Restorative Care, Mobility, and Nutrition/Hydration
Restorative care and mobility
Restorative care means helping residents do what they can for themselves - prompt, cue, set up, and allow time, rather than doing everything for them. Use a gait belt for transfers and ambulation unless contraindicated, stand on the resident's weaker side while walking, and hold the belt underhand. Lock the wheelchair, swing the footrests away, and transfer toward the resident's stronger side. Use good body mechanics: wide base, bend the knees, keep the load close, and do not twist. Reposition immobile residents at least every two hours, keep heels off the mattress, and report reddened areas that do not blanch. In range of motion, move slowly to the point of resistance and stop - never force a joint past pain.
Nutrition and hydration
Check the tray against the diet card before serving (regular, low-sodium, diabetic, mechanical soft, pureed, thickened liquids). For a resident with swallowing problems, sit them upright, tuck the chin slightly down, offer small bites, one food at a time, and discourage talking while eating. Check the cheek for pocketed food. Do not use a straw unless it is allowed. Feed at the resident's pace and never force food or fluid.
Stop and report coughing, choking, a wet or gurgly voice, or a new fever - these suggest aspiration. Keep the resident upright for about 30 minutes after eating.
Record intake and output in milliliters, and note dark, cloudy, or foul-smelling urine or output below 30 mL per hour. Weigh daily residents at the same time, on the same scale, in the same clothing; report a loss of about 2–3 pounds in a day or 5% in a month.
Trap: answers that rush a meal to keep food warm, or that feed a resident lying flat.
Rule of thumb: if a resident can lift the spoon, your hands stay off the spoon.