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Reablement: a solution to the increasing demand for care

Have you already heard about the care concept reablement? Reablement is a way of helping elderly people become independent of care, and is a huge success in Denmark. Professor Tine Rostgaard is conducting research on this subject: ‘Reablement is based on what the elderly people want, and not necessarily what homecare organisations want’.

It all started in 2007. ‘Not in Denmark, but in Sweden’, says Rostgaard. ‘The municipality of Frederica started an experiment there. Elderly people who needed help but still wanted to live at home, were not offered the standard service of help and home care. Instead, they received an intensive rehabilitation program, aimed at making them completely independent again. At the end of this process, most of the participants were able to live at home independently without any support or assistance.’

Up to 27,000 hours less care

The result of the experiment was that up to 27,000 hours less care and guidance were needed than before. 220 care customers participated in the experiment, after which, 103 people were able to continue independently and 68 needed less care. ‘The result is not only that people can do the housekeeping and prepare a meal themselves, but, even more important, that participants are also able to get up from their beds and go to the toilet independently.’

Restorative care

The reablement model is offered in the Netherlands, Norway, Australia, England and New Zealand and is known under the heading ‘restorative care’. The big difference is that in Denmark it has been part of the national legislation since 2015, and is offered in all regions. It also has the full support of professional groups, trade unions and other organisations. According to the European Commission, Danish long-term care for elderly people offers new and innovative ways of dealing with the ageing population and the increasing need for long-term care. Other EU Member States are encouraged by the Commission to go to Denmark to learn how to develop their own long-term care in line with the Danish approach.

Different view on ageing

Rostgaard is often asked which target groups are more suitable for reablement. However, she believes that no one is too old or too fragile to learn something new. ‘It is sometimes assumed that reablement stops at a certain age and that it will no longer work, say, for clients older than 90.  But I think it is even possible in the terminal phase. This requires a very different view on ageing.’

Independence of the elderly

Another argument that Rostgaard often encounters, is that people think that you should not bother elder people with a variety of lessons and assignments. ‘Grandma deserves to enjoy her peace, so to speak.’ She remembers a trajectory in which she helped a single man after a hip fracture to live independently at home. Among other things, he was able to warm up his food in the microwave himself, and only received home care for complex tasks. ‘When I visited this man months after the reablement trajectory, someone from home care was present. Uninvited, she walked with the man’s meal to the microwave to warm it up. When I asked why she did that, she replied: ‘Well, he just likes it when he is looked after.’ In this way, people, often relatives or family members, endanger the independence of older people from a totally understandable way of thinking.’

‘Not a downsizing strategy’

According to Rostgaard, traditional ideas about ageing need to be thoroughly considered in order to ensure effective implementation of reablement.  ‘There is a chance that it will be labeled in public opinion as an ordinary downsizing strategy,’ she says, ‘as if municipalities no longer want to reimburse home care. However, the primary goal is to make people as independent as possible of care. Therefore, it is important to make this very clear in the communication.’

Contact for this project:
Henk
Nies