A Wellness and Reablement Approach to Purposeful Ageing
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Purpose is the difference between existing, and living.
Purpose means having clear goals to keep us engaged in our day-to-day lives. Without it, we lack vitality, productivity and risk cognitive and physical decline (Conci 2018).
A wellness and reablement approach to ageing sees older adults setting purposeful goals for how they wish to live, to help regain and maintain independence and autonomy, for as long as possible.
The Federal Government announced an increase in funding for aged care in 2018 to focus on promoting greater independence, mobility and autonomy (Australian Government Department of Health 2018). As a result, service providers are now acknowledging that a key way to do this is through wellness and reablement, with reablement embedded firmly within the Commonwealth Home Support Programme (CHSP) assessment, referral and service pathway (Eastern Sector Development Team 2018).
The adoption of this approach sees a shift from a model that may have supported dependence (‘doing for’), to one that is actively supporting independence (‘doing with’) (Wimmera Primary Care Partnership 2019).
Wellness and reablement are directly tied to the Aged Care Quality Standards, particularly Standard 1: Consumer Dignity and Choice, Standard 2: Ongoing Assessment and Planning with Consumers, and Standard 4: Services and Supports for Daily Living.
What is Wellness and Reablement?
- Wellness is the emphasis on identifying an individual’s needs, aspirations and goals, while acknowledging and building on existing strengths, in collaboration with support services.
- Reablement, similar in concept to rehabilitation, is the use of goal-oriented activities to regain or improve their functional capacity for independent living.
(Nous Group 2018)
Wellness and reablement reject the notion that ageing is an irreversible and inevitable decline. Through purposeful engagements, the approach aims to empower older adults to improve their quality of life by improving their physical and mental fitness (Fine 2018).
Wellness and reablement can be adopted in both home care and in a residential setting.
Some examples of wellness and reablement activities may include:
- A personalised, targeted exercise plan;
- Easy living equipment (e.g. shower chair, cutlery with large grips, pick-up stick, signs, screen readers, etc.);
- Volunteer programs;
- Social engagement activities;
- Creative engagement (e.g. art classes, art and music therapy);
- Self-care skills (e.g. cooking for recently widowed men who may have never learned before).
(Fine 2018; Municipal Association of Victoria 2014)
Once an older adult is assessed, in collaboration with their care worker, the client identifies their basic needs and larger goals and aspirations. Together, a plan can then be developed to help the client achieve their goals (Nous Group 2018).
- Clients should first be assessed to understand what is happening in their life at this time (pre-intervention). Consider adopting a collaborative, ‘strength-based’ approach, which recognises the client as the expert of their own experience and is therefore instrumental to understanding where to go from here.
- Ask broad questions to find out what is most important to the client, what challenges they currently face in life, and what their strengths are.
- Explain to your client what goals are and why you are setting them.
- Individualise your language to what you think will best convey your message.
- Your care plan should be a living document - they will change often, with your client’s needs, and this should be communicated to your client.
- Consider collaborating with other health professionals or service providers, and family members, to help align goals.
(Kate Pascale and Associates Pty Ltd 2019)
Multiple Choice Questions Q1. Which of the following is not a benefit of wellness and reablement?
- Create social and economic opportunities for the community.
- Improve the quality of life of clients.
- Improve the independence of clients.
- Increased pressure on advanced healthcare services.
- Q2. Which of the following are examples of wellness and reablement in action?
- A client is taught strength training exercises to help regain mobility after a fall, with the aim of being able to return to ballroom dancing events.
- A client with limited mobility is given a kit which includes long handled-gardening tools and a seat with wheels, to help them continue to maintain their garden.
- After losing his wife of over 55 years, an older male client is assisted to create a meal plan, and has ingredients and cooking classes delivered to help improve his independence at home.
- All of the above.
- Australian Government Department of Health 2018, Better Ageing - Promoting Independent Living, Commonwealth of Australia, viewed 4 September 2019, https://www1.health.gov.au/internet/budget/publishing.nsf/Content/1EBE3C2BB8D2690ACA25826D00063645/ $File/088_FINAL_FS_AAC_PromotingIndependentLiving.pdf.
- Conci, L 2018, Wellness, Reablement and Purposeful Ageing, 8 March, viewed 4 September 2019, https://lasa.asn.au/wp-content/uploads/2018/03/Day-2-1430-Wellness-and-Reablement-Lidia-Conci- 1.pdf.
- Eastern Sector Development Team 2018, Wellness & Reablement, ESDT, viewed 4 September 2019, http://www.esdt.com.au/wellness--reablement.html.
- Fine, M 2018, ‘Reablement: the best aged care policy no one ever heard of’, Aged Care Insite, 10 December, viewed 4 September 2019, https://www.agedcareinsite.com.au/2018/12/reablement-the-best-aged-care-policy-n o-one-ever-heard-of/.
- Hannon, K 2017, ‘How to Stay Forever Young, Really’, Forbes, 8 January, viewed 4 September 2019, https://www.forbes.com/sites/kerryhannon/2017/01/08/how-to-stay-forever-young-r eally/#58d48c6f12d3.
- Kate Pascale and Associates Pty Ltd 2019, Service specific goal setting and care planning for Commonwealth Home Support Programme (CHSP) service providers, Hume Whittlesea, Kate Pascale and Associates, viewed 4 September 2019, https://static1.squarespace.com/static/598d301fbebafb69f8d0bb5a/t/5d2a7665bcb3f2000127ed8d/1563063927953/Service+Specific +goal+setting+and+care+planning.pdf.
- Municipal Association of Victoria 2014, Enabling the use of easy living equipment in everyday activities, MAV, viewed 4 September 2019, http://docs2.health.vic.gov.au/docs/doc/DE51FCD348B39D74CA257D7F001515EC/$FILE/easy%20living%20equipment%20guide.pdf.
- Nous Group 2018, Wellness and Reablement in the home care sector, Commonwealth of Australia, viewed 4 September 2019, https://agedcare.health.gov.au/sites/default/files/documents/05_2018/wellness_and_reablement_review_summ ary_of_consultations_1.pdf.
- State of Victoria, Department of Health and Human Services 2018, Wellness and reablement in the Victorian home care sector, Victorian State Government, viewed 4 September 2019, https://centralvicpcp.com.au/lmcca/wp-content/uploads/2018/11/Wellness-and-reablement-in- the-Victorian-home-care-sector-Statewide-review-of-progress.pdf.
- Wimme ra Primary Care Partnership 2019, Wellness & Reablement, Wimmera PCP, viewed 4 September 2019, http://wimmerapcp.org.au/hacc-and-community-aged-care/active-service-model/.
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