Aging & Social Change: Thirteenth Interdisciplinary Conference

Abstract

Reablement is time-limited home-based intermediate care for older adults to regain independence. The UK has been a pioneer in developing, piloting, and rolling out reablement; however, widespread misunderstandings of reablement by health professionals, service users, and families indicate that the ethos of reablement – independence, has not been embraced by the wider public. This contrast challenges the fit between the core notion of reablement and UK practices; and its sustainability. This paper is part of an investigation into user engagement in reablement. Five research sites across England and Wales were selected, representing different models of service organisation and delivery and broader contexts. Data were collected through focus group discussions with reablement staff (n=78) and interviews with service users (n=12) and families (n=5) during June and August 2022. Thematic analysis was applied. The analysis identified three paradoxes in service organisation and delivery that threatened the core of reablement. Overall, the increasing number of low-potential referrals undermined its ability to achieve independence. As a key player, families were more of a barrier to engaging seniors with reablement activities, leading to constant negotiations among multi-stakeholders that inevitably compromised the pursuit for independence. The functionality-focused model has caused an unintended consequence of user dependency on staff companionship, exacerbated by disjointed services. The paradoxes suggest that current practices undermine the sustainability of reablement. The quest for active ageing and independence requires forward-thinking and sound management, as some influencing factors are unamenable to limited resources. Therefore, policy rethinking and resource mobilization and reallocation are imperative.