A function-focused approach to long-term facility care.

M than 20 years ago, Atchinson (1992) described restorative care as care that maximized a resident’s ability; it focused on what an individual is able to do, and it sought to create independence for the older adult. More recently, Galik, Resnick, Hammersla, and Brightwater (2014 ) have described this concept as function-focused care. Atchinson (1992) titled her article “Restorative Nursing as a Concept Whose Time has Come.” Interestingly, a colleague and I were recently talking about restorative care. We were asking ourselves, “What if we changed our philosophy of care from resident centered to one that emphasized function-focused resident care?” What impact would such care have on the quality of life for residents within long-term care facilities, and, if we wanted to change our philosophy and practice, how would we do it? Why change? Several reasons exist. Older adult residents with functional disabilities are at risk for deconditioning and are more likely to have a lower quality of life and experience depression (Kleinpell, Fletcher, & Jennings, 2008). In addition, the culture of care in longterm care facilities is to meet the needs of the older adult through task completion (e.g., dress the resident, take him or her to Sunday hymn group for social interaction) rather than by enhancing their underlying physical abilities. The consequence of such care may strip residents of their remaining competencies. So for us, function-focused care’s time has come. “What do we do now?” was our next question. Implementation is achieved using the following five pillars: (a) restructure the physical environment; (b) educate staff, families, and residents; (c) establish function-focused resident care goals; (d) mentor staff; and (e) provide administrative support. We can only touch on these pillars here.