A New Model for Community Care – Wellness and Reablement

A new approach to community care has emerged in recent years, and continues to gain traction in Australia. The traditional model for community care services has a focus on illness and dependence through providing passive support for individuals. The concept of ‘wellness and reablement’ (or ‘enablement’) replaces this with a model of care centred around ‘capacity building’, whereby independence in performing activities of daily living is encouraged and facilitated. There is an increasing body of evidence that this shift in focus produces more favourable outcomes for consumers with improved wellness, through achieving greater independence, and consequently reducing the amount and cost of care. So here exists a true win-win situation, where we can achieve better client outcomes at a reduced financial cost.

 

What is ‘Wellness’?

Wellness is the optimisation of a person’s physical and mental health and well-being. In the context of community care, wellness centres on the understanding that an individual, despite increasing frailty and decreasing health, has the capacity to improve their physical, social and emotional well-being. This is achieved through a flexible and tailored approach to delivery of care, taking into account the individual’s unique set of circumstances and goals.

 

What is ‘Reablement’?

Reablement is closely linked, but distinct from wellness. It is the process of helping people regain, or re-learn, skills required for daily living which have been lost due to deteriorating health or advancing frailty. It is distinct from addressing specific health care issues. Reablement programs are led by Allied Health professionals and are time-limited (6-12 weeks) with specific goals set around activities required for daily living. The focus is on engaging individuals in a program designed to improve their ability to perform specific activities of daily living, and minimise the amount of care required for these activities. For example, making a cup of tea, dressing themselves or independent showering.

 

Benefits to the Individual

·         Increased feelings of independence, empowerment and autonomy in managing their health and abilities.

·         Improved physical and emotional well-being

·         Improving their ability to self care and to perform everyday activities of daily living

·         Reducing the need for ongoing home care services

·         Reducing the risk of falls and falls related injuries

·         Avoiding hospital admission for reasons directly addressed by this program, for example, falls, medication or chronic disease mismanagement

 

The Evidence

Lewin et all (2008) found consumers on a Reablement program had:

·         71% had less difficulties with IADLS

·         33% no longer needed ongoing care services

·         and 39% needed a lower level of service.

 

A study on Reablement programs in the UK found:

·         53-68% of people left the reablement program not requiring any immediate homecare

·         36-48% of that group still required no homecare at 2 years

·         34-54% had maintained or reduced their levels of care 2 years after reablement.

 

In keeping with this evidence-based best practice, LifeCare has developed its Wellness and Reablement Program for individuals receiving community care.