What is reablement?
The terms ‘Reablement’ and ‘intermediate’ are sometimes used interchangeably, however they’re not really the same thing.
Reablement care focuses specifically on helping you to rebuild your confidence, and independence at home through a person-centred approach and goal setting. During scheduled care assistant visits, your reablement care assistant will work with you to agree achievable goals relating to practical, daily activities – such as getting washed, preparing meals, and getting up and down stairs safely.
These support professionals will provide gentle encouragement while you do things yourself, and a quick response if you need help.
The benefit of reablement programmes is the opportunity for the person receiving support to regain control, increase self esteem, and improve their quality of life.
For their carers and family members, it can provide additional peace of mind during a loved one’s recovery. It can also ease worries around caring for a loved one themselves, especially if they’re already working full time, or have children to look after.
The key principles of reablement care are –
- Making support accessible to those who need it, regardless of their financial means
- Encouraging wellbeing
- Taking a flexible approach that’s tailored to the individual
- Rebuilding confidence and self-care skills that may have been lost
- Helping people get to a place where they can manage with minimal support
- Reducing the risk of social isolation
- Preventing readmission to hospital, or moving into a care home unnecessarily
Intermediate care on the other hand is more focused on your physical rehabilitation. It’s usually delivered by a multidisciplinary team of healthcare professionals such as occupational therapists and community nurses. The team will work with you to improve your strength, mobility and balance as you recuperate at home.
What does reablement involve?
It be difficult to get back to normal after a period of illness, a fall, or an injury. If you’ve been admitted to hospital too, then there can be extra hurdles to overcome. A qualitative study from the University of Arkansas suggests that a 67 year old is reasonably good health could lose 14 percent of their hip muscle strength, and 12 percent of their lung capacity after being in a hospital setting for 10 days.
Reablement is an important part of a rehabilitation plan following a hospital discharge, and can ensure older people receive dedicated care after illness. It can also help prevent people who have experienced a short illness at home from being admitted to hospital.
A Reablement service is usually free on the NHS, and offered for up to six weeks. If you need support beyond this timeframe you may need to pay for it. Some people may only need reablement for one or two weeks if they achieve their goals in this time.
You’ll be assigned a reablement team, who may include –
- Occupational therapist (OT)
- Physiotherapists (PT)
- Social worker
- Doctors from the hospital, or your GP
- Care workers
Your reablement programme will be built around your individual circumstances.Your team will complete an assessment into what you can do, and what everyday tasks you need support with. You’ll be fully involved in this process and work with the team to create a reablement plan. This plan will highlight the basic activities you’d like to focus on and set goals for. It’ll also introduce the person or people who will be delivering the support, and how often they’ll visit you.
Reablement can help you with the following things –
Daily living and domestic tasks
- Getting dressed
- Preparing meals
- Getting out of bed or a chair
- Taking the right dose of medication, at the right time
- Support with social activities, such as attending clubs or church
At first, your reablement team may take on a more active role in caring for you, and you’ll likely have various care visits throughout the day and night. They’ll assess your ability weekly, and as you become more confident they’ll take a step back and encourage you to practice daily skills yourself – providing support only when needed.
Experiencing an illness or a change in your abilities can be a lonely experience. While reablement means someone is around to talk to during those six weeks of care, it can be easy to feel isolated once reablement care has stopped. Building social activities into a reablement plan such as calling friends or attending local social groups or community events is just as important as setting domestic goals.
Your team may also be in contact with family members who will provide on-going support once your reablement plan has finished. This helps your family to understand your progress and what kind of pace you’re comfortable with. Your team may share particular approaches they’ve used in your reablement – for example recording your progress in a care diary to show how far you’ve come in your rehabilitation journey.
They may able offer advice on tools that can help you continue your rehabilitation at home, such as personal alarms that can send an alert if you need help quickly.
It’s important to remember that while there are many benefits of reablement, recovery takes time. Reablement care focuses on restoring your independent functioning to a level where you feel confident in your own home. It’s unlikely to result in huge, immediate improvements to your overall health.
Mental health reablement
If you’ve been in hospital due to a mental health concern under section 3 of the Mental Health Act 1983, you may be offered a form of free reablement support too.
Your needs should be assessed before you leave hospital and your reablement team will work with you in much the same way, to ensure you get the right level of everyday rehabilitation, so that you can live safely at home. As well as daily activities such as shopping and cleaning, a mental health reablement service can provides support with things like benefits and housing, accessing local community services, reducing isolation, emotional support, managing medication and attending hospital appointments.
What happens when your reablement period ends?
As your period of reablement comes to an end, your team will review whether you can manage the daily tasks you need to live independently. They’ll advise you on what to do if you feel you need more support in the future, and share any information on any relevant support groups or equipment that could improve your quality of life going forward. Their review may include –
- Care you may need moving forward
- How to get further reablement support in the future if you need it
- What to do, or who to contact if you experience a relapse in your on-going recovery
- Information on equipment or home adaptations that could help might help
If they decide you’re likely to need ongoing care, they’ll work with your local adult social care services to arrange an initial assessment into your needs.
This assessment will look at your care needs and work out whether you would benefit from long-term care services. If so, you’ll also be offered a financial assessment too, as you may be entitled to funding from your local authority to help pay for it.
If you’re living with on-going health issues, or your doctors think you are likely to experience a deterioration in health over the coming months or years, it’s usually worth applying for NHS Continuing Healthcare too. If you qualify for this type of funding will cover all your care needs in full.
Once you’ve secured any funding you’re eligible for, it’s important to discuss your wishes and the type of care you’d prefer with your family and social care team – this will help ensure your care plan complements your everyday life and supports your routine.
If you need low level support that’s not eligible for funding, you’ll need to cover the costs of any additional care that happens once your reablement period ends. Don’t be afraid to ask your reablement team or your local council’s social care professionals for advice on what to do next.
There may be some additional things you need help with around the home during your reablement and beyond. Day to day tasks such as doing laundry, keeping bathrooms clean, and food shopping aren’t included in standard NHS reablement. So, you may need to arrange for a friend, family member or neighbour to help. If this isn’t possible, there are a number of housekeeping and temporary care providers that can offer this service. If you’re worried about the cost of this support, charity organisations such as AgeUK and Friends of the Elderly may be able to help through national volunteer programmes.
When you can get free short-term care and how to get it
in most regions in the UK, home care reablement services are free to anyone who needs them when leaving NHS hospital care. If you or a family member are in hospital, it’s important to raise the topic of reablement with hospital staff, who’ll be able to let you know if you’re eligible.
If you’ve had a fall or are recovering from an illness at home, your local council may be able to arrange some free or subsidised temporary care to help keep you safe and avoid admission to hospital. Speak to a GP or health professional to find out what’s available in your local area, and how you can access this support.
In some areas people can also be referred by an Adult Social Care Community Team without a hospital admission. However, his varies between local authorities and may come at a cost.
Who can’t use this service?
Unfortunately, a hospital admission won’t always automatically mean you’re eligible for a free reablement service when you leave. Only those who have experienced an ‘acute episode’ of illness – or an injury that has severely impacted functional independence will be offered on-going support once they’ve been discharged.