7.4 Restorative Care, ROM, Ambulation, and Independence
Key Takeaways
- Restorative care helps residents maintain or regain function.
- Range of motion prevents stiffness and contractures but must never be forced.
- Ambulation supports strength, circulation, mood, and independence.
- Use assistive devices and care-plan instructions exactly.
- Report pain, dizziness, weakness, shortness of breath, or refusal during restorative care.
Restorative Care Goals
Restorative care focuses on what the resident can still do and what function can be maintained. It is not just exercise. It supports dignity and independence.
Examples include:
- Ambulation programs.
- Range-of-motion exercises.
- Splint or positioning routines.
- Self-feeding encouragement.
- Grooming independence.
- Toileting schedules.
- Transfer practice.
Range Of Motion
ROM exercises move joints through their normal range. Passive ROM means the CNA moves the limb for the resident. Active ROM means the resident does the movement.
Rules:
- Explain the procedure.
- Support above and below the joint.
- Move slowly and smoothly.
- Stop if pain occurs.
- Do not force beyond free movement.
- Ask about discomfort.
- Follow the care plan.
Ambulation
Before walking a resident, check the care plan, footwear, assistive device, gait belt need, and resident condition.
Report dizziness, shortness of breath, chest pain, sudden weakness, or unsteady gait. Do not keep walking because a goal sheet says a certain distance.
Independence
Promoting independence means allowing safe self-care even if it takes longer. A resident who brushes part of their hair, washes their face, or buttons one button is using ability.
Exam Tip
The exam favors independence with safety. Avoid answers where the CNA takes over everything, rushes the resident, or forces movement.
During passive range of motion, the CNA feels resistance and the resident reports pain. What should the CNA do?
Which action promotes independence?