A Prospective Intervention Study With 6 Months Follow-up of the Effect of Reablement in Home Dwelling Elderly: Patient-reported and Observed Outcomes

Jeanette Kjernsholen; Inger Schou-Bredal; Rolf Kaaresen; Helene Lundgaard Soberg; Aase Sagen

doi:10.1016/j.arrct.2023.100311

A Prospective Intervention Study With 6 Months Follow-up of the Effect of Reablement in Home Dwelling Elderly: Patient-reported and Observed Outcomes

Arch Rehabil Res Clin Transl. 2023 Nov 20;6(1):100311. doi: 10.1016/j.arrct.2023.100311. eCollection 2024 Mar.

Authors

Jeanette Kjernsholen¹, Inger Schou-Bredal², Rolf Kaaresen³, Helene Lundgaard Soberg⁴, Aase Sagen⁵

Affiliations

¹ Oslo Metropolitan University, Oslo, Viken, Norway.
² Institute of Health and Society, Department of Nursing Science, University of Oslo, Oslo, Viken, Norway.
³ Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Viken, Norway.
⁴ Faculty of Health Sciences, Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Viken, Norway.
⁵ Department of Health and Life Skills, Municipality of Aurskog-Holand, Oslo, Viken, Norway.

Abstract

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.

Keywords: Functional decline; Home care services; Interdisciplinary team; Reablement; Rehabilitation.