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Unit 13 Basic Restorative Services

Unit 13 Basic Restorative Services. Nurse Aide I Course. Basic Restorative Services. Introduction This unit explores various aspects of restorative care and the role of the nurse aide in this process.

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Unit 13 Basic Restorative Services

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  1. Unit 13Basic Restorative Services Nurse Aide I Course DHSR Approved Curriculum-Unit 13

  2. Basic Restorative Services Introduction This unit explores various aspects of restorative care and the role of the nurse aide in this process. Disease, injuries and surgery are often responsible for the loss of a body part or the loss of bodily function. DHSR Approved Curriculum-Unit 13

  3. Basic Restorative Services(continued) Introduction Working with the elderly and disabled requires a great deal of patience, caring and understanding from health care workers. Working together to assist the resident to attain the highest possible level of functioning can be a very challenging and rewarding experience. DHSR Approved Curriculum-Unit 13

  4. Rehabilitation/ Restoration DHSR Approved Curriculum-Unit 13

  5. Objective 13.0 Demonstrate skills which incorporate principles of restorative care under the direction of the supervisor. DHSR Approved Curriculum-Unit 13

  6. Rehabilitation/Restoration • Definition - process of restoring disabled individual to highest level of physical, psychological, social and economic functioning possible DHSR Approved Curriculum-Unit 13

  7. Rehabilitation/Restoration(continued) • Emphasis on existing abilities • Encourages independence • Promotes productive lifestyle DHSR Approved Curriculum-Unit 13

  8. Rehabilitation/Restoration(continued) • Goals include: • Prevention of complications • Retraining in lost skills • Learning new skills DHSR Approved Curriculum-Unit 13

  9. Objective 13.1 Identify the nurse aide’s role in rehabilitation/restoration. DHSR Approved Curriculum-Unit 13

  10. Rehabilitation/Restoration(continued) • Nurse Aide’s Role • Encourage resident • Praise accomplishments • Review skills taught • Report progress or need for additional teaching DHSR Approved Curriculum-Unit 13

  11. Rehabilitation/Restoration(continued) • Nurse Aides Role (continued) • Promote independence • praise all attempts at independence • overlook failures • show confidence in resident’s ability DHSR Approved Curriculum-Unit 13

  12. Rehabilitation/Restoration(continued) • Nurse Aides Role (continued) • Promote independence (continued) • be patient and allow time for residents to do things for themselves • Be sensitive and understanding DHSR Approved Curriculum-Unit 13

  13. Self-Care According To Resident's Capabilities DHSR Approved Curriculum-Unit 13

  14. Objective 13.2 Provide training in and the opportunity for self-care according to the resident’s capabilities. DHSR Approved Curriculum-Unit 13

  15. Self-Care According To Resident’s Capabilities • Training in self-care requires that three questions be answered prior to starting: • What is the goal to be achieved? • What approaches are used to help the resident achieve the goal? • How will progress or lack of progress be measured? DHSR Approved Curriculum-Unit 13

  16. Self-Care According To Resident’s Capabilities(continued) • Resident included in goal-setting process, whenever possible. DHSR Approved Curriculum-Unit 13

  17. Self-Care According To Resident’s Capabilities(continued) • Functional losses cause: • Resentment • Anger • Frustration • Withdrawal • Depression • Grief DHSR Approved Curriculum-Unit 13

  18. Guidelines To Assist With Restorative Care And Training • Assist resident to do as much as possible for himself/herself • Be realistic • Never offer false hope • Explain what is going to be done • Begin tasks at resident’s level of functioning DHSR Approved Curriculum-Unit 13

  19. Guidelines To Assist With Restorative Care And Training(continued) • Provide encouragement and reinforcement • Praise successes • Emphasize abilities • Treat resident with respect • Explain what resident needs to accomplish, and how you will help. DHSR Approved Curriculum-Unit 13

  20. Guidelines To Assist With Restorative Care And Training(continued) • Accept residents and encourage them to express their feelings • Help to put new skills into use immediately • Assist the resident to recognize his or her progress DHSR Approved Curriculum-Unit 13

  21. Self-Care According To Resident’s Capabilities • Treatment initiated by: • Physical therapist • Occupational therapist • Speech therapist • Licensed nurse DHSR Approved Curriculum-Unit 13

  22. Self-Care According To Resident’s Capabilities(continued) • ADL considerations for resident: • Resident to control how and when activities carried out, when possible • Use tact in making resident aware of hygiene needs DHSR Approved Curriculum-Unit 13

  23. Self-Care According To Resident’s Capabilities(continued) • ADL considerations for resident (continued): • Encourage use and selection of clothing • Be patient and allow time for slower paced activities DHSR Approved Curriculum-Unit 13

  24. Self-Care According To Resident’s Capabilities(continued) • ADL considerations for resident (continued): • Provide for rest periods • Assist to exercise • Promote independence by having do as much of activity, as possible • Encourage use of adaptive devices DHSR Approved Curriculum-Unit 13

