Bridging The Gap Between The Hospital and Home

By Jan Howard

Ashlar of Newtown opened a 34-bed short-term rehabilitation and nursing facility in the spring that offers care for adults following surgery or serious illness.

“It’s truly taken off tremendously,” Jan Martuccio of Ashlar said.

The facility is geared to patients who need a little time following hospitalization to regain their health and strength before going home. Medicare will cover up to 100 days in the facility.

The facility offers care for patients with joint replacements/fractures, cardiac conditions, stroke, diabetes, conditions requiring IV medications, respiratory conditions, complex wounds, and those needing postoperative care.

The facility offers a 24-hour nursing team, physical, occupational and speech therapy, social worker, dietitian, education and support for patients and caregivers, and specialized teaching, “the whole team approach,” Ms Martuccio said.

The facility stresses education and encouraging family involvement, including nutritional teaching, pastoral care, social services, and recreation therapy.

Walker Taylor of Newtown, 83, a recent patient at Ashlar following heart valve surgery September 10 at Yale New Haven Hospital, speaks highly of the new facility. He went home after two weeks, ahead of schedule.

“It’s great,” Mr Taylor said. “It’s the best place in the world when you need it.”

A long-time resident of Newtown who was born in Bethel, Mr Taylor’s stay at Ashlar’s short-term rehabilitation and nursing facility included varied forms of physical therapy, such as step therapy, and exercises to build up his pulse and to build muscles in his hands and arms.

Physical therapy was tailored to his needs and what he could tolerate, Ms Martuccio said. It can include gait training, strengthening, stairs, and education in use of a walker, if one is needed.

“His therapy was designed for what he would encounter around the house,” she said. He was also instructed in energy conservation so he would not get short of breath.

“The food is great,” Mr Taylor said. The dietitian sees every patient and addresses their likes and dislikes, Ms Martuccio said, in addition to providing a selective menu according to a patient’s diet needs and restrictions.

Mr Taylor attributes his early discharge to a positive attitude.

He said being able to go to a short-term facility was helpful not only to him but to his wife, Peggy. Following bypass surgery nine years ago, Mr Taylor said he went directly home, which necessitated more care from his wife than if he had been admitted to a care facility.

Ms Martuccio said occupational therapy at the facility includes working with the family to help them care for the patient, such as showing them how to get the patient in and out of a car. It includes daily living activities, such as dressing, cooking, and tying shoes. “It’s individualized,” she said. “The goals are different according to individual needs.”

Prior to discharge, Ms Martuccio said a patient would be given instructions for at home care.

Ashlar of Newtown redesigned a wing on the third floor to accommodate the new facility. Each of the rooms has individual televisions and telephones, she said. The patients are also able to attend the various social and recreational activities that Ashlar provides, such as music programs.

 Hospital discharge planners and a person’s physician will evaluate whether a patient needs rehabilitation before going home, Ms Martuccio said. “It’s a safety concern,” she said, noting the patient and the hospital team discuss where the patient should go to fit his/her needs.

Ms Martuccio said she does on-site evaluation of patients and speaks with the discharge team members regarding their assessment of the patient. “We serve all area hospitals. It doesn’t matter where you are in the hospital.”

Once admitted to Ashlar’s short-term facility, a patient is evaluated, and a care plan is put into effect. The average length of stay is 21 days, she said. “These patients are going to go home.”

Before a patient does go home, the nursing staff addresses effects of medications and provides information, such as when the patient needs to see their doctor, such as for changing surgical dressings. Ashlar staff members also set up visiting nurse visitations and meet with the patient’s family about in-home care to assure a safe and comfortable return home.

For more information, call the Ashlar of Newtown admission office at 426-5847. All are welcome to make an appointment for a personalized tour. Ashlar of Newtown is at 139 Toddy Hill Road. For more information, visit the website at www.masonicare.org.