Restorative care is a philosophy focused on helping individuals maintain or improve their highest level of independent function following an illness, injury, or intensive medical treatment. It is an ongoing, supportive approach integrated into a person’s daily life, especially within long-term care settings. The primary goal is to maximize functional ability and prevent the physical and psychosocial decline that can accompany chronic conditions. This care seeks to prolong independence and enhance the overall quality of life for the patient.
Defining Restorative Care’s Purpose
Restorative care (RC) is distinct from the more intensive, goal-oriented therapy known as rehabilitation. Rehabilitation, which includes physical, occupational, and speech therapy, is typically time-limited, often following an acute event like a stroke or hip fracture. It is considered “skilled care” and is provided by licensed therapists whose objective is to help a patient achieve rapid, documented progress toward a specific functional goal.
In contrast, restorative care is a non-skilled, ongoing nursing intervention that focuses on sustaining functional gains made during rehabilitation or compensating for skills lost due to chronic conditions. The objective shifts from rapid improvement to long-term maintenance and slowing functional decline. RC is considered a nursing model of care, whereas rehabilitation is a medical model.
Activities within a restorative program are integrated into a patient’s routine and can include range of motion exercises, assistance with ambulation, and structured feeding programs. These activities are consistently carried out by nursing staff, such as Certified Nursing Assistants (CNAs), rather than licensed therapists. The aim is to promote the patient’s ability to adapt and adjust to living as safely and independently as possible.
The Initial Assessment and Eligibility Determination
The decision to begin a formal restorative care program is most frequently triggered when a patient reaches a plateau or is discharged from intensive rehabilitation services. When a licensed therapist determines that a patient has achieved their highest level of measurable function, the shift from skilled therapy to long-term maintenance care becomes appropriate. This moment marks the transition to the restorative phase of the patient’s recovery journey.
A formal assessment process is mandatory in certified long-term care settings to determine eligibility for restorative care. The Minimum Data Set (MDS) is a federally mandated assessment tool used in facilities that receive Medicare or Medicaid reimbursement. The MDS and its associated Resident Assessment Instrument (RAI) process evaluate a patient’s functional status, including their ability to perform activities of daily living (ADLs) and cognitive status.
Restorative care officially begins after this comprehensive assessment confirms the patient is appropriate and a structured care plan is developed and implemented. For a restorative nursing program to be formally recognized and coded on the MDS, it must meet specific criteria. This often requires a minimum of two qualifying programs to be performed for at least 15 minutes each, six days a week.
Transitioning to Long-Term Restorative Programming
Once eligibility for restorative care is determined, the program transitions into the daily, long-term routine of the patient’s life. Certified Nursing Assistants (CNAs) and nursing staff become the primary deliverers of this care, acting under the direction of a supervising nurse and a structured plan. The care is integrated seamlessly into the daily schedule, such as a CNA assisting with ambulation during a walk to the dining room or performing range of motion exercises during bathing.
Consistent and accurate documentation is required for the program’s success and regulatory compliance. Nursing assistants must record when and how long the restorative care activity was performed. This ensures the facility can demonstrate the patient is receiving the prescribed level of care and supports the data collected during periodic MDS assessments.
Restorative care is designed to be a long-term, ongoing process that continues as long as the patient demonstrates a benefit or a need. The patient’s condition and the appropriateness of the program are subject to required periodic reviews, such as quarterly assessments or when there is a significant change in functional status. This review process ensures the program remains relevant, allowing for adjustments to the care plan to maximize independence.