Perceptions of Reablement for Increasing Independence

Purpose

Advancement in healthcare has led to people living longer. This has made older adults' care become a concern in the United Kingdom. There is added pressure on hospitals, social services and the government in the human and financial resources needed for their care. County councils are using reablement which focuses on relearning skills for independence to reduce older adults' care cost. This study focused on evaluating the reablement of older adults in a centre in the north of England for areas of improvement. The centre helps facilitate discharges from hospitals. The evaluation became necessary due to the recurrent admissions of some clients. It was also important to know the perceptions of the recipients of reablement to incorporate in improvement of the service.

The purpose of the study was to find out the perceptions of older adults 65 years and over admitted in a specialist care centre about the reablement provided to increase their independence to return home.

Approach

A narrative methodology was employed with the use of discovery interviewing method. Eight participants were interviewed at the end of their reablement after consenting. Three family members were also interviewed. The interviews were recorded and transcribed verbatim. Discovery interviews are not designed for creating themes, however, as themes evolved, they were analysed. The principles of discovery interviews' data analysis and thematic analysis were used to analyse the data.

Outcomes

14 sub themes were identified under the themes of perception of reablement, factors encouraging longer stay at home, factors limiting longer stay at home and areas of improvement.

Reablement was thought to be good and staff were found to be pleasant and creating a conducive atmosphere. Longer stay at home was related to having support at home whereas poor psychological wellbeing limited longer stay at home. The findings also identified that there was a need to improve communication, insufficient reablement, delayed discharges, staffing levels and transfer to an interim place prior to reablement.

Cost and savings

Most recurrent admissions to hospital of older adults could be related to effects of loneliness faced by those who do well at reablement. 

Implications

Reablement is thought to be helpful in relearning skills to be independent with activities of daily living by older adults. It is however important that, the concerns of recipients' of reablement especially in relation to poor psychological wellbeing are addressed prior to discharge to encourage longer stay at home. A pilot referral of clients with poor psychological wellbeing to befriending services to support longer stay at home is needed. Reviewing the staffing levels in line with the various professional bodies and communication may positively impact reablement outcomes.

Further studies may be beneficial in evaluation of the content of reablement provided. Researching older adults' self-reported outcome measures of reablement might help with person centred care.

Poor psychological wellbeing limited older adults' longer stay at home. Inadequate staffing levels was impacting on the quality of reablement delivered. Poor staff client communication affects the perceptions of clients of the reablement received.

Top three learning points

  1. Older adults’ physical abilities could decline with loneliness.
  2. Reablement of older adults should incorporate referral to services in the community targeted at loneliness for those at risk.
  3. Older adults’ should be involved in their reablement through simple and clear communication.

Fund acknowledgements

This study was self funded by the main author as a dissertation for an MSc qualification.

Additional notes

Presented at Physiotherapy UK 2018. 

Full details of this study could be found at www.olderadultsreablement.simplesite.co.uk