Rehabilitation and restorative nursing care
Objectives
• Define the key terms and key abbreviations listed in this chapter.
• Describe how rehabilitation and restorative care involve the whole person.
• Identify the complications to prevent.
• Identify the common reactions to rehabilitation.
• List the common rehabilitation programs and services.
• Explain your role in rehabilitation and restorative care.
Key terms
activities of daily living (ADL) The activities usually done during a normal day in a person’s life
disability Any lost, absent, or impaired physical or mental function
prosthesis An artificial replacement for a missing body part
rehabilitation The process of restoring the person to his or her highest possible level of physical, psychological, social, and economic function
restorative aide A nursing assistant with special training in restorative nursing and rehabilitation skills
restorative nursing care Care that helps persons regain health, strength, and independence
KEY ABBREVIATIONS
| ADL | Activities of daily living |
| ROM | Range-of-motion |
Disease, injury, and surgery can affect body function. So can birth injuries and birth defects (Chapter 45). Often more than one function is lost. Losses are temporary or permanent. Eating, bathing, dressing, and walking are hard or seem impossible. Some persons cannot work. Others cannot care for children or family.
A disability is any lost, absent, or impaired physical or mental function. Causes are acute or chronic (Box 46-1).
Disabilities are short-term or long-term. A leg fracture is short-term. The person has a cast. Crutches are used until the bone heals. A spinal cord injury is long-term if paralysis results.
The person may depend totally or in part on others for basic needs. The degree of disability affects how much function is possible.
A goal of health care is to prevent and reduce the degree of disability. Helping the person adjust is another goal. Rehabilitation is the process of restoring the person to his or her highest possible level of physical, psychological, social, and economic function. The focus is on improving abilities. This promotes function at the highest level of independence. For some persons the goal is to return to a job. For others, self-care is the goal. Sometimes improved function is not possible. Then the goal is to prevent further loss of function. This helps the person maintain the best possible quality of life.
Some nursing center residents have physical disabilities. Causes include strokes, fractures, amputations, and injuries. They need to regain function or adjust to a long-term disability. Often these residents return home. The rehabilitation may continue in home or community settings.
Restorative nursing
Some persons are weak. Many cannot perform daily functions. They need restorative nursing care. Restorative nursing care is care that helps persons regain health, strength, and independence. With progressive illnesses, the person becomes more and more disabled. Restorative nursing programs:
Restorative nursing may involve measures that promote:
Many persons need restorative nursing and rehabilitation. Often it is hard to separate them. In many centers, they mean the same thing. Both focus on the whole person.
Restorative aides
Some centers have restorative aides. A restorative aide is a nursing assistant with special training in restorative nursing and rehabilitation skills. These aides assist the nursing and health teams as needed.
Usually nursing assistants are promoted to restorative aide positions. Professional behaviors are highly valued when considering staff to promote. Restorative aides need patience, kindness, and good communication skills. Those chosen have a positive attitude and excellent work ethics, job performance, and skills. Required training varies among states. If there are no state requirements, the center provides needed training.
Rehabilitation and the whole person
A health problem has physical, psychological, and social effects. So does a disability. Suppose an illness left you paralyzed from the waist down.
• Would you be angry, afraid, or depressed?
• How would you care for yourself?
• How would you care for your family?
• How would you worship, shop, or visit friends?
The person needs to adjust physically, psychologically, socially, and economically. Abilities—what the person can do—are stressed. Complications are prevented. They can cause further disability.
Rehabilitation takes longer in older persons than in other age-groups. Changes from aging affect healing, mobility, vision, hearing, and other functions. Chronic health problems can slow recovery. Older persons also are at risk for injuries. Fast-paced rehabilitation programs are hard for them. Their programs usually are slower-paced.
Physical aspects
Rehabilitation starts when the person first seeks health care. Complications are prevented. They can occur from bedrest, a long illness, or recovery from surgery or injury. Bowel and bladder problems are prevented. So are contractures and pressure ulcers. Good alignment, turning and re-positioning, range-of-motion (ROM) exercises, and supportive devices are needed (Chapters 16, 17, and 26). Good skin care also prevents pressure ulcers (Chapters 20 and 36).
Elimination
Some persons need bladder training (Chapter 22). The method depends on the person’s problems, abilities, and needs. Some need bowel training (Chapter 23). Control of bowel movements and regular elimination are goals. Fecal impaction, constipation, and fecal incontinence are prevented. Follow the care plan and the nurse’s instructions.
Self-care
Self-care is a major goal. Activities of daily living (ADL) are the activities usually done during a normal day in a person’s life. ADL include bathing, oral hygiene, dressing, eating, elimination, and moving about. The health team evaluates the person’s ability to perform ADL. The need for self-help devices is considered.
Sometimes the hands, wrists, and arms are affected. Self-help devices are often needed. Equipment is changed, made, or bought to meet the person’s needs.
• Eating devices include glass holders, plate guards, and silverware with curved handles or cuffs (Chapter 24). Some devices attach to splints (Fig. 46-1).
• Electric toothbrushes are helpful. They have back-and-forth brushing motions for oral hygiene.
• Longer handles attach to combs, brushes, and sponges. Or the devices have long handles. See Chapters 20 and 21.
• Self-help devices are useful for cooking, dressing, writing, phone calls, and other tasks. Some are shown in Figure 46-2.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
