A person of any age who suffers serious illness or injury may require rehabilitation and/or restorative care. Rehabilitation services employ therapists to help people regain physical function. Restorative nursing care is ongoing and may be provided in long-term care or skilled nursing facilities (commonly known as nursing homes), often following rehabilitation. Licensed and paraprofessional staff provide restorative care to preserve a person's optimum level of functioning and independence, according to "Hartman's Nursing Assistant Care."
According to a PBS special report, early in the 20th century the elderly poor often lived in state-sponsored almshouses where quality of care was inadequate. With the passage of the Social Security Act in 1935, private institutions for elder care became eligible to receive federal funds and the stigma of senior care homes began to fade. However, scandals in the 1960s preceded new federal guidelines for the care and treatment of the elderly. The Omnibus Reconciliation Act of 1987 was the largest nursing home reform bill. Today, the industry standards include patients' rights, family support and restorative care.
The goal of restorative nursing care is to maximize a person's level of function and minimize decline. With training, nursing assistants and physical therapy assistants engage people to participate in their care by encouraging them to make decisions. These activities include allowing people to participate as much as possible in their daily activities, including bathing, dressing and going to the bathroom. Restorative care also includes physical activity while promoting safety--for example, instructing a person on how to safely transfer to bed from a wheelchair. Restorative care aides reinforce the training people receive from physical, speech and respiratory therapy.
Assessing Need for Restorative Care
Restorative care can be provided in a person's home, assisted living or nursing home. Functional decline may occur gradually and involve sensory deficits like vision loss or may be the result of surgery, illness or trauma, such as a fall. A nursing home stay can be temporary for someone who no longer requires acute hospital care but needs to be monitored to ensure medical and functional stability before returning home. Nursing home residents generally have chronic disease or disability and require physical assistance with personal care, meals and medical treatments.
Choosing a Facilty
"Long-Term Care: How to Plan and Pay for It" suggests families consider their own time commitments, finances and the cost of care. Medicaid certification signals that a facility demonstrates adequate compliance with federal guidelines in order to receive state and private insurance funds. Recommendations from the community can help narrow the search as well. When touring a facility, determine if restorative activities are in place to promote autonomy, safety and function, such as a fall prevention exercise program for the residents.
Financing a Facility Stay
A 2009 CDC report states that 131 billion dollars were spent on nursing home care in 2007. Some pay out of pocket for long-term care, and many others use Medicaid or private long-term insurance care policies. State Medicaid programs limit the types and amounts of assets a person can hold and still qualify for Medicaid. Long-term care insurance may cover home care, assisted living and restorative nursing home care, depending on the policy. It can be a good investment, considering family and personal medical history and resources.
- "Hartman's Nursing Assistant Care: Long-Term Care"; Susan Alvare, Jetta Fuzy R.N., M.S., and Susan Rymer M.S.T.E., R.N.-B.C., L.S.W.; 2010
- The Online Newshour: The Evolution of Nursing Home Care in the United States
- "Long-Term Care: How to Plan and Pay For It"; Joseph L. Matthews; 2004
- Centers for Disease Control and Prevention: Health, United States, 2009