Ask the care expert: What is the difference between rehab nursing and restorative nursing?

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Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
Q: When I hear “nursing restorative programs,” are providers talking about only walking, like for physical therapy? I'm not sure I know the difference between rehab and nursing therapy.

A: Restorative nursing is not rehabilitation therapy. Rehab and restorative nursing are complements to one another, but they are not the same.

Residents work to keep up their skill level for the programs and things they learned in rehab therapy in nursing restorative programs. Therapy is based on the medical model and restorative programs are based on the nursing model. Rehab therapy is done at a much faster pace. 

In order for Medicare to pay for these programs, there must be significant improvement. Restorative is for the most part started when the skilled (physical, occupational and speech) therapy is discontinued. Restorative nursing programs may involve a toileting program for an incontinent resident, an indwelling catheter, a decline in range of motion, a decline in late loss ADLs-bed mobility, transfers, toilet use and eating. Preventing decline may be the only reason for doing a restorative program.

The MDS and other assessments that may be required can determine the need for a restorative program.

Your restorative staff should work closely with therapies. Before a resident is discharged from formalized rehab therapy, the staff should be observing how the resident is doing. For instance, they may be walking 10 feet, and it is determined that they have reached their max potential. Now, restorative's job is to keep them from declining once the rehab therapy is done. You want them to maintain walking the 10 feet, even though their formalized rehab therapy has ended. The goal is to prevent decline.

Please send your resident care-related questions to Sherrie Dornberger at ltcnews@mcknights.com.

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