Introduction
Reablement is a core strand of the UK government’s intermediate care strategy. The purpose of reablement is to pre-empt or reduce demand for social care (including moving to residential care) by enabling people to live as independently as possible in their own homes. Increasing frailty or discharge from hospital are key reasons for referring an older person for reablement. COVID has served to highlight its central role in the way older people are cared for and supported in the UK. It is provided by Local Authorities (or integrated health and social care localities), free of charge, for up to six weeks.
Unlike traditional homecare, which does things for individuals, reablement aims to help people resume activities of daily living (e.g. self-care, housework, social activities). This may involve regaining prior skills and confidence, or helping individuals find new ways to do things, sometimes with the provision of equipment. Its approach is intensive, but time-limited. Specially trained reablement practitioners work with individuals to achieve daily living goals identified through an holistic assessment process.
A key barrier to someone benefitting from reablement is a poor understanding of it and what it is trying to achieve. Families’ understanding and/or support for reablement may also affect progress, and whether achievements are maintained after discharge. This has been seen in other interventions (e.g. physiotherapy) when, if someone does not understand and ‘buy into’ their treatment, they will not recover as much as they could. People use the term ‘engagement’ to describe this.
Objectives
This study will create a Resource created in partnership with older people, family members/carers and professionals for use by localities which:
- enables them to identify critical points on their referral/care pathways where attention needs to be paid to ensuring older people and their families understand and engage with reablement
- provides evidence-informed guidance on how to address or prevent poor understanding or engagement, and support good understanding of, and engagement with, reablement.
Methods
This study will work with older people, family members/carers and professionals to:
- Develop a theory about how and why older people and family members do, or do not, understand and engage with reablement
- Identify points on referral and care pathways where understanding/ engagement is at risk, or could be boosted (‘windows of opportunity’)
- Identify ‘evidence-informed’ ways to address these risks, or make the most of ‘windows of opportunity’.
Based on this, and continuing to work with different stakeholder groups, the study will develop the Resource.
Six-eight localities will pilot the Resource, and the study will investigate how it is used and its impacts on senior staff, service delivery, service provision and practice.
Based on findings from the pilot, the study will refine the Resource and its underlying theory.
The Social Care Institute for Excellence – a national body supporting evidence-informed social care – will host the Resource on their website and publicise it widely. Subsequent studies will further develop and evaluate the Resource.