  25. Bowel And Bladder Retraining DHSR Approved Curriculum-Unit 13

  26. Objective 13.3 Discuss methods for assisting with bowel and bladder retraining. DHSR Approved Curriculum-Unit 13

  27. Bowel And Bladder Retraining • Incontinence: Inability to control urination or defecation • Embarrassing for resident • Uncomfortable DHSR Approved Curriculum-Unit 13

  28. Plan Bowel Retraining • Plan developed to assist to return to normal elimination pattern and recorded on care plan • Information collected: • bowel pattern before incontinence • present bowel pattern • dietary practices DHSR Approved Curriculum-Unit 13

  29. Plan Bowel Retraining(continued) • Participants in plan • resident • family • all staff members DHSR Approved Curriculum-Unit 13

  30. Guidelines For Bowel Retraining • Enemas may be ordered by physician and given by nurse aide, as directed by supervisor • Regular, specific times to evacuate bowels established • Fluids encouraged on regular basis DHSR Approved Curriculum-Unit 13

  31. Guidelines For Bowel Retraining(continued) • High bulk foods given, if not restricted • fruits • vegetables • bread • bran cereals DHSR Approved Curriculum-Unit 13

  32. Guidelines For Bowel Retraining(continued) • Bowel aids ordered by physician and administered by licensed nurse only: • laxatives • suppositories • stool softeners • Regular exercise encouraged DHSR Approved Curriculum-Unit 13

  33. Ways nurse aide can assist with defecation process: offer bedpan on set schedule assist to bathroom when request is made provide privacy display unhurried attitude Guidelines For Bowel Retraining(continued) DHSR Approved Curriculum-Unit 13

  34. Guidelines For Bowel Retraining(continued) • Ways nurse aide can assist with defecation process (continued): • offer warm drink • be patient • encourage with positive remarks • do not scold when accidents happen (abuse) • check on resident frequently DHSR Approved Curriculum-Unit 13

  35. Plan developed to assist to return to normal voiding pattern and recorded on care plan Staff must be consistent and follow plan Plan Bladder Retraining DHSR Approved Curriculum-Unit 13

  36. Individualized plan includes: schedule that specifies time and amount of fluids to be given schedule for attempting to void Schedule Bladder Retraining DHSR Approved Curriculum-Unit 13

  37. Guidelines for Bladder Retraining • Get resident’s cooperation • Record incontinent times • Provide with opportunities to void: • when resident awakens • one hour before meals • every two hours between meals • before going to bed • during night, as needed DHSR Approved Curriculum-Unit 13

  38. Guidelines for Bladder Retraining(continued) • Provide for comfortable voiding position • Be supportive and sensitive • Provide encouragement • Offer fluids according to schedule DHSR Approved Curriculum-Unit 13

  39. Guidelines for Bladder Retraining(continued) • Provide stimuli as needed: • run water in sink • pour water over perineum • offer fluids to drink • place hands in warm water DHSR Approved Curriculum-Unit 13

  40. Week 6 Week 5 Week 4 Week 3 Week 2 Week 1 Guidelines for Bladder Retraining(continued) • Provide good skin care to prevent skin breakdown • Retraining may take 6-10 weeks • be patient • be supportive • ignore accidents • respect resident’s feelings DHSR Approved Curriculum-Unit 13

  41. Guidelines for Bladder Retraining(continued) • Follow facility procedure for use of: • incontinent pads • adult protective pants • incontinent briefs DHSR Approved Curriculum-Unit 13

  42. Adaptive Devices For Assisting With Activities of Daily Living (ADL) DHSR Approved Curriculum-Unit 13

  43. Objective 13.4 Identify ways to assist the resident in activities of daily living and encourage self-help activities. DHSR Approved Curriculum-Unit 13

  44. Adaptive Devices For Assisting With Activities of Daily Living (ADL) • Special utensils available to help with eating • Electric toothbrushes for brushing teeth • Long-handled brushes and combs for hair care DHSR Approved Curriculum-Unit 13

  45. Adaptive Devices For Assisting With Activities of Daily Living (ADL)(continued) • Supportive devices to assist with walking – canes, crutches, walkers • Wheelchairs and motorized chairs to provide movement from place to place DHSR Approved Curriculum-Unit 13

  46. Adaptive Devices For Assisting With Activities of Daily Living (ADL)(continued) • Prosthesis to replace missing body parts • Successful use of adaptive devices depends on the resident’s: • attitude • acceptance of limitations • motivation • support from others DHSR Approved Curriculum-Unit 13

  47. Ambulation Devices And Transfer Aids DHSR Approved Curriculum-Unit 13

  48. Objective 13.5 Discuss the various ambulation devices and transfer aids. DHSR Approved Curriculum-Unit 13

  49. Ambulation Devices And Transfer Aids • Walker - four-point aid with rubber tips • Resident stands erect when moving walker forward • Walker adjusted to height of hip joint • Elbows at 15-30 degree angle • Walker picked up and put down, not slid DHSR Approved Curriculum-Unit 13

  50. Walker - four-point aid with rubber tips (continued) Back legs of walker even with toes so resident walks into walker Resident steps toward center of walker Leads with weaker leg Ambulation Devices And Transfer Aids(continued) DHSR Approved Curriculum-Unit 13

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