Development of an internationally accepted definition of reablement: a Delphi study

Abstract

With an ageing society, the demand for health and social care is increasing. Traditionally, staff provide care for their clients rather than with them. In contrast, reablement aims to support people to maximise their competences to manage their everyday life as independently as possible. There is considerable variation between and within countries regarding the conceptual understanding of the approach. This variation affects the ability to evaluate reablement approaches systematically, compare and aggregate findings from different studies, and hinders the development of a robust evidence. Therefore, a Delphi study was conducted in 2018/9 with the aim of reaching agreement on the characteristics, components, aims and target groups of reablement, leading towards an internationally accepted definition of reablement. The study consisted of four Web-based survey rounds. In total, 82 reablement experts from 11 countries participated, reaching agreement on five characteristics (e.g. person-centred), seven components (e.g. goal-oriented treatment plan) and five aims (e.g. increase clients’ independency). Furthermore, most experts agreed that reablement is an inclusive approach irrespective of the person's age, capacity, diagnosis or setting. Based on these features, a definition of reablement was developed, which was accepted by 79 per cent of participating experts. This study is a significant step towards providing conceptual clarity about reablement. Future research should focus on evaluating the implementation of agreed reablement components to inform practice, education and policy.

Promotion of Physical Activity Through Reablement for Older Adults: Exploring Healthcare Professionals’ Clinical Reasoning

“…Emerging in several industrialized countries over the last two decades, reablement is an interdisciplinary home care approach that aims to improve function and maintain independence among people receiving home care services. 1 There has been high political interest in reablement due to its promising expectations for reducing healthcare spending and solving some of the sustainability challenges found within an aging population. 2 …”

“…Internationally, reablement is provided either through social care services or healthcare services and involves various interventions that builds upon goal-oriented support plans. 1 Reablement is not specific to particular diseases, and those receiving reablement are typically a heterogenic group comprised of older adults with a mean age of 80 years 3 and no severe cognitive problems 4–6 who are experiencing challenges with managing their daily life independently. 1 In Norway, where this study was conducted, reablement is provided as part of the publicly-funded municipal healthcare service.…”

“… 1 Reablement is not specific to particular diseases, and those receiving reablement are typically a heterogenic group comprised of older adults with a mean age of 80 years 3 and no severe cognitive problems 4–6 who are experiencing challenges with managing their daily life independently. 1 In Norway, where this study was conducted, reablement is provided as part of the publicly-funded municipal healthcare service. It may be organized differently between municipalities, but is typically handled by the pre-existing home care service or a specialized reablement team.…”

“…13 In a recent definition of reablement developed through a Delphi study with reablement experts, it suggests that reablement consists of training in daily activities, home modifications, assistive devices and involvement of a social network. 1 While these intervention components may target the levels of activity and participation, none of them specifically targets body functions, which may influence the effectiveness of reablement.…”

“… 3 While the majority of studies published over the last two decades included exercises as a component of reablement, as well as a focus on practicing and participating in ADLs, 3 there is no consensus that exercises or motivation for PA should be included in reablement. 1 …”