Note: Includes Shoulder Flexion/Extension and Abduction/Adduction Movements

1. Gather Supplies: None

2. Routine Pre-Procedure Steps:

• • Knock on the client’s door.
  • Perform hand hygiene.
  • Introduce yourself and identify the resident.
  • Maintain respectful, courteous, and professional communication at all times.
  • Provide for privacy.
  • Explain the procedure to the client.

3. Procedure Steps:

• • Raise the bed height if needed.
  • Position the resident in supine position (with the bed flat).
  • Place one of your hands under the resident’s elbow with your palm facing up.
  • Place your other hand under the resident’s wrist with your palm facing up.
  • Watch the resident for objective signs of pain during movement.
  • Move their arm gently and stop if there is any resistance.
  • While keeping the resident’s arm straight, raise their arm up and over their head (i.e., flexion).
  • Ask the resident if they are experiencing any pain during movement.
  • Stop the ROM exercise if the resident reports pain or displays objective signs of pain.
  • Bring the resident’s arm back down to their side (i.e., extension).
  • Complete flexion and extension movements of the shoulder according to the order in the restorative care plan.
  • Continue to support the elbow and wrist of the resident.
  • Keeping the resident’s arm straight, move their entire arm out away from the body (i.e., abduction).
  • Move their arm gently and stop if there is any resistance.
  • Ask the resident if they are experiencing any pain during movement.
  • Return the resident’s arm to their side (adduction).
  • Complete abduction and adduction movements of the shoulder according to the order in the restorative care plan.

4. Post-Procedure Steps:

• • Perform hand hygiene.
  • Check on resident comfort and ask if anything else is needed.
  • Ensure the bed is low and locked. Check the brakes.
  • Place the call light or signaling device within reach of the resident.
  • Open the door and privacy curtain.
  • Perform hand hygiene.
  • Document and report ROM performed and any skin issues, pain with movement, or other changes noted with the resident.