Evidence-based interventions involving occupational therapists are needed in re-ablement for older community-living people: A systematic review

Abstract

Introduction

Re-ablement services are in a period of strong development, but the terms and definitions used remain unclear, and the scientific evidence is still weak. The aim of this systematic review was to obtain an overview of the scientific literature in this evolving research area, and investigate whether there is scientific evidence for positive effects of re-ablement services for older community-living people.

Method

The systematic literature search was conducted in the databases CINAHL, PubMed and Svemed+(Swemed) and covered the years 2000–2014. Owing to the heterogeneity in the included studies, a narrative synthesis was performed.

Results

Eight original publications were found eligible and included in the systematic review. When addressed, terms and definitions varied among the papers. Effects such as less use of home care, higher likelihood to live at home, improved activities of daily living (ADL) skills, quality of life and physical health, increased physical activity and lower costs compared to conventional home care were reported.

Conclusion

More high-quality research is needed to strengthen the evidence-base regarding re-ablement services. The specific roles of various professional and staff groups are often insufficiently described, as are the interventions as such, and there is a lack of attention to person-centered aspects such as the meaningfulness of the specific activities.

Keywords

Activity everyday rehabilitation restorative care home care occupational therapy

Get full access to this article

View all access options for this article.

References

Beard

Bloom

(2015) Towards a comprehensive public health response to population ageing. The Lancet 385(9968): 658–661.

Boniface

Mason

Macintyre

(2013) The effectiveness of local authority social services’ occupational therapy for older people in Great Britain: a critical literature review. The British Journal of Occupational Therapy 76(12): 538–547.

Burton

Lewin

Boldy

(2013) Physical activity levels of older adults receiving a home care service. Journal of Aging and Physical Activity 21(2): 140–154.

Carswell

McColl

Baptiste

(2004) The Canadian Occupational Performance Measure: a research and clinical literature review. Canadian Journal of Occupational Therapy 71(4): 210–222.

Cochrane

McGilloway

Furlong

(2013) Home-care ‘re-ablement’ services for maintaining and improving older adults’ functional independence. The Cochrane Library 11: 1–14.

Francis

Fisher

Rutter

(2011) Reablement: a cost-effective route to better outcomes. Social Care Institute for Excellence (SCIE): London 1(1): 1–20.

Glendinning

Clarke

Hare

(2008) Progress and problems in developing outcomes-focused social care services for older people in England. Health & Social Care in the Community 16(1): 54–63.

Hackett

Newton

Rapley

(2014) Systematic reviews of occupational therapy interventions: summarizing research evidence and highlighting the gaps. The British Journal of Occupational Therapy 77(9): 479–482.

Hjelle

Tuntland

Førland

(2016) Driving forces for home-based reablement; a qualitative study of older adults’ experiences. Health & Social Care in the Community. Epub ahead of print 24 January 2016. doi: 10.1111/hsc.12324.

10.

Iwarsson

Wahl

H-W

Nygren

(2007) Importance of the home environment for healthy aging: Conceptual and methodological background of the European ENABLE–AGE Project. Gerontologist 47(1): 78–84.

11.

King

Parsons

Robinson

(2012) Assessing the impact of a restorative home care service in New Zealand: a cluster randomised controlled trial. Health & Social Care in the Community 20(4): 365–374.

12.

Langland

Tuntland

Førland

(2015) Study protocol for a multicenter investigation of reablement in Norway. BMC Geriatrics 15: 111.

13.

Legg

Gladman

Drummond

(2015) A systematic review of the evidence on home care reablement services. Clinical Rehabilitation 30(8): 741–749.

14.

Lewin

Alfonso

Alan

(2013b) Evidence for the long term cost effectiveness of home care reablement programs. Journal of Clinical Interventions in Aging 8: 1273–1281.

15.

Lewin

De San Miguel

Knuiman

(2013a) A randomised controlled trial of the Home Independence Program, an Australian restorative home-care programme for older adults. Health & Social Care in the Community 21(1): 69–78.

16.

Liberati A, Altman DG, Tetzlaff J, et al. (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Annals of Internal Medicine 151(4): 65–94.

17.

Newton

(2012) Personalising reablement: inserting the missing link. Working with Older People 16(3): 117–121.

18.

Parsons

Rouse

Robinson

(2012) Goal setting as a feature of homecare services for older people: does it make a difference? Age and Ageing 41(1): 24–29.

19.

Petch

(2008) Reablement and the Role of the Occupational Therapist. Journal of Integrated Care 16(2): 38–39.

20.

Rabiee

Glendinning

(2011) Organisation and delivery of home care re-ablement: what makes a difference? Health & Social care in the Community 19(5): 495–503.

21.

Ryburn

Wells

Foreman

(2009) Enabling independence: restorative approaches to home care provision for frail older adults. Health & social Care in the Community 17(3): 225–234.

22.

Tinetti

Baker

Gallo

(2002) Evaluation of restorative care vs usual care for older adults receiving an acute episode of home care. The Journal of the American Medical Association 287(16): 2098–2105.

23.

Tinetti

Charpentier

Gottschalk

(2012) Effect of a restorative model of posthospital home care on hospital readmissions. Journal of the American Geriatrics Society 60(8): 1521–1526.

24.

Townsend

Polatajko

(2007) Enabling occupation II: advancing an occupational therapy vision for health, well-being & justice through occupation, Ottawa: CAOT Publications ACE.

25.

Tuntland

Aaslund

Espehaug

(2015) Reablement in community-dwelling older adults: a randomised controlled trial. BMC Geriatrics 15: 145.

26.

Tuntland

Espehaug

Forland

(2014) Reablement in community-dwelling adults: study protocol for a randomised controlled trial. BMC Geriatrics 14: 139.

27.

Upton

Stephens

Williams

(2014) Occupational therapists’ attitudes, knowledge, and implementation of evidence-based practice: A systematic review of published research. The British Journal of Occupational Therapy 77(1): 24–38.

28.

Vardagsrehabilitering - en kunskapsöversikt (2015) [In Swedish] June. Available at: http://www.med.lu.se/content/download/113774/751550/file/vardagsrehabilitering.pdf (accessed 1 March 2017).

29.

Vik

Eide

(2014) Evaluation of participation in occupations of older adults receiving home-based services. British Journal of Occupational Therapy 77(3): 139–146.

30.

Whitehead

Drummond

Walker

(2014) Occupational Therapy in HomEcare Re-ablement Services (OTHERS): study protocol for a randomized controlled trial. Trials 15(6): 447.

31.

Whitehead

Worthington

Parry

(2015) Interventions to reduce dependency in personal activities of daily living in community dwelling adults who use homecare services: a systematic review. Clinical Rehabilitation 29(11): 1064–1076.

32.

Winkel

Langberg

Waehrens

(2015) Reablement in a community setting. Disability and Rehabilitation 37(15): 1347–1352.

33.

Witsø

Eide

Vik

(2011) Professional carers’ perspectives on participation for older adults living in place. Disability and Rehabilitation 33(7): 557–568.

34.

World Report on Disability - World Health Organization 2011. Available at: http://www.google.se/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0ahUKEwiXoKinhrLPAhXDFSwKHSoTAu4QFggqMAE&url=http%3A%2F%2Fwww.who.int%2Fdisabilities%2Fworld_report%2F2011%2Freport.pdf&usg=AFQjCNGFgnl6GnAVzgDMBkrFKJLEUIc47w (accessed 27 September 2016).