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Reablement is introduced with the aim of improving functioning in daily activities for older people, but also has implications for care workers in changing the aim and tasks of the work. Using Danish reablement as a case, this chapter looks into how reablement affects care work.

It is based on qualitative interviews with reablement care workers in two local settings in Denmark in order to unfold their experiences of how reablement has changed their approach to their work and their understanding of quality of care. It also applies representative and national survey data among Danish care workers in order to understand the further implications for the attractiveness of working in the sector.

Results show that the care workers find it attractive to work with reablement. Reablement appears to provide care workers with more professional autonomy and flexibility in the planning of their daily work while they also receive more support and attention from managers. The care workers find that the introduction of reablement enables them to better meet the clients’ individual needs and preferences. The new motivational approaches and working as change facilitators encouraging clients towards achieving independence is found meaningful and professionally rewarding by the care workers. The attractiveness of working with reablement means that they are less likely to want to quit their job.

The results are important, since there is otherwise a high turnover in the home care workforce, and it is difficult to recruit young people to the sector.

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In this concluding chapter, a number of the authors reflect on the content of the book chapters, based on a facilitated online discussion. The chapter summarises the key learnings and messages from the book and, using quotes from the discussion, illustrates the potential implications for reablement practice and research. Moreover, the editors reflect in the conclusion over the key issues discussed in the book, learning points and the way forward.

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This chapter looks at the evidence regarding the effectiveness of reablement for older people themselves. The most commonly examined client-level outcomes are daily functioning, physical function and quality of life. The evidence relating to each of these is described in separate sections, while that pertaining to less commonly used measures is described together. When assessing the evidence, most weight is given to studies with more rigorous research methodologies which are considered to be higher on the evidence hierarchy. Overall, the evidence that reablement enables older adults to have better personal outcomes than if they had received conventional home care, was found to be relatively weak, although in relation to outcomes such as quality of life or wellbeing, perhaps promising. On the other hand, there is little evidence that the outcomes for reablement participants are any worse than for non-participants and service evaluations found that the majority were satisfied with the service and what they felt they had achieved.

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This chapter describes client-level outcomes used for evaluating reablement. The authors have examined outcomes and instruments used in empirical, clinical trials regarding reablement, and provide an overview of this. A literature review and a comparative analysis have been conducted to examine which client-level outcomes and instruments have been used in different countries across the world. An analysis including 18 studies deriving from nine countries has been conducted. In all, 12 categories of client-level outcomes were identified. Functional independence in ADL, physical functioning and health-related quality of life were the most frequently used outcomes. In all, a total of 40 instruments were used, of which the Barthel ADL Index, EQ-5D and TUG were the ones most frequently used.

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Our societies are ageing, and we need to identify sustainable and empowering solutions for supporting frail older people in their homes.

Reablement offers an approach that may reduce the need for long-term care by actually reducing need for care, as well as supporting quality of life. It offers a radical new integrated and interprofessional care approach which seeks to support older people to regain and maintain functioning and independence through training in daily activities.

Reablement implies the provision of active, person-centred, and goal-oriented support; it should be seen as an alternative to other types of support that merely compensate for care needs and thereby increase the risk of the client becoming passive. In fact, understanding the client’s own priorities and concepts of independence is considered to be key to the potential for enhanced effectiveness. In other words, reablement has the potential to change the way societies approach long-term care policies and implement them into practice.

This interdisciplinary book provides a comprehensive introduction to the remarkable, if haphazard, international growth in reablement practices and policies in aged care over the past 20 years. The book introduces reablement models, and their ideational foundation, implementation, and outcomes across the world. Incorporating theoretical and empirical research, it critically considers the benefits for older people and care workers, the cost-saving potential, and how reablement may be provided for persons with dementia. Finally, the book reflects on key findings, challenges, and the way forward for applying reablement in long-term care for older people.

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Our societies are ageing, and we need to identify sustainable and empowering solutions for supporting frail older people in their homes.

Reablement offers an approach that may reduce the need for long-term care by actually reducing need for care, as well as supporting quality of life. It offers a radical new integrated and interprofessional care approach which seeks to support older people to regain and maintain functioning and independence through training in daily activities.

