Basic Restorative Services
What this domain covers
Restorative care keeps residents as independent and mobile as possible after illness, injury, or with chronic conditions. The guiding principle is "use it or lose it," balanced with safety and the care plan.
Range of motion and positioning. Perform range of motion as ordered, moving the joint gently to the point of resistance - never past pain. Support the limb above and below the joint. Encourage the resident to do active range of motion themselves whenever they can. Position with proper alignment, using pillows to support limbs and prevent contractures; change position at least every two hours.
Ambulation and devices. A gait belt goes around the resident's waist, over clothing, and is held from behind with an underhand grip. Check that the resident has non-skid shoes and that assistive devices are within reach. A cane is used on the stronger side, moving it with the weaker leg. A walker is picked up and placed ahead, then the resident steps into it - never let a resident use a walker to pull themselves up; provide a stable chair or the bed. Stand slightly behind and to the side of the resident while walking.
Transfers and self-care. Lock the bed and wheelchair, lower the bed, and raise the head of the bed before a transfer. Encourage the resident to help - a dependent transfer for a resident who can assist weakens them. Follow the care plan for splints, prosthetics, and braces: apply and remove them as directed and check skin underneath.
Retraining. Follow bladder and bowel programs consistently; offer the bedpan or toilet on schedule rather than waiting to be asked.
Traps. Look for cane on the wrong side, walkers used to pull up to standing, or range of motion forced past pain.
Rule of thumb. Canes go on the strong side, gait belts go at the waist, and pain means stop.