How can podiatrists contribute to reablement for older people: a qualitative study of Australian podiatrists perspectives

Abstract

Background: The ageing of Australia’s population is placing significant pressure on health and social aged care services due to an increasing demand for services and a relative decrease in the healthcare workforce. Reablement has been introduced by the Australian Commonwealth Government and is aimed at increasing older people's independence to age in place and decrease dependency on aged care services. To date research on reablement practice has focussed on interventions from physiotherapists, occupational therapists, and nurses, with no data available on podiatrist involvement. The aim of this research was to explore how Australian podiatrists can align their practice with the reablement model in aged care. Methods: Using a qualitative approach, semi-structured interviews were conducted with podiatrists from a diverse range of clinical settings. An interview guide was utilised which focussed on podiatrists’ current clinical practice when working with older people and to discuss how they believed the reablement model might work in the podiatry discipline. Interviews were audio-recorded, transcribed verbatim, and analysed using Braun and Clarke's approach to thematic analysis.Results: 14 podiatrists were interviewed. Using thematic analysis, three themes emerged; (i) It’s not what I was taught, “I am just a podiatrist”, (ii) Reconciling practice with competing pressures, (ii) Funding influences on podiatry practice and reablement. Podiatrists revealed that they deliver their care through a biomedical model and lack knowledge and skills in the application of the reablement model of care. Rather than finding practice examples that demonstrate involvement by podiatrists in older peoples reablement, our analysis identified a series of systemic barriers which predominantly inhibit the implementation of reablement from the podiatry discipline. Conclusions: Australian podiatrists considered their role in reablement for older people was limited. Some factors to improve podiatrists’ involvement in older peoples reablement could be addressed through training of of podiatrists in the application of holistic models of care such as reablement. However, factors such as inadequate funding arrangements involve wider health system reform and are seemingly more intractable.