A Wellness and Reablement Approach to Purposeful Ageing
Published: 03 September 2019
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.
‘An important key to ageing successfully is feeling that our lives are meaningful… At every age we need some structure in our lives and a reason to get up in the morning. Without it, sickness and earlier death are more likely.’
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 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.);
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)
Benefits of Wellness and Reablement
Along with improving the independence and autonomy of a client, the benefits of wellness and reablement include:
Improving function and quality of life in home care settings;
Facilitating integration between residential aged care residents and their local communities;
Embracing a positive and varied professional environment and more autonomy for allied health workers;
Increasing broad social and economic opportunities for the community.
(Conci 2018; State of Victoria, Department of Health and Human Services 2018)