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

Terminology #2 –F–F–F–Flotation pad –T–T–T–Trochanter rolls –H–H–H–Heel protector / elbow protector –A–A–A–Assistive devices –P–P–P–Passive range of motion –A–A–A–Active-assistive range of motion

Terminology #3 Terminology #3 –D–D–D–Disability –A–A–A–Atrophy –A–A–A–Alternating pressure mattress –A–A–A–Activities of daily living –P–P–P–Pressure sores –I–I–I–Independence –A–A–A–Ambulation –J–J–J–Joint –W–W–W–Water bed

Terminology #4 –S–S–S–Stasis pneumonia –T–T–T–Thrombophlebitis –T–T–T–TCDB –P–P–P–Phlebitis –E–E–E–Embolism –H–H–H–Hemiplegia

Terminology #5 –Quadriplegia –Paralysis –Paraplegia –Clinitron bed –Contractures –Decubiti

Discuss rehabilitation 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 ClergyDietitian

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 TrapezeSheepskin

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