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A Prospective Intervention Study With 6 Months Follow-up of the Effect of Reablement in Home Dwelling Elderly: Patient-reported and Observed Outcomes.
OBJECTIVES: To investigate the effect of a reablement intervention (a person-centered, interdisciplinary rehabilitation approach) compared with usual care services in home-dwelling elderly experiencing functional declines in activities of daily living.
DESIGN: A non-randomized controlled trial comparing a reablement intervention with usual care; outcomes were measured at baseline, after intervention, and at a 6-month from baseline in both groups.
SETTING: Municipal public health service.
PARTICIPANTS: Sixty-five home-dwelling elderly with functional decline were assigned by the participants home care service zone to a reablement group (n=35), or a usual care group (n=30). The mean participant age was 80±11 years in the reablement group and 78±12 in the usual care group.
INTERVENTION: The reablement group received a person-centered and tailored reablement program provided by an interdisciplinary team, consisting of a physiotherapist, an occupational therapist, and a nurse. The usual care group received standard home care services.
MAIN OUTCOME MEASURES: The dimension "Your health today" from the European Quality of Life-Visual Analog Scale (HRQOL), the patient-specific functional scale for goals in ADL (PSFS), the short physical performance battery (SPPB), and home care services in hours per week.
RESULTS: There were significant differences over time in favor of the reablement group with between-group effect sizes of Cohen h2 =0.36 ( P =.001) for HRQOL, h2 =0.60 ( P =.001) for PSFS, h2 =0.30 ( P =.001) for SPPB, and h2 =0.10 ( P= .013) for hours of home care services per week. The within-group effect size for PSFS was h2 =0.15 ( P= .010) in favor of the reablement group. The mean number of hours of home care services per week was mean 0.38±1.07 ( P =.001) in the reablement group and mean 30.38±64.13 ( P =.023) in the usual care group.
CONCLUSIONS: The participants in the reablement group achieved and maintained better physical function, a higher HRQOL and needed considerably less home care services than the usual care group participants. Thus, reablement appears to be a more beneficial and sustainable approach than the usual care services for the home-dwelling elderly with functional decline.
DESIGN: A non-randomized controlled trial comparing a reablement intervention with usual care; outcomes were measured at baseline, after intervention, and at a 6-month from baseline in both groups.
SETTING: Municipal public health service.
PARTICIPANTS: Sixty-five home-dwelling elderly with functional decline were assigned by the participants home care service zone to a reablement group (n=35), or a usual care group (n=30). The mean participant age was 80±11 years in the reablement group and 78±12 in the usual care group.
INTERVENTION: The reablement group received a person-centered and tailored reablement program provided by an interdisciplinary team, consisting of a physiotherapist, an occupational therapist, and a nurse. The usual care group received standard home care services.
MAIN OUTCOME MEASURES: The dimension "Your health today" from the European Quality of Life-Visual Analog Scale (HRQOL), the patient-specific functional scale for goals in ADL (PSFS), the short physical performance battery (SPPB), and home care services in hours per week.
RESULTS: There were significant differences over time in favor of the reablement group with between-group effect sizes of Cohen h2 =0.36 ( P =.001) for HRQOL, h2 =0.60 ( P =.001) for PSFS, h2 =0.30 ( P =.001) for SPPB, and h2 =0.10 ( P= .013) for hours of home care services per week. The within-group effect size for PSFS was h2 =0.15 ( P= .010) in favor of the reablement group. The mean number of hours of home care services per week was mean 0.38±1.07 ( P =.001) in the reablement group and mean 30.38±64.13 ( P =.023) in the usual care group.
CONCLUSIONS: The participants in the reablement group achieved and maintained better physical function, a higher HRQOL and needed considerably less home care services than the usual care group participants. Thus, reablement appears to be a more beneficial and sustainable approach than the usual care services for the home-dwelling elderly with functional decline.
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