Published: 28 July 2021
Reablement in the home for people aged 65 years and over: components, effectiveness, and influencing factors. An evidence review
Reablement services help older people accommodate illness or disability by helping them to learn or re-learn skills necessary for daily living. They are typically provided for a period of 6-12 weeks, and during this period they seek to enable older people to be as independent as possible in their day-to-day lives. The provision of reablement services requires an interdisciplinary approach involving skilled professionals from a range of specialities.
This review of reviews examined (1) the defining features and components of reablement services; (2) the effect of reablement services on patient outcomes, health and social care system outcomes, and value-for-money outcomes; and (3) the factors that facilitate the delivery and acceptance of reablement services. We included 13 reviews supplemented by 6 primary studies and 2 technical reports. Based on research from Australia, New Zealand, Norway, the United Kingdom, and the United States, reablement services differ in structure, delivery, and staff skill mix. However, commonalities among services include supporting people to do things for themselves, being goal-oriented and intensive, having a predefined duration, and being delivered older people’s homes.
We found that the evidence thus far, as reported in reviews comparing reablement services with usual care, is inconclusive regarding their effect on postintervention home care requirements, quality of life, physical and functional status, and admissions to the health and social care system. While there is some evidence that reablement services may outperform usual care in terms of reducing the need for post-intervention home care services and increasing physical and functional status, further research is needed so that more confident conclusions can be made.
An important finding from this review of reviews is that the delivery and acceptability of reablement services are facilitated by putting the values of the service users at the centre of service provision and implementing shared dialogue and collaborative decision-making between older people and service providers. Older people prefer when services are delivered by competent, trained, and integrated teams that are sensitive to their needs and values.