Rehabilitative / Restorative Care

1. Rehabilitative / Restorative Care • Terminology • Active range of motion • Adaptive • Restorative care • Bed cradle • Foot board • Fleece pad • Egg-crate mattress

2. Terminology #2 • Flotation pad • Trochanter rolls • Heel protector / elbow protector • Assistive devices • Passive range of motion • Active-assistive range of motion

3. Terminology #3 • Disability • Atrophy • Alternating pressure mattress • Activities of daily living • Pressure sores • Independence • Ambulation • Joint • Water bed

4. Terminology #4 • Stasis pneumonia • Thrombophlebitis • TCDB • Phlebitis • Embolism • Hemiplegia

5. Terminology #5 • Quadriplegia • Paralysis • Paraplegia • Clinitron bed • Contractures • Decubiti

6. 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

7. 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

8. State goals of restorative care • Physical goals • Maintain present level of function • Improve physical function • Encourage independence • Psychosocial goals • Adjust to psychosocial effects of disability • Stabilize economic resources

9. 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

10. Members of the team • Resident • Family members • Nurse assistant • Licensed nursing staff • Physical therapist • Occupational therapist

11. Members of the team #2 • Physician • Activity leader • Social worker • Clergy • Dietitian

12. 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

13. 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

14. 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

15. Activities of Daily Living • Activities of Daily Living (ADL’S) • Daily hygiene • Grooming • Eating • Self-care activities necessary for normal functioning in society

16. Activities of Daily Living #2 • Examples: • Grooming • Dressing • Feeding • Hygiene • Elimination – bowel and bladder • Mobility/ambulation • Self-turning and positioning

17. Comfort devices and their purposes • Bed board • Footboard • Trochanter roll • Handroll • Bed cradle • Trapeze • Sheepskin

18. Comfort devices and their purposes #2 • Heel/elbow protectors • Flotation pads • Egg crate mattress • Water bed • Alternating pressure mattress • Pillows

19. Adaptive/self-help devices • Eating utensils • Hygiene and grooming aides • Promote independence • Artificial limbs and eyes • Casts and splints

20. Complications from inactivity • Types • Respiratory • Circulatory • Musculo-skeletal • Integumentary • Gastro-intestinal • Genito-urinary • psychosocial

21. Complications from inactivity #2 • Causes • Bed rest • Prolonged illness • Recovery from injury • Surgery

22. Complications from inactivity #3 • Preventive methods • Turning/repositioning • TCDB • Body alignment • Rang of motion • Supportive devices • Skin care

23. Complications from inactivity #4 • Encouraging independence • Toileting • Bowel and bladder training • Elastic stockings

24. Range of Motion Exercises • Purpose • Maintain muscle strength • Stimulate circulation • Maintain body alignment and make positioning easier • Prevent thrombophlebitis • Prevent contractures

25. Range of Motion Exercises #2 • Frequency • At least three times each day • As indicated in the care plan

26. Range of Motion Exercises #3 • Techniques • Active ROM • Passive ROM • Active assistive ROM

27. 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

28. 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

29. Promoting Mobility • Procedures • Transfer techniques • Gait training • Training in self-transfer techniques • Use of gait belt for ambulation

30. Promoting Mobility #2 • Assistive devices • Cane • Walker • Wheelchair • Transfer board

31. Promoting Mobility #3 • Braces, splints and prostheses • Seeing eye dog • Braille • Modifications to accommodate wheelchair access • Disabled parking

32. 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

33. 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