All people involved in the caregiving process must be focused on the purpose of caregiving in the broadest sense to help the resident be as comfortable and functional for as long as possible. Restorative programs are at the core of this process. Residents should be allowed and encouraged to be as independent as possible. When a person can do the activities of daily living, like eating, it helps a person to feel like a person and helps them to keep their dignity.

Restorative programs provide services that enhance quality of life, promote independence of thought and function, enhance personal dignity, and prevent the complications associated with inactivity or immobility. The restorative plan is built on the resident’s strengths, needs, and problems for the purpose of helping the person achieve and maintain the highest practicable level of well being mentally, physically, and psychosocially. The well developed and implemented restorative program can have a significant positive impact on residents, clinical outcomes, and proper utilization of rehabilitative services, regulatory compliance, and payment. Restorative programs are developed and directed through the nursing department with coordination from therapy and other operational departments. Regulatory information and the MDS refer to nursing-based rehabilitative/restorative care.

When people speak about restorative programs, dining programs are among the first to be discussed. It is an important factor impacting many of our residents, but the priority of the program for an individual resident is impacted by that resident’s strengths, needs, and problems. The use of the information in the resident assessment protocols (RAPs) is very important when the restorative plan is being established. Restorative programs have the ability to integrate many RAPs into one plan and one set of interventions rather than many duplicative problems, goals, and interventions. A restorative dining program helps residents to increase their independence during meals while getting a complete diet.

Restorative dining programs use the skills of nursing, occupational therapy, speech therapy, a dietitian and others during dining. Residents in restorative dining programs may:

Nurses and/or nursing assistants should always be present in a restorative dining room so they can cue residents and help them increase their independence with meals. Once a resident’s independence is restored, the resident may be discharged from the program. If it is deemed that a resident’s independence will not be restored, the resident should be discharged from the program and a new care plan should be developed. This is a very important part of nursing care.

A well-managed restorative dining program can improve resident outcomes, promote well-being of residents and staff, reduce regulatory risk, and improve payment. Sound too good to be true? It works and is working well today in facilities that have integrated restorative care into the total scope of their care delivery process.