Restorative Care and Range of Motion
What you must understand
Restorative care means helping residents keep or regain function and do as much for themselves as safely possible. It is a philosophy as much as a set of tasks: set up supplies, allow extra time, encourage effort, praise progress, and follow the care plan for adaptive equipment such as a long-handled sponge, reacher, or built-up utensils.
Range of motion is either active (the resident moves the joint) or passive (you move it). Know the movements you may be asked to perform: flexion, extension, abduction, adduction, rotation, circumduction, pronation, supination, dorsiflexion, and plantar flexion. Support the joint above and below, move slowly, and stop at resistance or pain - never push through it, and never exercise a joint that is newly injured, hot, red, or swollen without an order.
Positioning prevents contractures and foot drop: reposition at least every two hours, align the body, keep joints in neutral, use pillows and heel protection, and apply ordered splints or boots.
Mobility
Use a gait belt for ambulation and transfers, non-skid shoes, and stand on the resident's weaker side while supporting the belt. Transfer toward the resident's stronger side. Never pull a resident up by the arms or shoulders, and use a mechanical lift for anyone ordered non-weight-bearing.
Traps
Doing everything for the resident because it is faster - that accelerates decline and violates the restorative philosophy. "Working through" joint pain. Leaving a splint off because the resident dislikes it (report instead). Bypassing the gait belt for a "quick" transfer.
Rule of thumb
If the resident can do it, let them. If they almost can, help just enough to finish - never more.