The reablement approach in homecare offers support and encouragement to individuals to empower them to help themselves and so increase their independence. It supports individuals ‘to do’ rather than ‘doing to’ or ‘doing for’.
Goal setting and review of outcomes achieved are central to the reablement ethos. This means that we work with individuals and their carers to establish what tasks they want to gain confidence in doing or relearn particular skills. By engaging with individuals around an agenda of what they can do and what they would like to do we can develop short term interventions which support them to achieve these goals. These are often around basic daily living skills such as dressing, meal preparation and mobility. It is not uncommon for an individual to have lost confidence around their ability to carry out certain tasks after spending time in hospital.
Our traditional home care approach has been to assess people around what they no longer can do and provide a service to meet these deficiencies. As a result services are embedded into people’s lives, often for length periods of time. While this is perfectly acceptable for a number of people who suffer from severe and complex conditions it has the potential to create a dependency for people who may have had the potential to relearn or regain skills. Reablement focuses on this potential and research suggests that many people who would have received a traditional service leading to risks of dependency can eventually become more confident and lead fulfilling lives when they regain lost skills.
Systems & processes are not always conducive to good communication, anticipatory planning and integrated working. This is particularly evident for people with complex needs requiring a multi agency, multi disciplinary approach who may not able to advocate for themselves.
All parts of the patient’s support system (the carer, acute and community care services etc) should work together to achieve the best outcome for both the cared for person and the carer. Despite the policy and good practice advice which has been developed to guide us across this pathway, carers often report that they feel ill-informed and that policy is often not reflected in practice.
Establishing Carer Support as a key component of the hospital discharge process addresses the need to identify carers at an early stage and ensure that they are well informed and supported. It also addresses the need to support carers at key times of transition, eg where the admission meant the carer was no longer able to continue care at home and the person they cared for was being admitted to long term care.
The increased number of older people living at home with one or more long term condition means there is increased risk of errors with medication. This has been identified as a risk for emergency admission to hospital. These older people are not a group who would routinely receive a review. Post Hospital Discharge a ‘transition’ time for many older people was originally targeted with the service now being available for all Care at Home clients.
Additional support to vulnerable older people to manage their medications can avoid emergency admission to hospital.
This programme provides the opportunity for Community Planning Partnership partners to work together to support older people and promote physical activity within a clear inequalities context.
Physical inactivity has been identified as the fourth leading risk factor for global mortality (6% of deaths globally). With the exponential growth in the older population, increasing physical activity and exercise in older people has been identified as a key target by the World Health Organisation (WHO) Active Ageing Framework (2002), to reduce the global burden of non-communicable disease.
Physical activity is beneficial for healthy ageing. There has been increased evidence that physical activity impacts on disease prevention and management, psychosocial benefits and complications of immobility. It also supports the maintenance of independence, improving the quality of life, and ‘successful ageing’ and can provide significant savings to health and social care services
These benefits can be achieved by healthy older people as well as the frail and very old.