Background: In recent years, home-based reablement has become an increasingly popular way to provide rehabilitation services. This health care service aims to enable older persons to live longer at home while reducing the need for institutionalization. To ensure the provision of high-quality services, there is a continual need for research on issues of user involvement and co-creation during the pathway of the reablement process.
Purpose: This study focused on user involvement and participation with health care professionals during the reablement process.
Methods: This was a longitudinal, instrumental single-case study, in which one 85-year-old female patient was followed over the pathway of a six-week reablement process. Data were collected at three stages, including the goal-mapping phase, evaluation phase, and three weeks after completing reablement.
Results: Our analyses revealed two themes for the goal-mapping phase (dialogue led by the care provider and main goal), three themes for the implementation phase (the home as the preferred setting, little influence on organizational factors, and participation, influence, and motivation), and three themes for the evaluation phase (patient understanding as a precondition, motivated by weak paternalism, and self-determination requires clear communication).
Conclusion: The patient becomes involved through a partly co-creation process. During this time, they are involved, motivated, and influenced over the pathway of reablement. Health care providers must avoid implementing too much control during the pathway of home-based reablement, as patients have contextual knowledge that care providers do not possess.
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http://dx.doi.org/10.2147/JMDH.S321760 | DOI Listing |
J Neurol Neurosurg Psychiatry
January 2025
Schools of Nursing, Medicine and Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Background: We investigated the effectiveness of an Interdisciplinary Home-bAsed Reablement Programme (I-HARP) on improving functional independence, health and well-being of people with dementia, family carer outcomes and costs.
Method: A multicentre pragmatic parallel-arm randomised controlled trial compared I-HARP to usual care in community-dwelling people with mild to moderate dementia and their family carers in Sydney, Australia (2018-2022). I-HARP is a 4-month, home-based, dementia rehabilitation model delivered by an interdisciplinary team.
BMC Geriatr
January 2025
Deputy Director of the Health and Social Care Workforce Research Unit (HSCWRU), The Policy Institute, King's College London, 22 Kings Way, London, WC2B 6LE, England.
Background: Over the past decades, self-directed models of care have been implemented throughout the world to support older people, including those with dementia, to live at home. However, there is limited information about how self-directed home care is experienced by older people with cognitive impairment and dementia, and how their thinking informs their care choices and quality of life.
Methods: We used the ASCOT-Easy Read, a staggered reveal method, talk aloud techniques, probing questions, and physical assistance to support users of self-directed home care in Australia with cognitive impairment and dementia to discuss their Social Care Related Quality of Life (SCRQoL).
Patient Prefer Adherence
December 2024
Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
Background: As the global population ages, there is increasing pressure on health systems to provide high-quality and cost-effective care for this growing segment of the population. Reablement, primarily a strategic home-based rehabilitation approach, has been demonstrated to be a cost-effective, multidisciplinary, holistic, and person-centred approach to maintaining functional independence as one ages. Given that care delivery in the home setting for older persons is complex, a key feature of effective implementation of reablement is the integration of a multidisciplinary team.
View Article and Find Full Text PDFJ Adv Nurs
October 2024
Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, Australia.
Background: Major knowledge and practice gaps exist in aged care home services to support independence of older people with dementia. This research evaluates an adaptation of a community-based rehabilitation model for care homes, namely Interdisciplinary Care Home-bAsed Reablement Program (I-CHARP), by examining whether (and, if so, how) I-CHARP produces its intended effects and how this programme can be practicably implemented, sustained and scaled up across care homes in Australia.
Methods: I-CHARP is a 4-month bio-behavioural-environmental rehabilitation model of care, integrated in care home services, supported through the deployment of an implementation strategy, the Research Enabled Aged Care Homes (REACH) network.
Australas J Ageing
March 2025
Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia.
Objectives: To identify the prevalence of and factors associated with medication use in people living with dementia in the community.
Methods: A cross-sectional study using baseline data from a randomised controlled trial known as the Interdisciplinary Home-bAsed Reablement Program (I-HARP) between 2018 and 2021 in Sydney, Australia. Participants included people with mild-moderate dementia and their carers.
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