Promotion of Function and Health of Residents
Independence is the goal
Restorative care means helping residents do what they can for themselves for as long as they can. Doing everything for a resident feels kind but leads to weakness, contractures, and depression. Encourage self-feeding, self-dressing (lay clothes out in order and offer adaptive devices), and self-toileting.
Mobility and skin
Perform range-of-motion exercises as ordered - active, active-assistive, or passive - slowly, and never force a joint past resistance or pain. Use a gait belt for transfers and ambulation per policy, lock wheelchair wheels, and stand on the resident's weaker side. Reposition bedbound residents at least every 2 hours and inspect skin at every turn. Highest-risk pressure points: sacrum, heels, hips, elbows, ears, and any area under a device. Report redness that does not blanch.
Nutrition and hydration
Position the resident upright for meals and for about 30 minutes afterward. Watch for swallowing problems - coughing, choking, a wet voice, pocketing food, drooling - and report them. Never feed a resident who is coughing or lying flat. Honor thickened-liquid and diet orders. Offer fluids often and record intake and output in milliliters.
Elimination and rest
Follow bladder and bowel training programs exactly. Provide prompt incontinence care, cleansing front to back. Promote sleep with a quiet, dim room, a back rub, and comfort measures rather than unnecessary awakenings.
Traps
The answer that does the most for the resident is usually wrong; the answer that encourages the resident is usually right. Never restrain or tie a resident to prevent falls.
Rule of thumb
Ask yourself, "Can the resident do part of this?" If yes, let them, and assist only the rest.