Reablement care for older adults

Learning about reablement care for older adults

 If you or someone you love is in hospital, you may be curious to learn more about reablement care. Here, we are looking at how reablement care works, who it is for, why it is important, who pays for this care, why reablement is often better at home, how it helps to keep older adults living independently at home and out of hospitals/care homes, and how a home carer might be able to support reablement care.At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about reablement care, we can help.

What is reablement care?

Reablement care is a type of temporary care put in place to support someone in becoming independent again after a significant event, such as coming home from hospital, or recovering from a fall or bad illness. You may also hear it called intermediate care, and it is designed to help people regain their strength and independence at home.This could mean taking care of cooking until the person is able to do this for themselves, or helping them to move around safely. Reablement differs from regular home care as it is often a short-term situation with a health and wellbeing goal, as opposed to a long-term, ongoing care arrangement. According to the Social Care Institute for Excellence, the UK government has invested in reablement services (through NHS funding) with the aim of promoting wellbeing and reducing unnecessary hospital admissions, re-admissions or delayed discharges. This type of short-term NHS and social care support can help to keep people out of hospital if a stay is not needed, and remain living in their own home instead of a care homeWhile the focus of reablement is enhancing physical and mental wellbeing, it may also attempt to improve their confidence and reduce the need for long-term care services after the person is recovered enough to manage on their own. Reablement services typically take place in a person’s own home, and will work through a defined set of goals in order to create a positive outcome at the end of the recommended time period. When reablement is done correctly, research has shown it can lead to improved health outcomes, better wellbeing, less time spent in hospital, and more autonomy in recovery. One of the most widely reported reablement outcomes is an increase in perceived quality of life compared to the results of other home care services.Studies have suggested the central goal of most reablement care services is to “improve the functionality of clients so they can continue to live in their own homes.” 

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Who could benefit from reablement care?

Reablement care most benefits those who:

  • Are recovering from an illness
  • Are recovering from a recent surgery
  • Are coming home after a hospital stay
  • Need temporary support to regain their independence

This service is not exclusively used by older adults, but it can provide many benefits for this age group, particularly if they have experienced a fall or have mobility issues after a hospital stay and want to avoid readmission. It is also very beneficial for people with a disability or a chronic health condition requiring support to become independent in their own home. In the past those being discharged from hospital without regaining all of their previous abilities would have been moved into a care home, but reablement care allows them to go home safe in the knowledge that they will have the support they need to get back on their feet.

How does reablement care work?

Reablement care is often curated for the individual with the help of a multidisciplinary team that conducts a comprehensive assessment to identify a person’s needs and set achievable goals for their health and wellbeing outcomes. The reablement care team will usually consist of a combination of practitioners such as doctors, nurses, occupational therapists, physiotherapists, speech and language therapists, social workers, carers and more. After carrying out an assessment of their needs, the team will put together a plan with input from the person and/or any family members who may be involved in their care. This type of care will be tailored to your needs and personal goals, but may include a combination of improving mobility, implementing self-care skills, and working on overall life skills to manage household tasks. Examples of goals that may be set for reablement include reaching a stage where you can safely stand up and walk around the home once again, or get washed and dressed by yourself in the morning. This might be done with the help of home adaptations, and visiting care workers or live-in careReablement typically lasts for a few weeks, but exactly how long your reablement service lasts will depend on your specific needs and the progress you make along the way. Studies have found that reablement care is usually helpful for older people and their family carers when they have an adequate understanding of their own role in the reablement journey and the goals they are working towards. If you are going through reablement care yourself, always ensure you understand the process and ask any questions you need to if you are unclear, as acknowledging the end goal could help you see better results. 

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Who pays for reablement care?

While not everyone is automatically entitled to free reablement care, in the UK this is typically funded by local authorities or theNational Health Service. However, there is a limit to how much free reablement care will be provided. Most people require reablement care for only a couple of weeks, but this service may be provided free of charge for up tosix weeksdepending on your needs and circumstances. This will be reduced if you regain your independence early. After the maximum of six weeks, you may need to contribute to the cost or pay for further care yourself if you are able. If you do require care lasting longer than six weeks, then depending on carer availability, how stretched the service is, and how able your carers believe you are, there may be some flexibility with when your free care will end. You may find more helpful information on who pays for care in our guide to who pays what for care.

Why is reablement care best done at home?

Most medical professionals will work towards getting a patient stable enough to leave hospital, but when they do return home they may require reablement care. Reablement care can be carried out in hospital, in a care home, or in a person’s own home, however research suggests maintaining independent living at home has the potential to improve health perception and self-efficacy in older adults, so often reablement care is provided at home to help get the person back to living independently. The World Health Organization also recommends older adults be cared for in their own homes for as long as possible to maintain a strong sense of wellbeing, so – provided they are healthy enough to return home following a hospital stay – this is usually the best option. This type of care is best done at home as it can enable you to get back to doing things for yourself in your usual, familiar environment, which can enhance your comfort and confidence. Being at home allows you to practise the daily activities you will likely be doing within the context they will be performed in everyday life. This can lead to more practical and sustainable skill development. Home-based care also reduces the risk of hospital readmission. For example, a 2022 study found home care reduced readmission and the length of hospital stays in advanced heart failure. It can also promote positive mental wellbeing by maintaining social connections and routines, and ultimately preserves quality of life. Additionally, home-based reablement care allows for personalised, real-time adjustments to the care plan so the support is always tailored to your living conditions and personal needs.Some other benefits of having reablement care at home include:

  • Being in familiar surroundings
  • Having clear goals that are relevant to your own life
  • Having support tailored to your own environment
  • Continuing with your usual routines and hobbies
  • Having more opportunities for visits with loved ones
  • Financial peace of mind (by avoiding potentially expensive care homes)
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How can reablement care be organised? 

Reablement care can be organised for you if you are in hospital, as either the doctor in charge or your care (or your GP if they are in touch) will discuss this with the hospital discharge team and create a referral for you. If you are not in hospital, you can be referred by your GP or a member of your health or social care team. From there, someone will visit you in your home (or come home with you after your hospital discharge) to help determine the care you need and arrange this for you. 

How can a home carer support an older person through reablement care? 

If you would like to engage the help of more carers during your reablement care, or you are coming to the end of your allotted free reablement care through the NHS and will be required to pay for any additional care yourself, private home care options could help. 

A home carer can support you through reablement care by:

  • Encouraging independence within your own home 
  • Assisting with typical daily activities and routines 
  • Helping to set achievable goals, and instilling motivation
  • Providing practical assistance with tasks such as personal care
  • Aiding with movement and any recommended exercises to improve mobility
  • Ensuring the home is a safe environment and there is no risk of falls or injuries
  • Providing light housework to ensure cleanliness 
  • Monitoring progress towards goals and adjusting support as needed 

Having a carer present during what could be an extremely vulnerable and worrying time in your life has a number of benefits for your wellbeing, too. Reablement care can help to provide emotional support, foster confidence and reduce anxiety when it comes to performing tasks independently. 

If you are interested in learning more about arranging home care for yourself or a loved one, you may find some helpful information in our guide on how to choose and arrange home care services.

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By coordinating with healthcare professionals and the existing reablement team, private home carers can ensure a comprehensive care arrangement addressing both the physical and mental needs of the person who requires additional help. If this is something you are considering for yourself or a loved one who is currently in hospital or in need of reablement care, feel free to reach out to your local Home Instead team to find out how we can help. 

Our Care Professionals are the best of the best, and highly trained to deliver the services you need. No matter what type of home care you are looking for, we can provide a tailored service that suits you or your loved one. 

We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.