What is Restorative Functional Support?
RFS combines two evidence-supported approaches; restorative engagement and functional support
Restorative Engagement
Restorative engagement is the purposeful use of connection and engagement used to support regulation, access to ability, participation and function.
It begins with understanding a person — their abilities, history, routines, interests, responses and what influences how they function from day to day.
Once established, engagement is then used intentionally to activate personal interest, encourage initiation, support regulation and create opportunities for the person to use their existing abilities.
The focus of RE is not simply on what we do together, but on what that engagement helps the person access and do for themselves.
Functional Support
Functional support focuses on maintaining a person's involvement in everyday life by supporting them to continue using the abilities they still have.
Rather than automatically stepping in or taking over when something becomes difficult, functional support looks at what part of the task the person can still do and what support will help them do it.
This may mean changing the cue, simplifying a step, adjusting the environment, allowing more time, or providing just enough assistance for the person to participate successfully.
The goal of FS to support ability, independence and participation for as long as possible.
Restorative Engagement → helps access and use ability.
Functional Support → carries that ability into everyday function.
Together, that's Restorative Functional Support.
Frequently Asked Questions
Understanding cognitive and functional change can raise a lot of questions.
Below are some of the questions families ask most often.
Q1. Who can benefit from Restorative Functional Support?
Restorative Functional Support can benefit people experiencing cognitive or functional change for many different reasons and at different stages of life.** A diagnosis is not required for support to begin. This may include people experiencing: - **Dementia and other cognitive changes** — supporting regulation, participation, independence and continued access to existing abilities. - **Delirium or sudden changes in cognition or function** — providing individualized regulation, engagement and functional support alongside clinical care. - **Stroke or acquired brain injury** — supporting initiation, participation and the use of existing or recovering abilities as the person adjusts to change. - **Spinal cord injury, physical injury or accident recovery** — supporting adaptation, participation and independence as abilities and circumstances change. - **Illness, hospitalization or acute care** — supporting regulation, engagement and function when illness, inactivity or unfamiliar environments make participation more difficult. - **Post-surgical recovery, rehabilitation or deconditioning** — helping the person continue using and applying their abilities in everyday life as strength, confidence and function are regained. - **Neurological conditions** — supporting participation when changes in movement, cognition, communication, initiation or function affect everyday life. - **Complex aging** — supporting people experiencing a combination of physical, cognitive, sensory, emotional or functional changes that affect participation and independence. - **Transitions in care or living environment** — including returning home after hospitalization, moving into retirement or long-term care, or adjusting to significant changes in health, ability or surroundings. - **Changes without a clear diagnosis** — when family or care teams notice new withdrawal, reduced initiation, behaviour expressions, difficulty with familiar tasks or changes in everyday function, even when the reason is not yet known. **RFS works alongside and complements clinical care, supporting regulation, participation and everyday function while remaining within the person's broader plan of care, and is not limited to a particular diagnosis or stage of change.
Q2. Where can Restorative Functional Support be provided?
Restorative Functional Support can be provided wherever a person calls home — from their own home or community setting through retirement living and long-term care. RFS adapts with a person- as their needs and circumstances change. This may include helping someone maintain function and independence at home, supporting adjustment during transitions, delirium support in acute care, or working alongside family and care teams when more support is required. The setting may change, but the focus remains the same: supporting regulation, participation and function while helping the person remain as involved in their own life as possible.
Q3. What does Restorative Functional Support actually look like?
RFS looks different for every person; because every person is different. It begins by learning about each individual — who they are, what matters to them and how they typically function in their day-to-day life. Through meaningful, familiar engagement, we begin to understand a person's usual baseline, what supports their abilities, and what helps them regulate and participate successfully. That understanding becomes especially important when or if abilities change or if responsive behaviours appear. It also helps guide the support needed to regain access to a person's abilities, help preserve function and reduce avoidable decline. **Restorative Functional Support is guided by From The Heart Supportive Care’s proprietary Living Picture™ framework. It recognizes that what we see in any one moment is only a snapshot. By looking at the person more broadly — their usual abilities, responses, environment, experiences and patterns over time — we can develop a more complete picture of what may be influencing regulation, participation and function.
Q4. What are responsive behaviours?
