Request for patient discharge

From: To:
Miriana Gavrila, Rose Edmonds, Doctor Byrne M.
Vanessa Swan
Neurologist at Catharina Ziekenhuis
Physiotherapists in training at Fontys hospital
University of Applied Sciences
Michelangelolaan 2, 5623 EJ
Eindhoven
Patient:
Mrs. Foolen
Date of birth: 07/06/1958
BSN number: xxxxxxxxxxxxxxxxxx

Dear Dr. Byrne M,

We are writing to ask for your professional opinion regarding the discharge of our patient, Mrs. Foolen.

Case history:
On 22/10/2023, two weeks ago, our patient Mrs. Foolen, a 65 year-old woman, suffered an ischemic
stroke on her left parietal side that left her unable to walk and with mild dysphagia and dysphasia. She
was admitted in the emergency department at the Catharina Ziekenhuis hospital, after which she was
transferred to the stroke unit, where she currently resides. For the past year she has been under the care
of a doctor because of high blood pressure. She takes medication (Prinivil) for this and they have advised
her to stop smoking.

Progress of patient:
On 24/10/2023, we got approval on starting pre-mobilization with Mrs. Foolen, alongside speech
therapy. We saw her for one hour, once a day in the mornings, where we focused on her transfers and
coping strategies regarding her impairments.

She can now talk without difficulty and is less fatigued. Shes improving with the use of her right arm,
for example, she can engage it when washing and dressing. Unfortunately, picking up a glass or combing
her hair with her right hand is not yet possible.

Mrs. Foolen can move herself in bed and sit on the edge of the bed independently. Standing up and
moving to a (wheel) chair is not yet independent but she is practicing this with us. She has also started
taking a few steps together with our assistance. For these actions she uses assistive devices. She finds it
very nice that she has started walking again, but she also shows signs of fear of movement.

Assessment measurements and results:

• Trunk Control Test:
▪ Baseline: 49/100
▪ Current evaluation: 87/100
• Functional Ambulation Categories:
▪ Baseline: 1
▪ Current evaluation: 3 (with assistive device)
• 10 Meter Walk Test
▪ Current evaluation: 0.2 m/s (with assistive device)
• Frenchay Arm Test
▪ Current evaluation: 3/5
• Tampa Scale

1
 ▪ Current evaluation: 17/68

Request for expertise:

After 2 weeks in the hospital, based on Mrs. Foolen progress and her current results, we believe she has
recovered enough to leave the hospital, however we don’t advise for her return to home, due to the fact
that she still needs help with various ADL activities and her walking is not yet safe enough. We would
like to request her discharge to the rehabilitation clinic instead.

Please feel free to contact us if you need any more information or have any further questions regarding
Mrs. Foolen’s case.

Kind regards,

Miriana Gavrila, Rose Edmonds, Vanessa Swan

Assistant Physiotherapists

m.gavrila@student.fonty.nl
r.edmonds@student.fontys.nl
v.swan@student.fontys.nl