Restorative nursing is a specialized, goal-oriented approach used in long-term care and post-acute settings to help individuals achieve and maintain their highest possible level of independence and functional ability. It uses nursing interventions to promote a resident’s ability to adapt and adjust to living as safely and independently as possible. This care focuses on optimizing physical, mental, and psychosocial functioning, acting as a bridge in the continuum of care after an acute event or in the presence of chronic conditions.
The Core Philosophy of Restorative Care
The philosophy of restorative care revolves around maintenance and prevention of functional decline, rather than focusing solely on recovery from an acute injury or illness. This person-centered approach is integrated into the resident’s daily life, aiming to maximize current abilities and promote dignity through self-care activities. The goal is to support the individual’s achievement and maintenance of optimal physical, mental, and psychosocial functioning every day.
Restorative care often begins when a resident is discharged from intensive rehabilitation or when functional needs arise during a long-term stay. It is rooted in the belief that consistent gains or the retention of function over time significantly improves the resident’s quality of life. By encouraging residents to perform tasks they are capable of, the program helps prevent the loss of skills due to disuse, which is a common challenge in long-term care settings.
Restorative care serves as a long-term strategy for function retention, ensuring that progress made during intensive therapy is not lost once that therapy concludes. The focus shifts from the rapid, short-term recovery of a specific injury to the ongoing process of adapting to and living with a condition. This support helps individuals avoid unnecessary dependence on staff for activities they could perform themselves with encouragement and minimal assistance.
Specific Restorative Nursing Activities
Restorative nursing is implemented through hands-on actions and interventions, primarily carried out by trained Certified Nursing Assistants (CNAs) under the direction of a licensed nurse. These activities are integrated into the resident’s daily routine, turning routine care into a therapeutic opportunity. The activities are planned, scheduled, and documented, with measurable objectives established for performance.
Range of Motion (ROM) exercises are a common intervention. This includes Active ROM, where the resident moves the joint independently, or Passive ROM, where staff gently move the joints to prevent stiffness and contractures. Mobility assistance is another component, including walking programs, gait training, or building endurance, often with assistive devices. This systematic approach helps maintain or improve the resident’s ability to move safely within the facility.
Toileting and continence management programs focus on implementing an individualized schedule based on the resident’s elimination patterns. The goal is to help the resident regain or maintain bowel and bladder control, which directly impacts dignity and reduces the risk of complications like skin breakdown. Feeding and swallowing assistance focuses on promoting independence at mealtimes, using techniques and adaptive equipment to allow the resident to feed themselves.
Restorative aides also manage specialized equipment and provide training in daily living skills.
Key Restorative Activities
Restorative nursing activities often include:
- Splint and Brace Assistance, involving the scheduled application and removal of devices, along with assessing the resident’s skin and circulation.
- Bed mobility training to improve the resident’s ability to move to and from a lying position.
- Dressing or grooming programs to maintain self-performance in personal hygiene tasks.
- Ambulation and mobility assistance.
Restorative Nursing Versus Intensive Rehabilitation
Restorative nursing and intensive rehabilitation, such as Physical, Occupational, or Speech Therapy, serve distinct, though complementary, purposes in the continuum of care. Formal rehabilitation is short-term, intensive, and triggered by an acute event like a fracture, stroke, or major surgery. It is provided by licensed therapists and focuses on rapid, measurable recovery and the retraining of lost skills.
Rehabilitation works under the medical model, requiring the resident to make significant functional progress in a short timeframe. Once the resident reaches their maximum potential or skilled therapy goals are met, the intensive therapy often concludes. Restorative nursing, in contrast, is based on the nursing model and is a long-term, ongoing process.
Restorative care takes over where formal therapy ends, focusing on maintaining the skills gained or preventing further decline in chronic conditions. Rehabilitation involves specialized, hands-on treatment from a therapist, while restorative nursing interventions are integrated into the daily care routine. These interventions are primarily carried out by trained nursing assistants under the supervision of a licensed nurse. The intent of restorative nursing is function maintenance and long-term adaptation, making it a continuous component of a resident’s life.