Restorative Care and Range of Motion
The restorative mindset
Restorative care means helping each resident reach and keep the highest level of function they can. You are the person who makes that happen day to day: prompting self-care, setting up supplies, using adaptive equipment such as built-up utensils or plate guards, and following the walking and toileting programs in the care plan. If a resident can button three buttons in five minutes, that is a success, not a delay. Doing the task for them to save time is a failure of restorative care.
Range of motion
Range of motion may be passive (you move the joint), active (the resident moves it), or active-assistive (the resident does part). Work from head to toe, support the joint above and below, move slowly, and stop at the point of resistance. Never force a joint past resistance or through pain; stop, note it, and report to the nurse. Perform range of motion on the schedule in the care plan, and never skip a scheduled session because the resident is "tired" without reporting it.
Splints and devices
Apply splints, hand rolls, and positioning devices exactly as ordered, for the time ordered, and check the skin underneath when you remove them. Report redness, swelling, or complaints of pain.
Traps on exams
Forcing a contracted joint to "loosen it," removing a splint because the resident dislikes it, or documenting that you performed the exercises when the resident did them are wrong answers. Documentation should record what the resident accomplished.
Rule of thumb
Move to resistance, never through pain, and let the resident do whatever they can do, even slowly.