Blog: Tackling barriers in intensive social care intervention

In today’s society, more of us are living into our 70s, 80s and even 90s.

Latest estimates suggest that there are more than 9.3 million people aged 70 and older in the UK, an increase of 24% since 2012. Meanwhile, the Centre for Ageing Better expects the number of those aged 80 and older to more than double in the next four decades.

Ageing is a natural part of life and for many people, maintaining independence is hugely important. Indeed, many people, as they get older, live active lifestyles, keep up with hobbies, volunteer in their communities and spend time with friends and family.

The ability to continue living at home and doing the things we love is a vital part of preserving our sense of self, but things like a hospital admission or a gradual loss of physical capabilities and confidence can threaten this. Reablement services are designed to help people regain their independence. It is entirely different from long-term care, which can increase dependency.

However, not everyone benefits from reablement as much as they could. This is often because they do not engage with the service. There are lots of different reasons why someone may not ‘buy into’ and actively work at being reabled, preventing them from benefitting fully.

What is reablement?

Reablement is an intensive social care intervention that helps people regain or maintain their independence by helping them find new ways to manage their daily lives. It is a time-limited set of services delivered to people in their own homes.

Older people recently discharged from hospital are among those who are referred to reablement services and can benefit from this intervention. Research shows that the people who achieve the best outcomes from reablement are those who participate fully with the intervention and engage well with practitioners. They often avoid the need for any form of ongoing care and their risk of hospital re-admission is decreased.

Although reablement has been a core pillar of social care for about 20 years, there remains key challenges that interfere with people fully embracing its potential.

The EAGER research project, funded by the National Institute for Health and Care Research’s School for Social Care Research (SSCR) and led by Professor Bryony Beresford from the University of York, identified several factors that affect engagement, including:

a poor understanding of reablement among referring agencies, older people and their families
misconceptions that reablement is the same as ‘traditional’, long-term home care
inconsistent language when talking about reablement, which can lead to confusion
a lack of support from family members
service delivery pressures, such as lack of time
gaps in staff training (e.g. conflict resolution skills).

To help the sector overcome these barriers and promote better outcomes for those being reabled, the SSCR funded Professor Beresford and her team to work with reablement staff, older people, and their families to develop a series of evidence-based, practical recommendations on supporting older people’s and family members’ engagement with reablement. SCIE has now published these recommendations as an online practical resource.

Supporting client and family engagement with reablement

This new resource, supporting client and family engagement with reablement, is aimed at those who manage and deliver reablement services, and those who commission these services. It includes evidence-based best practice guidance and information to tackle those key barriers preventing users from benefitting fully from the intervention.

Maximising the potential of reablement makes sense to local public services as well as older people. Effective reablement helps people to avoid the need for ongoing care, easing pressures on families, the NHS and the wider social care system.

The resource aims to address key issues, such as:

information provision to older people and their families
ensuring consistent messaging about reablement by referring agencies
ways of working which support engagement and overcome resistance
ensuring timely access to equipment and other aids
staff training and maximising peer learning and supervision opportunities within the team.

In addition to recommendations for reablement services, the resource also calls for greater investment at a national level to raise public awareness of reablement and social care. Equally, more funding locally is needed to ensure reablement staff have the time they need enough time to work with clients and their families.

As our society continues to age, reablement services will only become more important in helping people to regain their independence, live well and enjoy a good quality of life. It is therefore crucial that we always strive to improve practice and boost outcomes wherever possible.