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 h=0.36 (=.001) for HRQOL, h=0.60 (=.001) for PSFS, h=0.30 (=.001) for SPPB, and h=0.10 (.013) for hours of home care services per week. The within-group effect size for PSFS was h=0.15 (.010) in favor of the reablement group. The mean number of hours of home care services per week was mean 0.38±1.07 (=.001) in the reablement group and mean 30.38±64.13 (=.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.