Impact of a restorative care program in the nursing home

The purpose of this study was to determine the impact of a progressive mobility restorative program on nursing home residents' ability to perform selected activities of daily living (ADLs) and the amount of staff assistance needed to help residents complete these ADLs. A one group repeated measures design study was conducted in a 255-bed university affiliated geriatrics center. A certified nursing assistant (CNA) specially trained in restorative mobility techniques worked with residents individually for at least 15 minutes per day, five days per week to achieve their individualized mobility goals. Items on ADL Self-Performance and ADL Support Provided from the Minimum Data Set (MDS) were collected at baseline, three months, and six months. Thirty-eight of 42 residents (90%) were included in the analyses and 31 residents (82%) completed at least 25 days of restorative activities. Some residents improved their ADL self-performance at three and six months (15% and 33%, respectively) and decreased in the amount of ADL support provided at three and six months (26% and 31%, respectively). Total ADL self-performance and support provided did not change significantly over the six-month period. Most residents maintained their baseline ADL self-performance and level of ADL support provided over the six-month study. A progressive mobility restorative program implemented by a certified nursing assistant specially trained in restorative techniques resulted in most residents maintaining their baseline ADL self-performance abilities and the level of assistance provided by staff. Studies are needed to determine if these types of programs can actually improve functional abilities and decrease the level of staff assistance needed to complete ADLs or if they are effective in maintaining or delaying functional loss and staff burden.