08/03/2026
Patrick “Pat” McDonough suffered a stroke decades ago that left him unable to use his left hand effectively. Fortunately, Pat’s dominant hand was his right, so he was able to get around the house with the use of a cane and manual wheelchair until an unexpected fall in April 2025. The fall resulted in a broken back and surgery, beginning what would become a long recovery.
Pat arrived at Brookdale Germantown and began working with the therapy team in early July 2025. Progress was slow but steady. Significantly contributing to his pain and weakness was an injury to Pat’s right hand and wrist—unfortunately, his dominant hand.
Doctors recommended surgery, which Pat underwent in December 2025. But instead of diving into physical and occupational therapy after surgery, Pat faced another setback. He was hospitalized in early February 2026 due to jaundice and other medical issues.
Following his hospitalization, Pat noticed a decline in his ability to care for himself. He struggled with activities of daily living and was unable to walk when he resumed therapy at Brookdale Germantown.
“You’d think if you learned how to do it all once, it would be enough, but that is just not the way it works,” Pat said.
Treating Pat during this phase of his recovery were Paul Evans, DPT; Vickie Haguewood, PTA; and Sarah Cobb, OT. The team had many factors to weigh. Between Pat’s left-side weakness and his other injuries, finding the right balance between making progress and avoiding overuse was crucial.
With their experience in inpatient healthcare settings, Vickie and Sarah recognized the need for a new and improved wheelchair. Although returning to walking with his cane was an attainable goal, the team educated Pat on the importance of energy conservation. Self-propelling his manual wheelchair with the hand that had recently undergone carpal tunnel surgery posed too great a risk of reinjury and required far too much energy.
“He could continue to do that,” Sarah said of Pat propelling his manual wheelchair. “But the energy spent doing that was tremendous. This wheelchair upgrade wasn’t about ability. It was about efficiency.”
Sarah facilitated the evaluation, fitting, and adjustments needed to secure Pat’s new wheelchair. The upgrade was a power chair with a narrower turning radius than his manual wheelchair. The new chair also allowed Pat to elevate his seat, making it easier to reach high places and relieve pressure on vulnerable areas, helping prevent pressure sores.
Physical therapist assistant Vickie Haguewood developed a strengthening plan focused on Pat’s lower body. At first, Pat required significant assistance to stand, but with time and repetition, his strength improved. He began working with a platform walker and eventually regained the ability to walk with his cane.
“They keep track of how you are doing,” Pat said of his therapy team. “Then they make sure you spend your time working on the good stuff.”
And good stuff it was. Pat progressed to walking 80 feet with a quad cane. He is still working to improve his balance and master proper weight shifting, but his progress is an encouraging step in the right direction. And for situations when walking is not the best option, Pat now has a wheelchair that conserves his energy and supports his independence.
“Having worked on the inpatient side of things, this has been so special,” Vickie said. “To see him making improvements at this level is so exciting.”
