B was pleased to participate in the physiotherapist's recommended treatment, which included a Resistance Strength Training Program (RSTP), and an Individual Physiotherapy program.
Mrs. B was noted to have shown significant improvement which was substantiated in the objective measures of her reassessment in January 2008:
- Tinetti Balance and Gait—14/28
- Three-minute walk test—267 feet with rollator walker and one person assistance
- TUG—35 seconds
Considering the impressive gains made by Mrs. B, the treatment plan was revised to include Individual Balance Exercises and continuation of the Resistance Strength Training program. Two months later, Mrs. B was reassessed and was elated that she had again made significant progress toward reaching her goal:
- Tinetti Balance and Gait had improved to 20/28.
- Three-minute walk test—310 feet with rollator walker
- TUG - 20 seconds
Since Mrs. B was doing so well, the physiotherapy treatment plan was now adjusted to prepare Mrs. B for going home. She greatly desired her independence and always wanted to know the next hurdle she had to jump over to get her that much closer to going home.She now participated in a Balance Training Program, stair climbing, and ambulation outside the facility with a rollator walker.
Her reassessment in May 2008 continued to show good results:
- Balance and Gait--22/28
- Three-minute walk test—530 feet
- TUG—16 seconds
With the guidance and recommendation of the physiotherapist, Mrs. B continued with the Balance Training Program, stair climbing, and ambulation outside with a cane rather than a walker.
With Spring in the air Mrs. B was anxious to get home and enjoy her garden. With this in mind, a pre-discharge assessment was completed by the physiotherapist. The results showed a Tinetti Balance and Gait score of 26/28. Mrs. B could walk 750 feet without any walking aid in the Three-minute walk test, and her Timed Up and Go now takes her only 10 seconds. She could also accomplish stair climbing—an impressive 40 steps, up and down.
June 30, 2008 marked the day that Mrs. B met her goal. She was discharged from the Villa and returned to her own home. She left behind her wheelchair, walker and her cane. She continues to visit her husband several times a week and enjoys seeing the staff and other friends she made in her time at the Villa.
Story 2
Mrs. T, a lovely lady who will be 78 this year had become a social butterfly.
Mrs. T first came to us in June 2009, from a stay in hospital which left her weakened and unable to stand or walk safely on her own. Due to her mild dementia, she was restrained in her wheelchair for safety purposes. This caused Mrs. T to become very agitated and upset. At this time it was only safe for her to walk with a one person assist.
The physiotherapist assessed her gait and balance in June 2009 and reported the following objective measures:
- Tinetti Balance and Gait - 12/28
- Three-minute walk test -180 feet with a rollator walker and one person assisting
- Timed Up and Go (TUG) - 138 seconds
With the physiotherapist's guidance and recommendations, Mrs. T participated in a Resistance Strength Training Program, Individual Balance Program, ambulation, and transfer training.
In August 2009, Mrs. T showed significant improvement in balance and TUG. Objective measures at this time were:
- Tinetti Balance and Gait - 19/28
- Three-minute walk test - 185 feet with rollator walker
- TUG - 28 seconds
At this time, the physiotherapist reassessed treatment to include the Strength and Balance Program, and decided to remove her restraints. Mrs. T continued to make astonishing gains.
The latest assessment was completed in November 2009. Her Tinetti Balance and Gait score improved to 23/28. The Timed Up and Go score remained at 28 seconds, however she is now able to walk 260 feet with a rollator walker unassisted.
Mrs. T is now very independent with her walker. She is off the Resident Home Area many times a day to participate in various recreational activities. We have also noticed that she has become quite a leader in her home area.
She is one of the newest residents yet many look up to her. This is an amazing improvement from the anxious and upset woman we met when she first arrived!
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