Basic Restorative Services
Restorative care means "use it or lose it"
Basic restorative services keep residents functioning at their highest level: range of motion, ambulation, transfers, positioning and alignment, pressure relief, splint and device use, and bowel and bladder retraining. Your role is to reinforce what therapy teaches, follow the care plan exactly, and let residents perform their own care with setup and cueing. Range of motion may be active (resident moves) or passive (you move the joint); work gently within the pain-free range and never force a joint.
Devices and body mechanics
- Cane: held in the hand opposite the weak leg and moved along with the weak leg.
- Walker: lift and place the walker first, then step into it.
- Gait belt: over clothing at the waist, used to guide - not to lift - during transfers.
- Splints and braces: worn on the ordered schedule; check skin before and after.
- Positioning: use pillows and wedges to align the body; reposition at least every two hours.
Traps
- Pulling a resident up by the arm or under the shoulder.
- Doing a task for a resident who can do it themselves - this speeds decline.
- Removing a splint because the resident complains, instead of checking skin and reporting.
- Running bladder retraining "whenever convenient" instead of on scheduled times.
Rule of thumb
Follow the care plan to the letter and document what the resident actually did, not what you did for them.
Worked example
A resident has a weak right side after a stroke. The cane goes in the left hand. She advances the cane and her weak right leg, then steps through with her strong left leg - you stand on her weak side holding the gait belt.