Chapter 36
Rehabilitation and Restorative Nursing Care
LEARNING OUTCOMES:
- 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
- Describe how rehabilitation can help the person with employment
- List the common rehabilitation programs and services
- Explain your role in rehabilitation and restorative care
- Explain how to promote quality of life
Body function can be affected by:
•Disease, injury, and surgery
•Birth injuries and birth defects
Often more than one function is lost.
•Losses are temporary or permanent.
A disability is any lost, absent, or impaired physical or mental function.
•Causes are acute or chronic.
•Disabilities are short-term or long-term.
•The person may depend totally or in part on others for basic needs.
The degree of disability affects how much function is possible.
•Goals of health care are:
To prevent and reduce the degree of disability
Helping the person adjust
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.
•Sometimes improved function is not possible.
Then the goal is to prevent further loss of function.
•Some persons return home after rehabilitation.
The process may continue in home or community settings.
RESTORATIVE NURSING
Restorative nursing care is care that helps persons regain health, strength, and independence.
Restorative nursing programs:
•Help maintain the highest level of function
•Prevent unnecessary decline in function
Restorative nursing may involve measures that promote:
•Self-care
•Elimination
•Positioning
•Mobility
•Communication
•Cognitive function
Many persons need restorative nursing and rehabilitation. Both focus on the whole person.
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.
•Required training varies among states.
REHABILITATION AND THE WHOLE PERSON
A disability has physical, psychological, and social effects.
•The person needs to adjust physically, psychologically, socially, and economically.
•Abilities are stressed.
•Complications are prevented.
Physical aspects
•Rehabilitation starts when the person first seeks health care.
•Complications are prevented.
Bowel and bladder problems are prevented.
Contractures and pressure ulcers are prevented.
•The following may be needed:
Good alignment, turning, and repositioning
Range-of-motion exercises
Supportive devices
Good skin care
Bladder training
Bowel training
Assistance with activities of daily living (ADL)
Self-help devices
Crutches or a walker, cane, or brace
Physical and occupational therapies
A prosthesis
Assistance with nutritional needs
Speech therapy and communication devices
Mechanical ventilation
Psychological and social aspects
•A disability can affect function and appearance.
Self-esteem and relationships may suffer.
•The person may deny the disability.
•The person may expect therapy to correct the problem.
•Successful rehabilitation depends on the person’s attitude.
•The focus is on abilities and strengths.
•Psychological and social needs are part of the care plan.
•Spiritual support helps some persons.
Economic aspects
•The goal is for the person to become gainfully employed.
REHABILITATION IS A TEAM EFFORT
The person is the key team member.
The family, doctor, nursing team, and other health team members help the person set goals and plan care.
•All help the person regain function and independence.
Families provide support and encouragement.
•Often they help with care when the person returns home.
Every part of your job focuses on promoting the person’s independence.
•Preventing decline in function also is a goal.
REHABILITATION PROGRAMS AND SERVICES
Common rehabilitation programs include:
•Cardiac rehabilitation
•Brain injury rehabilitation
•Spinal cord rehabilitation
•Stroke rehabilitation
•Respiratory rehabilitation
•Musculoskeletal rehabilitation
•Rehabilitation for complex medical and surgical conditions
The rehabilitation process may continue after the person leaves the hospital.
•The person may need nursing center care.
•Some persons transfer to rehabilitation agencies.
•Home care agencies, some assisted living residences, and some adult day-care centers also provide rehabilitation services.
QUALITY OF LIFE
The more the person can do alone, the better his or her quality of life.
To promote quality of life:
•Protect the right to privacy.
•Encourage personal choice.
•Protect the right to be free from abuse and mistreatment.
•Learn to deal with your anger and frustration.
•Encourage activities.
•Provide a safe setting.
•Show patience, understanding, and sensitivity.
Do not give pity or sympathy.