What is Reablement?

After leaving hospital due to an illness or injury, many people require aftercare. This can include healthcare, social care or supported accommodation and is particularly necessary for the elderly. If it is short-term care, this is often called reablement.

In this article we will cover what reablement is in health and social care and why it is important. We will also discuss how it works to support individuals, along with examples of when and how it is used.

What is Reablement in Health and Social Care?

Reablement refers to the care you receive after experiencing an illness or injury. The main aim of reablement is to allow people to gain or regain their confidence, ability and the necessary skills to live as independently as possible, especially after an illness, injury or deterioration in health.

Reablement consists of daily visits from specially trained staff with a focus on observing, guiding and encouraging the individual to do things independently. This helps rebuild their confidence and any skills that may have been lost when the individual was unwell with their injury or illness.

Most individuals who receive reablement care do so for around one or two weeks, although it is offered for a period of up to six weeks. It is also possible that reablement will last for longer if full independence can be achieved with further support.

The length of time that reablement takes depends on the intensity of risk to the individual when operating on their own. For example, if an individual has injured their ankle in a fall and it has been put in a plaster pot, they may be unsteady on their feet. Consequently, they may need support with their personal care until their plaster pot is removed, as they risk falling again and suffering from further injuries.

Reablement is a person-centred approach and support is usually delivered in the individual’s home, or in some cases, a care home. Consistency of workers is highly important in reablement to enable a relationship to be built between the individual and the workers, and for progress to be properly monitored.

Reablement is one of the intermediate care services, along with home-based intermediate care, bed-based intermediate care and crisis response. Intermediate care services provide support for a short period of time to help individuals recover and increase their independence.

There are differences between the four services offered under intermediate care, which the following definitions explain:

Why is Reablement Important?

There are many benefits to reablement and it can lead to improved outcomes for all involved. This includes the individual receiving care, their family and friends, as well as health and social care staff.

Some benefits of reablement include:

• An improvement in the individual’s confidence, functional ability, mobility, independence and wellbeing.
• A prolonged ability to live at home.
• A reduction in the demand on health and social care services.
• A reduced need for ongoing support.
• A non-means-tested approach, meaning the individual will qualify for reablement if they meet the eligibility criteria, regardless of income or capital.
• Preventing premature admissions to long-term care.
• Staff seeing marked improvements, leading to a sense of achievement.
• A reduced need for loved ones to support and care for the individual, leaving more time to enjoy their company.

As mentioned, reablement is a person-centred approach. It also supports the role of active participation by encouraging individuals to do something if they have the ability to do so. If you work in health and social care, encouraging active participation where possible is part of your duty of care.

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Our range of Safeguarding Courses include Levels 1, 2 and 3 in safeguarding adults, as well as specific courses on Dementia Awareness and Mental Health Awareness.

How Might Reablement Support Individuals?

Reablement can be used with a variety of people including those with physical disabilities, dementia and learning disabilities. As local authorities run reablement services, eligibility can vary depending on where you live. Whilst authorities should refer individuals based on their needs rather than medical diagnosis, some use a selective approach and target those who are most likely to benefit.

For this reason, in some areas where individuals have ongoing conditions that will not improve, such as dementia, they are less likely to be offered reablement care if the authorities are using a selective approach.

In order to determine the amount of care needed, there will be an assessment designed to figure out what the individual can comfortably achieve without requiring help. Based on their assessed needs, they may require multiple visits per day or less frequent visits, such as once or twice per week.

Reablement for People Living with Dementia

The government’s policy for supporting people living with dementia is to keep them actively engaged in their daily life for as long as possible. This can be achieved through a personalised reablement approach which draws on the person’s strengths and considers their declining abilities.

To achieve this, staff need to be appropriately trained to ensure they have adequate knowledge of assessment methods and how to build on the remaining ability of the person with dementia.

Principles and Examples of Reablement in Care

For effective reablement, the focus should be on achieving outcomes rather than completing care tasks. These goals or outcomes should have meaning to the individual and be aimed at promoting wellbeing, autonomy, independence and choice.

Therefore, reablement plans should be determined by both the long- and short-term outcomes that the individual has identified. This helps to reduce, or even eliminate, the need for future care.  

Reablement services are delivered using different models. Broadly there are two categories of reablement service:

Intake and assessment service – this service supports a range of users including hospital and community referrals. They tend to operate a ‘de-selective’ model, where all those referred from home care undergo reablement unless it is agreed that they will not benefit. For example, if someone has end of life care needs, they will be de-selected.

Hospital discharge service – this service usually operates on a more selective basis, meaning they only support those who are likely to benefit from reablement. For example, an individual discharged from hospital who lacks confidence in their abilities following a fall which resulted in injury.

Some examples of reablement include: supporting an individual when getting dressed, showering or bathing, preparing meals, moving around their house, participating in social activities and managing their medication.

Reablement Scenario

Dean is 77 years old and was referred to the reablement team after suffering a stroke that affected the left-hand side of his body and his memory. At the time of the stroke, Dean was supporting his husband who was undergoing treatment for cancer. Due to Dean’s memory loss and poor mobility after the stroke, he was feeling vulnerable and anxious at the prospect of caring for himself and his husband.

The reablement team assessed Dean’s needs and he initially received four visits a day and some equipment. The equipment included grab rails, toilet surrounds and a showering stool, these tools gave Dean more independence with personal tasks, such as bathing.

Due to Dean’s memory loss, he was given a dossette box from the pharmacy to ensure he was taking the correct medication. Over the six weeks, Dean was able to reduce the visits to two times a day and take more control of his life. He is now independent and has the confidence that if his husband was to be admitted to hospital, he would be able to manage independently at home.

When reablement has finished, the value or success of the support provided can be measured. There are a few methods for doing this, such as using quality of life questionnaires and by comparing the individual’s functional status when the service began, to how it was when it ended.

The success can also be measured on a wider scale through service outcomes, including:

• Reductions in traditional care home hours.
• The percentage of people able to remain living at home.
• The percentage of people requiring long-term support or admission to long-term care.
• The percentage of people no longer requiring a service up to 12 months post-reablement. 

Reablement is a person-centred approach that promotes and maximises independence and wellbeing. It aims to enable people to gain, or regain, the confidence, ability and skills to live as independently as possible following an illness or injury. Reablement usually lasts for up to six weeks and support should be provided by specially trained health and social care workers to ensure the best possible outcomes.

Further Resources:

• Safeguarding Adults Courses
• How to Prevent Falls in the Elderly
• Duty of Care in Health and Social Care: Responsibilities and Examples
• Champions in Healthcare: Role and Responsibilities
• What is the Hospital Discharge Process?