Reablement in community-dwelling older adults: a randomised controlled trial

Tuntland, Hanne; Aaslund, Mona Kristin; Espehaug, Birgitte; Førland, Oddvar; Kjeken, Ingvild

doi:10.1186/s12877-015-0142-9

Cited by 117 publications

(244 citation statements)

References 27 publications

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“…Although rehabilitation may be important for individuals in their own homes, rehabilitation has traditionally not been an active part of the home care service. The evidence base concerning the effects of reablement is inconclusive, but promising 1–3. Four recent systematic reviews conclude that there is uncertainty regarding the effects of reablement on health and function 4–7.…”

Section: Introductionmentioning

confidence: 99%

Interdisciplinary collaboration in reablement – a qualitative study

Birkeland¹,

Tuntland²,

Førland³

et al. 2017

JMDH

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BackgroundIn-depth knowledge regarding interdisciplinary collaboration, a key feature in reablement, is scarce.ObjectiveTo elucidate how the interdisciplinary collaboration in reablement worked in a Norwegian context.Sample and methodsSeven focus group interviews were conducted with 33 health care providers working in interdisciplinary reablement teams in seven municipalities across the country. The focus group interviews were transcribed and an hermeneutical analysis was conducted.ResultsThe analysis resulted in four main themes: “participant’s own goals as a common interdisciplinary platform”, “a positive professional community”, “learning from each other’s skills and competencies” and “new roles and joint efforts but specific competencies”. The results show that interdisciplinary collaboration in reablement depends on participants defining their own rehabilitation goals, which function as a professional unifying platform for the interdisciplinary collaboration. The challenges for participants in reablement are often complex and include assessments, effort and a need for close collaboration between several different professionals. A tight interdisciplinary collaboration causes major changes in roles, often from a particular role to a more general role with broader job tasks. Although different professionals perform the same rehabilitation tasks, it is important that each professional contributes their unique competence and thus together they complete each other’s competencies.ConclusionFactors that have a positive impact on interdisciplinary collaboration in reablement are participants’ definitions of their goals, number and variety of professionals involved, how closely these professionals collaborate, the amount of time for communication and shared planning and decision making.

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Section: Introductionmentioning

confidence: 99%

Interdisciplinary collaboration in reablement – a qualitative study

Birkeland¹,

Tuntland²,

Førland³

et al. 2017

JMDH

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“…Our pattern of results suggests further and broader gains in functioning may be achieved once individuals are discharged from reablement. The absence of a comparator group means we cannot attribute these improvements to reablement and they may, instead or in part, be due to non‐specific recovery processes observed after, for example, a fracture has healed (Tuntland et al, ). However, a study which did use a comparator groups found differences between groups in (practitioner‐reported) abilities to carry out extended activities of daily living (favouring the reablement group) were not observed until some months after discharge (Lewin, De San Miguel, et al, ).…”

Section: Discussionmentioning

confidence: 99%

Outcomes of reablement and their measurement: Findings from an evaluation of English reablement services

Beresford

Mayhew

Duarte

et al. 2019

Health Soc Care Community

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Reablement – or restorative care – is a central feature of many western governments’ approaches to supporting and enabling older people to stay in their own homes and minimise demand for social care. Existing evidence supports this approach although further research is required to strengthen the certainty of conclusions being drawn. In countries where reablement has been rolled out nationally, an additional research priority – to develop an evidence base on models of delivery – is emerging. This paper reports a prospective cohort study of individuals referred to three English social care reablement services, each representing a different model of service delivery. Outcomes included healthcare‐ and social care–related quality of life, functioning, mental health and resource use (service costs, informal carer time, out‐of‐pocket costs). In contrast with the majority of other studies, self‐report measures were the predominant source of outcomes and resource use data. Furthermore, no previous evaluation has used a global measure of mental health. Outcomes data were collected on entry to the service, discharge and 6 months post discharge. A number of challenges were encountered during the study and insufficient individuals were recruited in two research sites to allow a comparison of service models. Findings from descriptive analyses of outcomes align with previous studies and positive changes were observed across all outcome domains. Improvements observed at discharge were, for most, retained at 6 months follow‐up. Patterns of change in functional ability point to the importance of assessing functioning in terms of basic and extended activities of daily living. Findings from the economic evaluation highlight the importance of collecting data on informal carer time and also demonstrate the viability of collecting resource use data direct from service users. The study demonstrates challenges, and value, of including self‐report outcome and resource use measures in evaluations of reablement.

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“…I Norge er det nå naermere 200 kommuner som gjennomfører hverdagsrehabilitering (Ness, 2016). I den norske litteraturen legges det vekt på at hverdagsrehabilitering skal kjennetegnes ved tidlig og intensiv innsats i en avgrenset periode, at tiltakene skal vaere tverrfaglige, og at tiltak skal ta utgangpunkt i brukerens egne ønsker for å styrke funksjonsnivå og mestring av daglige aktiviteter i brukerens hjem/naermiljø (Tuntland, Aaslund, Espehaug, Førland, & Kjeken, 2015;Høverstad & Fürst, 2014;Tuntland & Ness, 2014;NOU, 2011).…”

Section: Bakgrunnunclassified

“…Studier viser at personene som mottar hverdagsrehabilitering oppnår en forbedring i motsetning til dem som mottar vanlige omsorgstjenester (Tuntland et al, 2015). En del betingelser må likevel vaere til stede for at hverdagsrehabilitering skal fungere optimalt: forankring i kommunens ledelse, ressurstildeling, kompetanse, kulturendring og tverrfaglig samordnet innsats (Høverstad & Fürst, 2014).…”

Section: Bakgrunnunclassified