Developing a Reablement approach within day services for older people

What was the issue you were addressing or working on?

Work towards policy objectives and strategies, such as:

  • Reshaping Care for Older People (2010)
  • Live Well in Later Life, Edinburgh’s Joint Commissioning Plan (2012-2022)
  • Integration of Health and Social Care
  • Market Shaping Strategy(2013)
  • Personalisation Agenda

to meet the challenge of increasing numbers of older people.  Key objectives of the service are to:

  • Facilitate early discharge from hospital and prevent admission
  • Maximise people’s independence to remain in the community for longer
  • Supporting people to achieve better outcomes
  • Reduce carer stress.

What you did?

Since July 2012 the OTs have been working in a focused way with individual service users dealing with assessments such as manual handling, mobility, feeding, access and equipment.  They have been working closely with day service staff to help change the culture in day services to a Re-ablement style approach.   Since March 2013, the OTs have also been training staff from the centres and have been running 14 week Cognitive Stimulation Therapy (CST) programmes working with service users with mild to moderate levels of dementia in small groups.  They are rolling this out across the city.

It is working closely with the voluntary sector where OTs are rolling out their work further.  This service is also linking in with Health services, Home Care Re-ablement, Intermediate Care and the Dementia Strategy.


What were the outcomes - benefits or otherwise?

The Re-ablement approach within day services can have a positive impact on both service users and carers by helping older people to regain life skills and maintain as independent a life as possible.

The approach has shown immediate, positive effects.  There has been instant improvement in service user’s abilities and staff skills, for example the mobilising of seven people who were in wheelchairs.  The OTs have been working closely with staff which has greatly helped to change the culture within day centres.  These results will continue to produce short, medium and long term results for the service and the outcomes of the service users.  A longer term objective is the anticipated increase in throughput to preventative services due to the Re-ablement approach and plans are underway to facilitate this.

CST has been shown to stimulate and improve memory and cognition therefore strengthening people’s resources and allowing them to function at the maximum capacity. This fits with the ethos of Re-ablement.  CST is being offered to older people through the day services as part of a structured programme.  It is believed that this programme can help to reduce carer stress by supporting older people to live as independent a life in the community for longer.  The service is looking into training relatives/carers in the future so they can undertake CST at home.  The response from the programme group members has been very positive, one stated:

“Helps with my confidence, I’m a lot cleverer than I thought!”

Feedback from family members/carers has also been very positive.  Two comments included:

“I am very happy that my mum is doing this type of group as it is something that I am trying to do with my mum at home.  I see that she is brighter in mood and says that she has enjoyed the group.”

and

“I have very much seen a difference in my mum since the group started, she is mentally brighter and her mood is brighter as well.  When I speak to my mum on a Tuesday she is able to put a conversation together better.  My mum has not spoken much about going to the centre before but she is now saying that she likes it and has met some nice people which is definite progress.”

Another benefit is that this has seen improved partnership working as connections and close working relationships have had to be made with Health, voluntary sector, other teams and worker types within the department, as well as service users and carers, in order to facilitate this shift in the way this service is being delivered.


Contacts - to find out more

Doreen Copeland (Development Manager for Older People’s Day Services) doreen.copeland@edinburgh.gov.uk 0131 5538453

Yvonne Gannon (Evaluation lead) Yvonne.gannon@edinburgh.gov.uk.

CST has been recommended by NICE (National Institute of Clinical Excellence).  See http://www.cstdementia.com/ for more details.