Unit 48 Rehabilitation and Restorative Services Copyright 2008

Objectives • Spell and define terms. • Compare and contrast rehabilitation and restorative care. • Identify five members of the interdisciplinary team. Copyright © 2008 Delmar Learning. All rights reserved.

Objectives • Describe the role of the nursing assistant in rehabilitation. • Describe the principles of rehabilitation and restorative care. • List the elements of successful rehabilitation/restorative care. Copyright © 2008 Delmar Learning. All rights reserved.

Objectives • List six complications resulting from inactivity. • Describe four perceptual deficits. • Describe four approaches used for restorative programs. • List the guidelines for implementing restorative programs. Copyright © 2008 Delmar Learning. All rights reserved.

Introduction to Rehabilitation and Restorative Care • Rehabilitation refers to a process in which the patient is assisted in reaching an optimal level of ability. Copyright © 2008 Delmar Learning. All rights reserved.

Introduction to Rehabilitation and Restorative Care • This means the health care team is concerned with helping the patient be the best he or she can be physically, mentally, and emotionally. Copyright © 2008 Delmar Learning. All rights reserved.

Reasons for Rehabilitation/Restorative Care • A person may need rehabilitation because of a disability. • A disability exists – When a person has an impairment that affects his or her ability to perform an activity that a person of the same age would normally be able to perform. Copyright © 2008 Delmar Learning. All rights reserved.

Reasons for Rehabilitation/Restorative Care • A handicap exists – If a disability limits or prevents a person from fulfilling a role that is normal for that person. Copyright © 2008 Delmar Learning. All rights reserved.

Reasons for Rehabilitation/Restorative Care • Rehabilitation and restorative care – Teach persons with disabilities new ways of doing routine tasks, such as dressing or bathing. Copyright © 2008 Delmar Learning. All rights reserved.

Reasons for Rehabilitation/Restorative Care • The programs help patients become as independent as possible • Patients with severely limiting conditions such as tetraplegia – Are taught how to verbally direct staff in their care to accomplish the results they want Copyright © 2008 Delmar Learning. All rights reserved.

The Interdisciplinary Health Care Team • Physicians who specialize in rehabilitation are called physiatrists. • Nurses and nursing assistants who work in rehabilitation receive additional training and education. • Many other disciplines may be involved in the rehabilitation process. Copyright © 2008 Delmar Learning. All rights reserved.

The Role of the Nursing Assistant in Rehabilitation • Nursing assistant help with: – Procedures to prevent complications – Mobility skills – Bathing and personal care procedures – Bowel and bladder training programs – Maintaining the patients’ nutritional status – Programs to increase the patients’ independence Copyright © 2008 Delmar Learning. All rights reserved.

Principles of Rehabilitation • Four principles: – Treatment begins as soon as possible – Stress the patient’s ability, not disability – Activity strengthens and inactivity weakens – Treat the whole person Copyright © 2008 Delmar Learning. All rights reserved.

Rehabilitation versus Restorative Nursing Care • Rehabilitation and restorative nursing complement each other – They are not competing programs or services Copyright © 2008 Delmar Learning. All rights reserved.

Rehabilitation versus Restorative Nursing Care • Following the restorative program reinforces what therapists are teaching – So the patient masters the skill more quickly – This is called restoration Copyright © 2008 Delmar Learning. All rights reserved.

Complications from Inactivity • People with disabilities may be unable to move about at will. • Inactivity or immobility can result in numerous complications affecting the body systems. Copyright © 2008 Delmar Learning. All rights reserved.

Activities of Daily Living • One purpose of restorative care – To increase the patient’s physical abilities • These include mobility skills and the ability to carry out activities of daily living (ADLs) Copyright © 2008 Delmar Learning. All rights reserved.

Activities of Daily Living • These tasks or skills are taught to us as children. • Healthy adults do them automatically. • If a patient cannot complete any or all of the ADLs – A self-care deficit exists Copyright © 2008 Delmar Learning. All rights reserved.

Restorative Programs • If a patient has the potential to relearn an ADL and is motivated to try: – A restorative program is planned. • Restorative programs are sometimes called retraining programs or ADL programs. Copyright © 2008 Delmar Learning. All rights reserved.

Restorative Programs • Make the task part of the regular routine so it is

Restorative Programs • Use the restorative care plan approaches each time the task must

Restorative Programs • When all staff use the same care plan approaches – Patient masters the task much faster. • Do the task at the normal time of day the task should be done. Copyright © 2008 Delmar Learning. All rights reserved.

Approaches Used in Restorative Programs • It is important that the same approach be used consistently in terms of: – Setup – Verbal cues – Hand-over-hand techniques – Demonstration Copyright © 2008 Delmar Learning. All rights reserved.

Adaptive Devices • Adaptive devices change the way the tasks are done – Enabling the patient to perform the skill independently – Refer to Figure 48 – 11 Copyright © 2008 Delmar Learning. All rights reserved.

Adaptive Devices Copyright © 2008 Delmar Learning. All rights reserved.

Adaptive Devices • Care plan will provide instructions in the types of devices used by patients. • Your role: – To make sure the device is clean, available, and used by the patient. – You may need to work on the skill with the patient when he or she is learning to use the device. Copyright © 2008 Delmar Learning. All rights reserved.

Communication • Use the restorative philosophy when communicating with the patient. • Avoid statements

Communication • Instead say, “You can use your left hand. ” • Allow the patient to struggle a little, but intervene before it progresses to the point of frustration. Copyright © 2008 Delmar Learning. All rights reserved.

The Restorative Environment • All patients benefit from living in an environment that attempts to improve their quality of life. • The interdisciplinary team can help promote this environment. Copyright © 2008 Delmar Learning. All rights reserved.

The Restorative Environment • Compliment the patient for making progress – Even if his

The Restorative Environment • It is better for the resident to complete part of a task than it is for you to perform the task. • Allow the patient to do what he or she can – Then finish the task without complaint Copyright © 2008 Delmar Learning. All rights reserved.