Bob

A Testament to Teamwork at Royal Oak

Our story begins with Bob, who had been living a functionally independent lifestyle with his wife, Carol. Bob had enjoyed his home, was doing yard work, and especially enjoyed painting model cars and spending time with his family and grandchildren.  This all changed when Bob was suddenly struck with Respiratory Failure, requiring an emergency tracheostomy.  This resulted in NPO status (no food or liquids by mouth) due to risk of aspiration, and the placement of a PEG (feeding) tube for nutrition, further complicated by the inability to speak, stand, or transfer, and dependence on caregivers for all personal needs.  Bob spent time stabilizing at a long-term acute care hospital (LTACH) before transitioning to Royal Oak for skilled nursing and rehabilitation. He arrived at Royal Oak severely debilitated, on the verge of giving up.

Speech-Language Pathologist Luke took the lead and worked determinedly to collaborate with the Respiratory Therapy & Nursing Teams, keeping pace to manage Bob’s tracheostomy, with the goal of downsizing and minimizing tubing, and ultimately, decannulation, or removal of the tube. Luke’s intuition to quickly facilitate achievement of fast gains showed Bob that he had potential for further improvement and kept Bob motivated to achieve more.  Luke pushed for portability in order for Bob to get out of bed and attend his therapy sessions in the Therapy Department.  Luke navigated the SLP interventions of Trach Management, Feeding & Voice seamlessly, implementing a Speaking Valve to facilitate early functional gains, and bringing HOPE to a seemingly hopeless situation.  Bob could now communicate effectively!  In the midst, Luke began trials of foods and liquids, passing through Bob’s room throughout the days to offer water when Bob was only safe to trial with Speech Therapy.  

Enter Physical Therapy Assistants, Peter and Kristy, as well as COTA, Tina, who made sure, every day, that Bob was bathed/dressed and transferred out of bed to his wheelchair, promoting the transition from “Patient” to a “Life as he knew it” mindset for Bob. Bob’s wife Carol was consistently supportive and involved in Bob’s therapy, which was paramount to keeping Bob encouraged with his sights set on homegoing. 

At times, Bob felt he would “Never get out of here”, and showed signs of despair.  This was discussed with the Interdisciplinary Team as a roadblock to Bob’s success.  Aaron the Administrator was quick to respond, making routine visits to Bob, offering encouragement and “guy talk”.  The result of Aaron’s attention and interest in Bob’s mental well-being had a staggering positive impact on keeping progress in forward motion  (Thank You, Aaron, for caring!).  

All disciplines of Therapy, from admission to discharge, communicated with the Nursing team and completed staff training to promote carryover for daily routine feeding techniques, mobility, and personal care within the Therapy-established limits of stability. The Therapy team, in turn, continued to challenge the limits and facilitate further progress. Once Speech Therapy had worked to facilitate Bob’s eating, speaking, and preparation for trach removal, the focus shifted toward mobility and activities of daily living (ADLs).  Bob soon began to walk, initiate, and increase participation with personal care.  Peter, Kristy, and Tina approached with compassion, and worked together in the best possible “Aspen Way” to overcome the barriers, incorporate Caregiver Training with Carol, downshift, when necessary, then offer the professional “tough love” support when needed for continued progress.

Several months post onset, Bob was able to discharge back to his home with no trach, no PEG tube, eating and drinking regular foods and liquids, speaking clearly, walking, and completing ADLs with very limited assistance. Because she completed training with the Therapy Team, Carol can safely meet Bob’s care needs at home.  Following nearly 3 months in skilled rehabilitation, Bob and Carol waved a tearful, grateful goodbye to the entire Royal Oak team, whom they will not soon forget.  

Pictured here with Bob and Carol are his therapists Peter, Kristy, Tina, and Luke, as well as Administrator Aaron.

Congratulations Bob & Carol!

Job well done, Team Royal Oak—what a Testament to Teamwork!