Responsive behaviours are actions, words or reactions that communicate something a person may be unable to express in another way. They can include resistance to care, and showering, agitation, aggression, wandering, crying, calling out, withdrawal, or simply behaviour that is unusual for that person. These behaviour expressions do not occur randomly- they occur for a reason. When cognitive change makes it difficult to understand what is happening to and around a person, the brain may rely more heavily on emotional and threat-response systems as a way to fill those gaps of information. Something that seems ordinary to us may suddenly feel confusing, frightening or unsafe to the person- and behaviour can become the expression of that experience. Pain, illness, fatigue, sensory overload, unfamiliar surroundings, changes in routine, communication difficulties and unmet needs can further contribute. when we understand behaviour as being a form of communication, we can look beyond what we see and begin to understand what may be contributing to the person's response. This allows us to support a greater sense of safety and regulation — creating a stronger foundation for a person to connect, participate and function.
Q5. Why is preserving function so important?
Most of us know the old saying, “If you don't use it, you lose it.” Of course, when we're talking about cognitive change, it's more complex than that, but the underlying message remains. Our brains and bodies are designed to be active. When something gets in the way of that — whether it's illness, cognitive change, pain, discomfort, fatigue or simply doing less — function can be lost surprisingly quickly- and when the brain is already experiencing change, regaining access to an ability after a period of not using it can be more difficult. Because our brain influences every aspect of how we function and live ( how we move, think, communicate, make decisions and carry out everyday tasks), changes in the brain can therefore affect much more than memory. That's why, in RFS, we continue creating opportunities to move, think, make choices, communicate and use familiar skills. The goal is to keep using and supporting what remains- even as abilities change, helping to preserve function and reduce avoidable decline wherever possible. The earlier support begins, the better — but it's never too late to support function.
Q6. What does success look like in Restorative Functional Support?
Success in RFS is individualized. It is different for each person and from one day to the next- and does not necessarily mean complete independence. Sometimes success is doing part of something, accepting support or simply participating. It might mean making a choice, participating in personal care, taking a walk, eating a meal, communicating a need, initiating something independently or reconnecting with an ability that has become harder to access. With that in mind-SUCCESS is ACCESS — Access to a person's abilities, Access to greater choice and control in their own life, and Access to the person they STILL are.
Q7. When should families consider Restorative Functional Support?
Families don't have to wait for a significant decline or crisis. If you're noticing changes in your person's abilities, independence, participation or behaviour, or you simply feel that something just isn't right- it may be time to look a little closer. Sometimes an ability has changed and sometimes something is getting in the way of accessing it. Regardless of what brings you here, reaching out and connecting with us can be a great first step in supporting your person. Knowing where to begin starts with a simple conversation.
Q8. When should healthcare teams and care facilities consider Restorative Functional Support?
There is no shortage of highly skilled, knowledgeable and dedicated professionals working across healthcare, long-term care and retirement settings. There is, however, a shortage of focused one-to-one time for individualized restorative engagement, functional support and observation beyond routine care interactions. Restorative Functional Support can complement the existing team when a person is experiencing responsive behaviours, delirium or other changes from their usual baseline, difficulty participating in care or daily routines, withdrawal, loss of initiation, dysregulation or functional decline. It can also provide additional support during transitions between care settings, adjustment to a new environment, and recovery following illness, injury or hospitalization. Within the demands of everyday care, a behaviour or change may be observed during a particular interaction. That observation is important, but it represents only one snapshot of the person at one moment in time. RFS provides focused, individualized restorative engagement and observation across different situations and times of day. This allows patterns to emerge that may not be apparent in a single interaction — what has changed, what may be contributing to that change, what precedes a behaviour expression, when abilities are more accessible, and what supports regulation and successful participation. Through From The Heart Supportive Care’s proprietary Living Picture™ framework, these observations are brought together to develop a more complete understanding of the person behind the behaviour or change — their patterns, responses, existing abilities and the factors that may be influencing their function. That understanding helps guide functional support. In collaboration with the healthcare or care team, RFS considers what the person can still do, what may be interfering with their ability to access or use those abilities, and what individualized approaches can support continued participation and function in everyday life. Relevant observations, patterns and successful approaches can then be documented and shared with the team to support greater consistency in care. From The Heart Supportive Care accepts referrals directly from healthcare professionals and care facilities. When organization-funded support is not available, professionals may also refer or recommend RFS to individuals and families who wish to arrange services privately. With appropriate consent, RFS can continue to collaborate with the person’s healthcare or care team. RFS works alongside existing professional expertise — providing focused restorative support that helps the team see beyond a single moment and support the person as a whole. A behaviour is a snapshot. A person is a Living Picture.™