History
75-year-old female with admitting diagnosis of Total Knee Arthroplasty. Resident’s functional status on admission was non ambulatory. Transfer from bed to chair, sit to stand with moderate assist of 2. Left knee ROM 10-30 degrees. Lower body dressing with moderate assist of 1. Toilet transfer with moderate assist of 1. Stairs were not attempted. Equipment received was standard walker.
Past Medical History
Hypothyroidism, osteoarthritis, rectal bleeding, cervical CA, low back pain, sciatica, diverticulitis, HTN, asthma
PLOF
Lives with husband who is at home at all times. Husband does driving/cooking
Primary medical diagnosis: Total Knee Arthroplasty
Payor source: Medicare A
Plan of Treatment:
Physical Therapy 5 days/wk
Occupational Therapy 6 days/wk
PLAN OF CARE WITH MODALITIES
OT POC
- Independent with toilet transfer
- Independent with chair level activities of daily living, shower with tub seat.
PT POC
- Independent with transfers from bed to chair
- Ambulate with walker 100-150 FT, as well as household ambulation
- Climb 5 stairs with one rail to enter house
- Improve knee ROM 0-100 degrees for car transfer, sit to stand
CLINICAL BENEFITS/OUTCOMES
At time of discharge patient’s functional status is ambulatory, 150’ x 3 with roller walker. Transfers from bed to chair and sit to stand is independent. Left knee ROM 3-70 degrees. Lower body dressing - independent. Toilet transfer independent with walker. Stairs were completed 5 up, 5 down. Husband was informed regarding contact guard. Patient can go up/down 5 steps with contact guard and one hand rail. Equipment received: commode, roller walker. Caregiver education was completed with husband for safety.
Quality of Life
- Decreased pain-increased ability to sleep, eat, participate in life activities
- Increased independence in ADL as resident regains increased function
- Decreased dependence on adaptive equipment
- Increased ability to return home and resumption of previous life activities