Elements of effective reablement
- Promote independence. Loss of independence can have a devastating effect, particularly for older people who may find it more difficult to regain it. Independence includes physical and psycho/social function.
- Individual assessment and person-centered goal setting to improve confidence and wellbeing. A person’s independence requires more than just services to help them remain in their home and maintain their current capacity. We should support clients to maintain and extend their activities in line with their capabilities.
- Service delivery that enables active (not passive) engagement in meaningful activities. This includes the ability to recall, plan and perform the required activities and roles of daily living and improved independence wherever possible. Service delivery should not take over activities that a person can do for themselves.
- Supporting and enabling positive risk-taking to maximise independence. Focus on what the person can do (rather than what they can’t do) and what they need to be able to do to have an optimal quality of life.
- An ‘outcome focus’ to appropriately minimise the ongoing support required. For example, an outcome focus requires regular reviews of the support to ensure continued progress towards goals and the level and duration of service required.
We have produced a tip sheet with examples which you may find useful. Click the document below to review and download the PDF.
Assessment and goal-setting in effective reablement
One of the core principles of effective reablement is the creation of a realistic support plan. This follows an active assessment that observes the clients’ current abilities in all aspects of daily living and involves them in identifying the outcomes or goals they would like to achieve.
It is important that the focus is on activities that the person identifies as important. The person would be asked, ‘What are the most important activities in your life right now?’
Goals can range from very small improvements to more complicated activities to help a person recover skills, confidence and independence.
They are likely to relate to:
- Activities of daily living tasks, such as getting washed and dressed, preparing a meal, and managing household activities such as laundry, gardening and housework
- Strength and mobility, such as moving safely around their home or outdoors
- Learning how to use assistive technology to support confidence, safety, and independence, and
- Enabling participation in social engagement, such as building confidence to take transport to their chosen activity in the community.
There is a need to review a person’s progress on a regular basis in order to maintain improvement – revisit goals and amend as necessary. If all goals have been achieved, support doesn’t need to continue for the full allocated time of the reablement period.
Reablement support can include rebuilding capacity to do previous activities, adapting to a different way of doing an activity and/or using equipment as a means of support. It can also assist people to connect back to their community and take ownership of key areas of their lives.
The methods used can be split into two categories:
- Restorative: the learning or re-learning of skills or behaviours, restoring capacity, improving confidence and increasing motivation. Increasing physical and cognitive capacity and strength to re-engage with previous activities.
- Compensatory: finding a way around a difficulty, including adapting the environment and/or using assistive technology/equipment.
Below are some examples of how these methods could be used:
Increasing physical activity and building strength
Loss of muscle power due to normal ageing (sarcopenia) has greater functional impact than loss of strength alone. Physical activity is known to be important for improving and maintaining function, (including cognition) among older adults.
There is a strong relationship between high levels of cardiovascular fitness and good health. Any activity or exercise that improves cardiovascular fitness may be beneficial, including day-to-day activities such as housework and gardening.
Older adults can improve their health by improving cardiovascular fitness. This imparts benefit even if starting from a low level of cardiovascular fitness. It is recommended to slowly build up and increase movement and activity levels daily.
Click the graphic to open the PDF document.
Demonstrate alternative ways of carrying out tasks
When putting on a shirt or blouse, always put the weaker arm or the arm with the least amount of movement into the sleeve first.
When doing laundry, put wet clothes in a trolley and wheel to the clothesline.
When vacuuming, try moving slowly and pushing the vacuum cleaner in front with the handle resting against one hip. Set the vacuum to the correct height.
Show how to use energy wisely
Plan ahead. Balance heavier activities with lighter activities. Where necessary balance activity with rest periods, spread activities throughout the day. Organise the timing of activities to optimise energy levels. Rest effectively. Rest before becoming tired. Do the activity in ‘bite-sized’ chunks.
Advise sitting to carry out an activity such as preparing vegetables if standing for a period is difficult. Work at appropriate heights. Store frequently used items between knee and shoulder level.
For household activities such as vacuuming, consider doing when energy levels are at their optimum. i.e in the morning or if experiencing pain undertake the activity at a time when any stiffness or pain is reduced.
Use equipment to support independence
Assistive technology can help people maintain independence and stay in their own homes as long as they wish to do so. It does this by:
- Maintaining or improving a person’s functional capabilities with everyday activities of daily and community living
- Preventing impairments and secondary health conditions—for example, reducing risk and improving safety through falls prevention
- Reduce/delay the need for more complex aged care services
- Enhancing confidence and safety, and
- Reducing the burden on family carers, as well as paid formal carers, by making it easier and safer to provide assistance.
Typical assistive technology that may be used within reablement include:
- Toilet frames
- Shower chairs
- Kitchen/laundry trolley
- Perching stool
- Dressing aids
- Long-handled equipment for housework and gardening, and
- Kitchen equipment such as jar openers.
Click on the document images below to open each PDF.
To view more, visit our ‘Support Workers guide to Assistive Technology (AT) and Equipment’ page.
Practical help to reduce social isolation and promote choice
Staying social connected can become more difficult in later life due to retirement, impact of chronic disease, reduced mobility and the death of spouses and friends.
Support the development of new social networks in the community or re-establish and maintain existing ones. Consider leisure and recreational activities and volunteer programs to increase social activity and connections.