Restorative Care and Mobility
The restorative mindset
Restorative care means helping residents keep or regain function - doing with them, not for them. Encourage self-feeding, grooming, and dressing, use verbal cues and praise, follow the care plan for range of motion and walking schedules, and report progress or setbacks. Range of motion can be active (resident does it) or passive (you move the joint gently). Never force a joint past resistance or pain; stop and report if the resident complains of pain or you feel a grinding or sudden resistance. Support joints and keep body alignment when turning.
Transfers and equipment
Apply the gait belt before transferring, lock wheelchair brakes, raise footrests out of the way, and move the resident toward their stronger side. Stand on the weaker side and slightly behind when walking. A cane goes in the hand on the stronger side. With a walker, the resident moves the walker forward first, then steps into it, and never uses the walker to pull up from a chair. When moving a resident up in bed, lower the head of the bed, get help, and use a draw sheet - never pull on the arms or shoulders. In a wheelchair, lock brakes before transfers, keep feet on footrests, back into elevators, and check for anti-tip devices.
Preventing decline
Reposition at least every two hours, check skin under splints and braces, apply non-skid footwear, keep the path clear, encourage activity and hydration, and report any redness, swelling, or new weakness. Contractures are prevented by positioning, support, and consistent range of motion.
Traps
Questions often suggest pulling a resident up by the arms, leaving brakes unlocked, using the walker to stand, or forcing a painful joint.
Rule of thumb: use a gait belt, get a second helper, and let the resident do the work they can do safely.