Basic Restorative Services
What candidates must know
Restorative care means helping residents regain and keep function. It includes range of motion, positioning and body alignment, ambulation with a gait belt, use of canes and walkers, splints and braces, bladder and bowel retraining, and re-learning ADLs such as dressing and feeding.
Range of motion is active when the resident performs it and passive when the caregiver moves the joint. Never force a joint past the point of pain or push against resistance; report pain, redness, swelling, or a sudden loss of motion. Position residents with the body in alignment, support limbs with pillows, and change position at least every two hours to prevent pressure injury and contracture. Encourage the resident to help with as much of each task as possible, even if it takes longer.
Traps in questions
- Placing a cane on the weak side. The cane goes on the stronger side and moves with the weaker leg.
- Lifting a walker to move it forward instead of picking it up, setting it down, and stepping into it.
- Pulling the resident up by the arm or shoulder instead of using the gait belt at the waist.
- Leaving a splint off because the resident says it is uncomfortable without reporting.
- Doing all the work for a resident who can do part of it.
- Skipping the two-hour repositioning because the resident is asleep.
Worked rule
For bladder retraining, offer the toilet on a scheduled interval, such as every two hours while awake, and gradually lengthen the time as continence improves. Praise success and never scold accidents. The rule of thumb is: the goal is function, so assist rather than replace.