Restorative Care, Mobility, and Positioning
The restorative mindset
Restorative care keeps residents as independent as possible: encourage them to do what they can, provide the device, and document progress. In range of motion, active means the resident performs it and passive means you move the joint for them. Support the joint, move slowly, never force past resistance or pain, and stop and report pain or a change in function. Reposition at least every two hours and use pillows, hand rolls, footboards, and splints as ordered to prevent contractures and foot drop.
Positions
Supine, lateral (side-lying), prone, Sims, and Fowler's (semi-Fowler 30-45 degrees, high Fowler 60-90 degrees). Align the body, avoid pressure on bony points, and place the call light within reach after every move.
Transfers and devices
Use a gait belt unless contraindicated, and lock the bed and wheelchair wheels first. When moving from bed to chair, position the resident's strong side toward the chair and lead with the strong leg - up with the strong, down with the weak. A cane goes on the stronger side and moves with the weaker leg. With a walker, the resident picks it up, sets it down, and steps into it; never lift a walker while the resident bears weight on it.
Body mechanics
Widen your base, bend your knees, keep the load close, face your work, and do not twist. Get help or use a mechanical lift as policy requires; never catch a falling resident by the arm.
Traps
Cane on the weak side, forcing a joint, and pulling a resident up by the arms are standard distractors.
Rule of thumb
If the resident can do it, they should - your job is to make it safe, not to do it faster.