Experiences of home‐care workers with the ‘Stay Active at Home’ programme targeting reablement of community‐living older adults: An exploratory study

Abstract

To face the challenges of an ageing population, many Western countries nowadays stimulate an ageing in place policy to empower older adults to grow old in their own homes with the highest degree of self‐reliance. However, many community‐living older adults experience limitations in (instrumental) activities of daily living ((I)ADLs), which may result in a need for home‐care services. Unfortunately, home‐care workers often provide support by taking over tasks, as they are used to doing things for older adults rather than with them, which undermines their possibilities to maintain their self‐care capabilities. In contrast, reablement focuses on capabilities and opportunities of older adults, rather than on disease and dependency. Consequently, older adults are stimulated to be as active as possible during daily and physical activities. The 'Stay Active at Home' programme was designed to train home‐care workers to apply reablement in practice. To explore the experiences of home‐care workers with this programme an exploratory study was conducting in the Netherlands, between April and July, 2017. In total, 20 participants were interviewed: nine nurses (including a district nurse), 10 domestic support workers and the manager of the domestic support workers. The semi‐structured interviews focused on the experienced improvements with regard to knowledge, skills, self‐efficacy and social support. Furthermore, the most and least appreciated programme components were identified. The study has shown that home‐care workers perceived the programme as useful to apply reablement. However, they also need more support with mastering particular skills and dealing with challenging situations. Future implementation of the 'Stay Active at Home' programme can potentially benefit from small adaptions. Furthermore, future research is needed to examine whether the programme leads to more (cost‐) effective home care.

Process evaluation of a reablement training program for homecare staff to encourage independence in community-dwelling older adults

“…A full description of the program, based on the Template for Intervention Description and Replication (TIDierR) checklist, has been published elsewhere [ 15 ]. The program applied in the current study differed slightly based on the learning from previous findings [ 18 ]. We added identifiable role models (program champions from the pilot study) to share their experiences with reablement, supporting materials to help homecare staff translate the program knowledge into practice (e.g., an exercise flyer, example communication questions and example goals and action plans), and a diploma ceremony for staff members who attended at least half of the program meetings.…”

“…With this, we aim to change homecare staff's behavior from taking over the activities of older adults towards encouraging older adults to perform activities for themselves, thereby supporting older adults in managing their everyday their everyday lives as independently as possible [ 6 , 17 ]. We pre-tested the program in a pilot study and an exploratory trial to obtain insight into staff's experiences with the program [ 15 , 18 ]. They perceived the program as useful to implement reablement, but required more support in mastering particular skills, such as conversational and goal-setting skills, and in dealing with challenging situations.…”

Turning Community Elder Care into a Profession: Insights from Trainees, Developers, Employers and Supervisors

“…The need for transforming the way we perceive care for older adults is discussed in the professional literature. For example, the 'Stay Active at Home' program in the Netherlands was designed to train home care workers to focus on the capabilities of older adults rather than on disease and dependency [21]. The authors stress that the program equipped the workers to master particular skills and learn how to deal with challenging situations.…”

Staff experiences of a reablement approach to care for older people in a regional Australian community: A qualitative study

“…With a growing population of older people world-wide, new health and social care services are required which can promote and include active client involvement (Bloom, 2019;Smeets et al, 2020).…”

“…Reablement is a relatively recent healthcare approach that has an emphasis on intensive, goal-oriented and interdisciplinary rehabilitation for older adults who are at risk of functional decline (Cochrane et al 2013;Doh et al 2020;Liaaen & Vik, 2019;Smeets et al, 2020;Wilde & Glendinning, 2012). There has been some concern that reablement programs are only slight variations of rehabilitation programs based on the definitions of rehabilitation by the World Health Organisation (2011) and the Department of Health in the UK (Legg et al 2016).…”