A sudden, clinically important deviation from a resident’s baseline in physical, cognitive, behavioral, or functional domains. Without appropriate evaluation and interventions, clinically important changes could cause further injury or complication.


Identify those at risk

Through knowledge of the resident’s medical history and the comprehensive therapy evaluation findings, it is important to be aware of residents that are at risk for an acute change of condition.

Recognizing a change

When a change is identified, it is extremely important to document symptoms accurately and completely and indicate that the change was communicated to the appropriate team member(s). It is important that you know and understand the method of communicating change in your care environment.

Examples of signs an acute change may be occurring:

·         Decline motivation ·         Decreased appetite
·         New or increased agitation ·         Changes in mood
·         Change in functional ability ·         New or worsening pain
·         New or worsening edema ·         New or worsening shortness of breath

Monitor Progress

Staff should closely monitor each resident that is being treated for an acute change in function and communicate regularly to ensure the condition is stabilizing, or if not improving as expected, additional medical evaluation should be requested. When clinically indicated, it may be necessary to hold the therapy treatment sessions pending additional medical evaluation.

Orthopedic Changes

Sign and symptoms of a joint dislocation may include:

·         Loss of motion ·         Pain during movement
·         Pain with weight bearing ·         Inability to bear weight
·         Numbness around the area ·         Tingling feeling
·         Visibly out of place or misshapen ·         Swelling or bruising

Signs and symptoms of a hip fracture or hip dislocation may include:

·         Severe pain in hip or groin ·         Inability to put weight on injured leg
·         Stiffness, bruising, or swelling in hip area ·         Shorter leg on the injured side
·         Injured leg externally rotated (turning   outward) ·         Inability to move immediately after a fall

Melissa Ward

Director of Clinical Services