Restorative care appears to lower emergency department visits and falls
Research Activities, December 2012, No. 388
Restorative care is a philosophy of care that focuses on restoring and maintaining nursing home residents at their highest possible functional and physical status, given underlying conditions. Unfortunately, this care is not consistently provided, since many caregivers in long-term care settings worry that encouraging more activity may boost residents' risk of falls and associated trauma. However, a new study found that a restorative care (res-care) intervention that encouraged residents to engage in activities did not result in increased risks of falling, injury, or other adverse events. Researchers tested the effectiveness of the res-care intervention, looked at adverse events (including falls, fractures, emergency department visits, hospitalizations, and deaths), and monitored the 256 nursing home participants to ensure that the intervention did not elevate their risk of adverse events. In fact, there was a potential protective effect on emergency department visits at 4 months and the proportion of fallers at 12 months compared with the rates 2 months before implementation of the intervention.
The res-care intervention activities were initiated by a research restorative care nurse (RCN) trained and supported by the investigative team. The RCN worked with the nursing assistants for 20 hours a week over the 12-month intervention period. Motivational techniques to encourage residents to engage in activities included verbal encouragement, role modeling, and cueing. The RCN also helped the nursing assistants to overcome the challenges and barriers associated with restorative care. A total of 12 nursing homes participated in the study. The study was supported by the Agency for Healthcare Research and Quality (HS13372).
See "Adverse events associated with the res-care intervention" by Ann L. Gruber-Baldini, Ph.D., Barbara Resnick, Ph.D., Richard Hebel, Ph.D., and others in the 2011 Journal of the American Medical Directors Association 12, pp. 584-589.