Reason for Services
What is Paula’s primary diagnosis?
Parkinson’s Disease (Non-Tremor Dominant).
What was Paula’s career before retirement?
History professor at a local college.
Where did Paula live before the SNF?
At home with her wife, Anne.
What motor symptoms are most impacted by Paula’s Parkinson’s?
Bradykinesia (slowness of movement) and postural instability.
What social goal is most important to Paula?
Maintain regular contact with her wife, Anne.
Why was Paula admitted to the skilled nursing facility (SNF)?
For long-term care after a decline in functional independence.
How did Paula stay connected with her professional community?
Reviewed manuscripts and maintained email contact with colleagues.
Why did Paula enter the SNF instead of assisted living?
She and Anne could not afford assisted living costs.
How does her non-tremor dominant presentation differ from typical Parkinson’s?
She has reduced movement (bradykinesia) without prominent resting tremor.
What communication goal could support Paula’s well-being?
Stay in touch with former colleagues via email or video calls.
What secondary conditions does Paula have?
Cataracts and hypertension.
What leisure activities did Paula enjoy?
Cycling, hiking, reading, and watching soap operas.
What social support does Paula still have?
Regular phone calls and visits from Anne, and occasional visits from their daughter.
What cognitive skill is important for Paula to maintain?
Memory and problem-solving, which are challenged by Parkinson’s progression.
What physical goal is most important for Paula?
Maintain safe mobility and reduce fall risk.
What are Paula’s main therapy goals in the SNF?
Maintain social interaction, access the community, and maintain her relationship with her wife, Anne.
How does Paula’s intellectual background impact therapy planning?
She benefits from cognitive engagement and maintaining a sense of purpose.
How does Paula’s separation from her wife affect her?
She feels lonely and disconnected from her primary emotional support.
How does Paula’s rigidity impact her daily function?
Stiffness makes self-care tasks, like dressing, more difficult.
How can therapy support Paula’s sense of identity?
Incorporate reading, cognitive tasks, and intellectual conversation.
Why does Paula struggle with being in the SNF?
She feels isolated, misses her independence, and is frustrated by the loss of her home.
Why is it important to acknowledge Paula’s academic identity?
It supports her self-esteem and motivation for cognitive activities.
Why is Paula’s connection with former colleagues important?
It helps her maintain her sense of identity and intellectual engagement.
What environmental factors in the SNF may affect Paula’s function?
Lack of familiar objects, reduced privacy, and less mental stimulation.
What long-term emotional goal is important for Paula?
Maintain a sense of purpose and connection to her academic community.