Predictors of outcomes following reablement in community-dwelling older adults

Abstract

BackgroundReablement is a rehabilitation intervention for community-dwelling older adults, which has recently been implemented in several countries. Its purpose is to improve functional ability in daily occupations (everyday activities) perceived as important by the older person. Performance and satisfaction with performance in everyday life are the major outcomes of reablement. However, the evidence base concerning which factors predict better outcomes and who receives the greatest benefit in reablement is lacking.ObjectiveThe objective of this study was to determine the potential factors that predict occupational performance and satisfaction with that performance at 10 weeks follow-up.MethodsThe sample in this study was derived from a nationwide clinical controlled trial evaluating the effects of reablement in Norway and consisted of 712 participants living in 34 municipalities. Multiple linear regression was used to investigate possible predictors of occupational performance (COPM-P) and satisfaction with that performance (COPM-S) at 10 weeks follow-up based on the Canadian Occupational Performance Measure (COPM).ResultsThe results indicate that the factors that significantly predicted better COPM-P and COPM-S outcomes at 10 weeks follow-up were higher baseline scores of COPM-P and COPM-S respectively, female sex, having a fracture as the major health condition and high motivation for rehabilitation. Conversely, the factors that significantly predicted poorer COPM-P and COPM-S outcomes were having a neurological disease other than stroke, having dizziness/balance problems as the major health condition and having pain/discomfort. In addition, having anxiety/depression was a predictor of poorer COPM-P outcomes. The two regression models explained 38.3% and 38.8% of the total variance of the dependent variables of occupational performance and satisfaction with that performance, respectively.ConclusionThe results indicate that diagnosis, functional level, sex and motivation are significant predictors of outcomes following reablement.

Home care as reablement or enabling arrangements? An exploration of the precarious dependencies in living with functional decline

“…Thus, contrary to policy ambitions of a universally applicable home care paradigm, reablement might instead be seen as an appropriate intervention only for the minority – in our study represented by Anna – who has a recent and sudden decline trajectory (Bødker , Rabiee and Glendinning , Tuntland et al . ). For the remaining majority of home care applicants, who are neither ‘recently independent’ nor only ‘temporarily dependent’, striving to become independent of care, however, might not be a meaningful pursuit.…”

Characteristics of occupational therapy and physiotherapy within the context of reablement in Swedish municipalities: A national survey

“…While no information on diagnosis was collected, it is reasonable to assume a similar mix and variety of diagnoses (e.g. orthopaedic, neurological, psychiatric) that has been presented in other trials conducted in a Nordic reablement context (Tuntland et al, ; Zingmark & Bernspång, ). Given that reablement is implemented for heterogeneous target groups, the focus and content of the intervention, and the role of different professionals may differ, for example, in relation to supporting clients after a hip fracture or clients diagnosed with neuropsychiatric limitations.…”

What constitutes ‘good care’ and ‘good carers’? The normative implications of introducing reablement in Danish home care

“…It is noteworthy that in our study professionals consistently referred to compensatory care as a ‘previous’ practice, disregarding the fact that this form of care is still offered to those who are either unable or unwilling to engage in reablement or do not benefit from it. Thus, although previous studies have demonstrated that reablement is only likely to benefit a selected group of home‐care applicants recovering from, for instance, an illness or fracture (Rabiee & Glendinning, ; Tuntland et al, ), and that compensatory care, therefore, often exists alongside and in combination with reablement (Bødker, ; Bødker, Christensen, & Langstrup, ; Dahl et al, ), these two forms of care are far from being viewed as equal in a normative sense. Rather, they are placed in a normative hierarchy where compensatory care is considered an inferior form of care, and reablement a superior form.…”