Reablement implies the provision of active, person-centred, and goal-oriented support; it should be seen as an alternative to other types of support that merely compensate for care needs and thereby increase the risk of the client becoming passive. In fact, understanding the client’s own priorities and concepts of independence is considered to be key to the potential for enhanced effectiveness. In other words, reablement has the potential to change the way societies approach long-term care policies and implement them into practice.

This interdisciplinary book provides a comprehensive introduction to the remarkable, if haphazard, international growth in reablement practices and policies in aged care over the past 20 years. The book introduces reablement models, and their ideational foundation, implementation, and outcomes across the world. Incorporating theoretical and empirical research, it critically considers the benefits for older people and care workers, the cost-saving potential, and how reablement may be provided for persons with dementia. Finally, the book reflects on key findings, challenges, and the way forward for applying reablement in long-term care for older people.

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Many high-income Western countries have been implementing reablement programmes in older people’s homes and community settings since the early 2000s. These programmes aim to enhance ageing adults’ independence and self-sufficiency as well as their social engagement. However, international research indicates that reablement services tend to focus on improving older people’s physical functionality – often while overlooking social participation – and the evidence for a positive effect on overall health, quality of life, and longevity is not consistent. But could reablement improve functional outcomes while also enhancing social engagement? The authors suggest that this would require a paradigm shift and a commitment to move beyond certain professional protocols. Specifically, rather than a linear approach to knowledge translation and transfer that focuses on functional outcomes and economic benefits, reablement professionals should provide ‘unhelpful help’. This messy, ‘open-system’ approach is central in providing autonomy-compatible help that supports social engagement and improves quality of life.

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Reablement approaches are growing rapidly across the Western world, reflecting ideas such as ‘healthy and active ageing’, which have framed reforms in health and social policies since the 1990s. Across world regions, there is today a general agreement that reablement is a person-centred approach, aiming to enhance the functioning and independence of older citizens through interprofessional training and activating them at home, thus reducing their need for long-term care. This chapter investigates how ideas of reablement have travelled and materialised into similar policies, activities, and institutional practices of reablement within and across different world regions.

Inspired by theories of ‘rhetorical frames’ and ‘travels of ideas’, we have interviewed eight key informants and studied policy documents and online information resources from governing authorities, representing three world regions. The analysis supports the argument that the travelling of ideas is quite complex and characterised by circularity rather than linearity. It focuses on the sustainability of the long-term care systems and the local and national needs to find efficient and cost-saving approaches. Our findings also indicate that transnational ideas of ‘successful ageing’, ‘active and healthy citizens’ have travelled to local and national practice, but also from local bottom-up initiatives to the agendas of supranational organisations.

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The introductory chapter presents the aim of the book and outlines the demographic and political context for the introduction of reablement. It also presents the definition of reablement which the chapters relate to and investigates the wider implications of introducing reablement, such as new understandings of need, power positions, and rationalities. The chapter ends with future considerations for the further spread of reablement.

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Our societies are ageing, and we need to identify sustainable and empowering solutions for supporting frail older people in their homes.

Reablement offers an approach that may reduce the need for long-term care by actually reducing need for care, as well as supporting quality of life. It offers a radical new integrated and interprofessional care approach which seeks to support older people to regain and maintain functioning and independence through training in daily activities.

Reablement implies the provision of active, person-centred, and goal-oriented support; it should be seen as an alternative to other types of support that merely compensate for care needs and thereby increase the risk of the client becoming passive. In fact, understanding the client’s own priorities and concepts of independence is considered to be key to the potential for enhanced effectiveness. In other words, reablement has the potential to change the way societies approach long-term care policies and implement them into practice.

This interdisciplinary book provides a comprehensive introduction to the remarkable, if haphazard, international growth in reablement practices and policies in aged care over the past 20 years. The book introduces reablement models, and their ideational foundation, implementation, and outcomes across the world. Incorporating theoretical and empirical research, it critically considers the benefits for older people and care workers, the cost-saving potential, and how reablement may be provided for persons with dementia. Finally, the book reflects on key findings, challenges, and the way forward for applying reablement in long-term care for older people.

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