Textbooks, monographs and policy-focused books on our Health and Social Care list push forward the boundaries of teaching, theory, policy and practice. The list covers areas including global health, health inequalities and research into policy and practice.
Key series include Transforming Care which provides a crucial platform for scholars researching early childhood care, care for adults with disabilities and long-term care for frail older people, and the Sociology of Health Professions, offering high-quality, original work in the sociology of health professions with an innovative focus on their likely future direction. Our leading journal in the area is the International Journal of Care and Caring.
Health and Social Care
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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.
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.
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.
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.
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.
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.
This chapter discusses reablement in the context of dementia care and reviews research on reablement intervention programs specifically designed for individuals living with dementia. Dementia can be viewed in different ways, but perhaps the most important is that it should be recognised as a disability so that individuals with dementia could receive care that addresses both their health and social needs and applies a dialectic approach to living with dementia. Reablement in dementia care is a relatively new concept and can be beneficial. Intervention programs consist of strategies to address function related goals, promote activity engagement, consider behavioural and psychological symptoms related to dementia and include the individual’s social networks. However, several barriers to reablement exist, including stigma attached to the disease and limited health professional knowledge regarding dementia.
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.
Numerous countries have been developing a reablement approach for several years. However, the stage of implementation, as well as the scaling up, differs across each country. The aim of this chapter is to consider key issues relating to the implementation of reablement to determine the shared issues for development, refinement, and spread. The chapter is informed by i-PAHRIS and Context and Implementation of Complex Interventions (CICI) implementation frameworks. Issues relating to the history and current status of reablement, target groups, characteristics, and key contextual factors at a participant, local, and national level are considered across New Zealand, Australia, Norway, Denmark, and the Netherlands. This allows for consideration of the key common features in the composition of reablement across the five countries/regions together with an illustration of differences in structuring reablement.
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.
