Reablement
Paul Collinge
Joint strategic Commissioning
Manager – Older People
What’s it all about
• Individuals tell us of their;
– Increased desire to retain and maximise
independence, choice and control over their
lives and not to be a passive recipient of care
– Increasing desire to live longer and healthier
with a good quality of life into old age.
– To increase their self esteem and resilience or
ability to care for themselves and manage
challenges and opportunities as they arise
Context
•
Significant increase in elderly population with similar potential increase in
demand and costs – approximately 30 % increase in over 75’s in next 10
years – and a growing proportion of all elderly are anticipated to have
dementia
•
Unchecked the costs of domiciliary care provision alone could rise by £7.5
over same time period.
•
Government and local policy to provide services which maximise
independence and opportunities for recovery for older people including
those with dementia
•
Many other LA’s through reablement are impacting on demand for LT care
•
Part of Devon’s development a range of integrated of health and social care
services including
•
•
•
•
Complex care teams
Intermediate Care
Equipment services
Etc
Social care reablement service
•
Available to support older people including those with dementia and
younger individuals with disabilities or life limiting long term conditions.
•
Offered to all individuals seeking personal care services for the first time or
where there has been a sudden and significant increase in personal care
needs.
•
Where necessary provided alongside primary care, complex care teams
and rehabilitation services.
•
Represents a different basis for engagement with individuals and their
carers
•
It means we will;
– Provide a full opportunity for recovery, to maximise independence and to support
the carer before agreeing with you your longer term support needs.
– Provide a full assessment is completed which will include the outcome of the
reablement intervention
Anticipated Outcomes of reablement
• Individual and carer outcomes
• Improved abilities with personal care, mobility, medication
and domestic routines
• Improved ability for self care (personal care and health care)
• Reduced carer stress
• Improved self esteem and well being
• Organisational outcomes
• Reduced demand for long term personal care services with
reductions in the anticpated increase in personal care costs
in future years
• Delay use of intensive services at home or in care home.
• NHS benefits in terms of reduced use of primary and
secondary care services.
Case Study
• Mrs Smith 75 years of age lives alone
• Daughter lives nearby and is the main carer
• Mrs Smith is experiencing increasing periods of forgetfulness. She
suffers with Arthritis and Diabetes. She has fallen recently and is
now less mobile around her home.
• Mrs Smith and her daughter are becoming increasingly anxious
about how she might cope with her personal care whilst at home.
Mrs Smith appears to have lost confidence in her ability to care for
herself.
• Prior to the fall Mrs Smith received no personal care services but her
daughter provided some assistance with bathing.
Reablement
What might happen next?
•
Mrs Smith Daughter contacts care Direct Plus and discusses the case with an
Occupational therapist (OT) – the OT also speaks to Mrs Smith – the OT also speaks
with Mrs Smith GP to see if there are any health issues that should be addressed.
•
They agree on what Mrs Smith and her daughter feel needs to improve (goals) to
enable Mrs Smith to care for herself as much as possible at home.
•
The OT devises a programme that captures those goals and instructs care workers
how care should be provided to ensure they are met
•
Mrs Smith is visited at home by a support worker who works with Mrs Smith to
improve her walking, strength and balance through various exercises, and to
improve her ability to transfer from bed and chair, initially assisted with appropriate
equipment that has been ordered by the OT.
•
The OT arranges bathing equipment to assist the daughter to bath her mother more
safely and with less strain for the carer.
•
The support worker works with the local pharmacist to introduce and train Mrs Smith
in equipment that reminds Mrs Smith when to take prescribed medication. Failing to
take medication being a critical factor in the original fall. Mrs Smith is issued with a fall
detector which reassures Mrs Smith and her daughter that in the event of fall in
future, help will get to Mrs Smith much more quickly.
Reablement – What Changes?
•
Mrs Smith’s walking, strength and balance improve and with the help of a
walking aid now feels fully confident getting around her house and
transferring from bed, chair and toilet unaided
•
Mrs Smiths daughter is reassured now her mother has a falls detector and
now that she has suitable bathing aids and equipment that reminds her
mother to take her medication
•
Because the GP was alerted Mrs Smith has been invited into her GP
surgery for an assessment of her forgetfulness, her bone health and her
Diabetes and her medication has been reviewed. Mrs Smith is now
attending a falls exercise class at her GP surgery.
•
Mrs Smith and her daughter now attend their local Dementia Café for
support.
•
By week 6 Mrs Smith requires no personal care services ( where she may
previously received 3 hours per week at £50 p.w.), she feels more
independent and less anxious that at the start of reablement.