Rehabilitative / Restorative Care
Terminology
– Active range of motion
– Adaptive
– Restorative care
– Bed cradle
– Foot board
– Fleece pad
– Egg-crate mattress
Terminology #2
– Flotation pad
– Trochanter rolls
– Heel protector / elbow
protector
– Assistive devices
– Passive range of motion
– Active-assistive range of
motion
Terminology #3
– Disability
– Atrophy
– Alternating pressure
mattress
– Activities of daily living
– Pressure sores
– Independence
– Ambulation
– Joint
– Water bed
Terminology #4
– Stasis pneumonia
– Thrombophlebitis
– TCDB
– Phlebitis
– Embolism
– Hemiplegia
Terminology #5
– Quadriplegia
– Paralysis
– Paraplegia
– Clinitron bed
– Contractures
– Decubiti
Discuss rehabilitation
Disability: a physical and/or
mental condition which
interferes with meeting
basic human needs
Effects of disability:
Feeling of loss
Damage to self-image
Loss of self-esteem
Discuss rehabilitation #2
Restorative care: helps
disabled individuals return
to their highest possible
level of physical and
psychological functioning
Helps person adjust to the
disability
Emphasizes abilities
Prevents complications
State goals of restorative care
Physical goals
1. Maintain present level of function
2. Improve physical function
3. Encourage independence
Psychosocial goals
1. Adjust to psychosocial effects of
disability
2. Stabilize economic resources
Rehabilitation team / Role of the
nurse assistant
Purpose:
Discuss and evaluate resident level
of functioning
Establish resident’ care plan and
goals for rehabilitation
Evaluate progress
Restore the resident to his/her
optimal level of functioning
Members of the team
Resident
Family members
Nurse assistant
Licensed nursing staff
Physical therapist
Occupational therapist
Members of the team #2
Physician
Activity leader
Social worker
Clergy
Dietitian
Nurse Assistant
Responsibilities/Rehabilitation
Participate in resident care plan
conference
Observe and report responses to
care
Follow the resident’s care plan
Encourage to follow the plan
Observe and report early signs and
symptoms of complications
Nurse assistant
Responsibilities/Resident Care
Protect resident rights
Ensure safety
Communicate therapeutically
Adhere to legal and ethical principals
Follow instructions of immediate
supervisor
Report changes in resident conditions
Nurse assistant responsibilities #2
Practice appropriate and effective
nursing care
ROM training plan for resident self
care
Encourage resident independence
Concentrate on resident’s abilities
Protect resident from abuse
Activities of Daily Living
Activities of Daily Living (ADL’S)
– Daily hygiene
– Grooming
– Eating
– Self-care activities necessary for normal
functioning in society
Activities of Daily Living #2
Examples:
– Grooming
– Dressing
– Feeding
– Hygiene
– Elimination – bowel and
bladder
– Mobility/ambulation
– Self-turning and positioning
Comfort devices and their purposes
Bed board
Footboard
Trochanter roll
Handroll
Bed cradle
Trapeze
Sheepskin
Comfort devices and their purposes
#2
Heel/elbow protectors
Flotation pads
Egg crate mattress
Water bed
Alternating pressure
mattress
Pillows
Adaptive/self-help devices
Eating utensils
Hygiene and grooming
aides
Promote independence
Artificial limbs and eyes
Casts and splints
Complications from inactivity
Types
– Respiratory
– Circulatory
– Musculo-skeletal
– Integumentary
– Gastro-intestinal
– Genito-urinary
– psychosocial
Complications from inactivity #2
Causes
– Bed rest
– Prolonged illness
– Recovery from injury
– Surgery
Complications from inactivity #3
Preventive methods
– Turning/repositioning
– TCDB
– Body alignment
– Rang of motion
– Supportive devices
– Skin care
Complications from inactivity #4
– Encouraging independence
– Toileting
– Bowel and bladder training
– Elastic stockings
Range of Motion Exercises
Purpose
– Maintain muscle strength
– Stimulate circulation
– Maintain body alignment
and make positioning easier
– Prevent thrombophlebitis
– Prevent contractures
Range of Motion Exercises #2
Frequency
– At least three times each day
– As indicated in the care plan
Range of Motion Exercises #3
Techniques
– Active ROM
– Passive ROM
– Active assistive ROM
Range of Motion Exercises #4
General rules to avoid injury
– Exercise correct joint
– Avoid unnecessary exposure
– Use good body mechanics
– Fully support each extremity
– Move join slowly, smoothly,
gently
Range of Motion Exercises #5
– Do not force the joint to
move past the pint of
discomfort
– Do not cause pain
– Report complaint of pain to
the licensed nurse
Promoting Mobility
Procedures
– Transfer techniques
– Gait training
– Training in self-transfer
techniques
– Use of gait belt for ambulation
Promoting Mobility #2
Assistive devices
– Cane
– Walker
– Wheelchair
– Transfer board
Promoting Mobility #3
– Braces, splints and
prostheses
– Seeing eye dog
– Braille
– Modifications to
accommodate wheelchair
access
– Disabled parking
Self-esteem and Family
involvement
Basic needs as defined by
Maslow
– Love/belonging/affiliation
needs
– The need for self-esteem
– The need for self-actualization
Self-esteem and Family
involvement #2
Methods
– Promote interaction
– Treat resident/family with
respect and dignity
– Be supportive
– Encourage independence
– Use a positive approach to
restorative plan