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International Perspectives and Future Directions

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

Reablement offers a radical new integrated care approach which supports older people to regain and maintain functioning and independence. This interdisciplinary book provides an introduction to the remarkable if haphazard international growth in reablement policies and practices in aged care over the past twenty years.

Incorporating theoretical and empirical research, it considers benefits for clients and care workers, cost-saving potentials and reablement provision also for persons with dementia. Finally, the book reflects on key findings, challenges and the way forward for long-term care for older people.

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Chapter 2 sets the scene for the investigation of the introduction of reablement in the seven countries presented in the book. The chapter provides country-specific demographic information and a presentation of how the long-term care systems in each country are situated in particular welfare regimes. It also takes a comparative perspective in the presentation of what characterises the reablement approach in the seven countries, before presenting more generic reablement model features and theoretical aspects for reablement.

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This chapter discusses health-economic perspectives in reablement and describes evaluation methods such as cost analysis, cost-effectiveness, and cost-utility analysis. The aim is to provide a summary of existing evidence, and to discuss health economic perspectives of reablement from a clinical and future research perspective. Eight studies comparing reablement to conventional home care were included; four cost-analyses and four cost-effectiveness analyses; time horizons for follow-up varied from 6 weeks to a lifetime perspective.

The results indicated that reablement was the more cost-effective intervention in seven studies; in five studies reablement resulted in both larger effects and/or lower costs; in two studies reablement resulted in larger effects and larger costs within established cost-effectiveness thresholds. A summary of the existing evidence indicates that reablement is promising regarding cost-effectiveness compared to usual home care services, but the evidence base is limited; additional studies designed to capture health-economic perspectives over the long term are urgently needed.

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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.

Restricted access

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.

Restricted access

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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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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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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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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