Chapter 38 Rehabilitation and Restorative Nursing Care

1. Chapter 38Rehabilitation and Restorative Nursing Care

2. Disability • 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.

3. Disability (cont’d) • A disability is any lost, absent, or impaired physical or mental function. • Causes are: • Acute—short course; recovery is complete. • Chronic—long course; problem is controlled–not cured-with treatment. • 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: • Prevent and reduce the degree of disability. • Help the person adjust.

4. Rehabilitation • 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. • The goal may be to return to work. • Another goal is self-care. • Improved function is sometimes 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.

5. 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 • Involve measures that promote: • Self-care • Elimination • Positioning • Mobility • Communication • Cognitive function

6. Restorative Nursing (cont’d) • 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.

7. 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.

8. Rehabilitation and the Whole Person (cont’d) • Physical aspects • Rehabilitation starts when the person first seeks health care. • Complications are prevented. • Bowel and bladder problems are prevented. • Contractures and pressure injuries are prevented.

9. Rehabilitation andthe Whole Person (cont’d) • The following may be needed: • Good alignment, turning, and re-positioning • 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

10. Rehabilitation andthe Whole Person (cont’d) • 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.

11. The Rehabilitation Team • Rehabilitation is a team effort. • The person is the key team member. • The family, doctor, and nursing and health teams help the person set goals and plan care. • The focus is on regaining function and independence. • Families provide support and encouragement. • Often, they help with home care. • Your job focuses on promoting the person’s independence. • Preventing decline in function also is a goal.

12. Rehabilitation Programsand Services • Common rehabilitation programs include: • Cardiac rehabilitation • Brain injury rehabilitation • Spinal cord rehabilitation • Stroke rehabilitation • Respiratory rehabilitation • Musculo-skeletal rehabilitation • Rehabilitation for complex medical and surgical conditions

13. Rehabilitation Programsand Services (cont’d) • The rehabilitation process may continue after hospital discharge. • The person may transfer to a nursing center or to a rehabilitation agency. • Home care agencies, some assisted living residences, and some adult day-care centers also provide rehabilitation services.

14. Quality of Life • Successful rehabilitation and restorative care improve 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.