Driving forces for home-based reablement; a qualitative study of older adults’ experiences

Abstract

As a result of the ageing population worldwide, there has been a growing international interest in a new intervention termed 'reablement'. Reablement is an early and time-limited home-based intervention with emphasis on intensive, goal-oriented and interdisciplinary rehabilitation for older adults in need of rehabilitation or at risk of functional decline. The aim of this qualitative study was to describe how older adults experienced participation in reablement. Eight older adults participated in semi-structured interviews. A qualitative content analysis was used as the analysis strategy. Four main themes emerged from the participants' experiences of participating in reablement: 'My willpower is needed', 'Being with my stuff and my people', 'The home-trainers are essential', and 'Training is physical exercises, not everyday activities'. The first three themes in particular reflected the participants' driving forces in the reablement process. Driving forces are intrinsic motivation in interaction with extrinsic motivation. Intrinsic motivation was based on the person's willpower and responsibility, and extrinsic motivation was expressed to be strengthened by being in one's home environment with 'own' people, as well as by the co-operation with the reablement team. The reablement team encouraged and supported the older adults to regain confidence in performing everyday activities as well as participating in the society. Our findings have practical significance for politicians, healthcare providers and healthcare professionals by contributing to an understanding of how intrinsic and extrinsic motivation influence reablement. Some persons need apparently more extrinsic motivational support also after the time-limited reablement period is completed. The municipal health and care services need to consider individualised follow-up programmes after the intensive reablement period in order to maintain the achieved skills to perform everyday activities and participate in society.

The reablement team’s voice: a qualitative study of how an integrated multidisciplinary team experiences participation in reablement

“…The participants in these studies expressed that they had to think and act differently and revise some of their tendencies from “doing for” to “letting them do as much as possible themselves”. This shift was confirmed in a study by Hjelle et al,21 in which health care personnel encouraged and supervised older people’s efforts to exercise and perform activities while some personnel were at their home. However, Liaaen16 found that implementing this different approach required negotiating dilemmas such as finding a balance between helping and enabling the person.…”

“…This is in-line with Randström et al15 and a review by Tessier et al,5 which emphasize the importance of professionals’ sensitivity to the older person’s goals for rehabilitation. A study by Hjelle et al21 highlighted that an integrated multidisciplinary approach focusing on the older adult’s goals was crucial to encouraging the care recipient to practice and achieve his/her goals. Many international studies in recent decades have investigated how professionals work together with the person in the rehabilitation context.…”

“…The current study is part of a larger research program on reablement in home-dwelling adults that includes a randomized controlled trial in a rural municipality in Norway with ~15,000 inhabitants 4,20,21. Health care professionals, including occupational therapists, physiotherapists, nurses, and health care personnel such as auxiliary nurses and assistants, were organized into an integrated multidisciplinary team 4…”

The relatives’ voice: how do relatives experience participation in reablement? A qualitative study

“…The current study is part of a larger research program on reablement in home-dwelling adults which includes a randomized controlled trial in a rural municipality in west Norway with ~14,000 inhabitants 5,23,24. Participants were recruited according to inclusion criteria.…”

Hverdagsrehabilitering - integrert eller spesialisert?

“…al., 2016, Whitehead, Worthington, Parry, Walker & Drummond, 2015. Noen kvalitative studier viser imidlertid at hverdagsrehabilitering er av positiv betydning for enkeltdeltakere, og ansatte opplever det faglig stimulerende å arbeide med hverdagsrehabilitering (Birkeland, Tuntland, Førland, Jacobsen & Langeland 2017, Førland & Skumsnes 2016, Hjelle, Skutle, Førland & Alvsvåg, 2016, Hjelle, Tuntland, Førland & Alvsvåg, 2016, Jokstad, Landmark, Hauge & Skovdahl, 2016, Wilde & Glendenning, 2012, Liaaen, 2015.…”