Time-limited home-care reablement services (up to 12 weeks) for supporting older adults to live independently
We aimed to assess the effectiveness of time-limited reablement for older people (aged 65 years or more) in helping them to maintain or improve their independence. We included two studies in the review.
Services that help older people to remain living in their own home have obvious appeal for service-users, family members, care-providers and policy makers alike, especially if those services help to reduce pressure on hospitals or the need for long-term care, or both. Reablement (or restorative care) is one potentially useful service that helps an older person to continue living at home. The service is typically provided by a team of health/social care professionals and care-workers who work with an older person to restore their independence. The service is time-limited (usually six to 12 weeks) and normally involves multiple visits to a person's home. It sets out to achieve goals set by the older person, and help them to regain ability to complete everyday tasks and activities.
The evidence is current to April 2015. The review included two studies, one each from Australia (750 participants) and Norway (61 participants). In both studies, half of the participants received a reablement-based home-care package and half usual home-care provision.
The very low quality evidence for all of the results means that we are uncertain about the effects of reablement when compared with usual care.
Reablement may help some older adults to improve their abilities to engage in everyday activities (functional status) to a small degree, but may make little or no difference to death rates or admissions to hospital. The findings mean we are also uncertain whether reablement affects quality of life or living arrangements. Reablement may lead to a small decrease in numbers of people needing higher levels of personal care, and may decrease care costs to a small degree, but neither study reported satisfaction of those using the reablement service.
Quality of the evidence
While there may be some small positive effects of reablement, the evidence was very low quality, meaning that we are very uncertain about how large or important these effects may be. There is a need for more studies to be conducted in a range of countries and situations before the effectiveness and safety of reablement can be determined with certainty.