title: New horizons: Reablement - supporting older people towards independence.
abstract: As the overwhelming majority of older people prefer to remain in their own homes and communities, innovative service provision aims to promote independence of older people despite incremental age associated frailty. Reablement is one such service intervention that is rapidly being adopted across high-income countries and projected to result in significant cost-savings in public health expenditure by decreasing premature admission to acute care settings and long-term institutionalisation. It is an intensive, time-limited intervention provided in people's homes or in community settings, often multi-disciplinary in nature, focussing on supporting people to regain skills around daily activities. It is goal-orientated, holistic and person-centred irrespective of diagnosis, age and individual capacities. Reablement is an inclusive approach that seeks to work with all kinds of frail people but requires skilled professionals who are willing to adapt their practise, as well as receptive older people, families and care staff. Although reablement may just seem the right thing to do, studies on the outcomes of this knowledge-based practice are inconsistent-yet there is an emerging evidence and practice base that suggests that reablement improves performance in daily activities. This innovative service however may lead to hidden side effects such as social isolation and a paradoxical increase in hospital admissions. Some of the necessary evaluative research is already underway, the results of which will help fill some of the evidence gaps outlined here.
authors.affiliation: Social Policy Research Unit, University of York, Heslington, York YO10 5DD, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Aspinal
authors.affiliation: School of Social Policy, Muirhead Tower, Room 829, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Jon
authors.initials: J
authors.lastname: Glasby
authors.affiliation: KORA - Danish Institute for Local and Regional Government Research, 1150 København K, Denmark.
authors.forename: Tine
authors.initials: T
authors.lastname: Rostgaard
authors.affiliation: Centre for Care Research Western Norway and Department of Occupational Therapy, Physiotherapy and Radiography, Bergen University College, 5020 Bergen, Norway.
authors.forename: Hanne
authors.initials: H
authors.lastname: Tuntland
authors.affiliation: Department of Public Health and Center for Healthy Aging, University of Copenhagen, 1123 Copenhagen K, Denmark.
authors.forename: Rudi G J
authors.initials: RG
authors.lastname: Westendorp
mesh_terms: D000203:Activities of Daily Living; D000368:Aged / Q000523:psychology; D003363:Cost Control; D016330:Frail Elderly / Q000523:psychology; D006299:Health Services for the Aged / Q000191:economics; D006801:Humans; D057187:Independent Living; D012046:Rehabilitation / Q000379:methods
keywords: goal-oriented; home-based rehabilitation; independence; older people; restorative care