Abstract
The UK has been at the forefront of developing, piloting, and rolling out reablement – time-limited home-based intermediate care provided by local authorities to help older adults regain independence. However, significant inconsistencies challenge the core notions of reablement, its fit with practice, and ultimately its sustainability. This paper examines reablement policy along (1) the policy lifecycle dimension, i.e. (in)coherence across policy design and implementation; and (2) the system dimension, i.e. (in)compatibility between reablement and the wider system. The paper is part of research into user engagement in reablement. Five research sites were selected across England and Wales. Data were collected through focus groups with reablement staff (n=78) and interviews with service users (n=12) and families (n=5) in 2022. Thematic analysis was applied. Four paradoxes are identified. The widespread misunderstanding of reablement has hindered this paradigm shift. Increasing low potential referrals have undermined the ability of reablement to achieve independence. Families have been more of a barrier to engaging seniors with reablement, leading to constant multi-stakeholder negotiation that compromises the pursuit of independence. The unintended user dependency on staff companionship caused by the functionality-focused model contradicted efforts towards independence. These paradoxes reveal a conflict between high aspirations for reablement in policy discourse and its low priority and deviations from the ideal in practice, calling for policy rethinking and resource mobilisation and reallocation. More broadly, examining and ensuring coherence within policy and its compatibility with the wider system is vital to the ongoing welfare reform, particularly the development of integrated care.
Presenters
Chunhua ChenResearch Associate, School for Business and Society, University of York, United Kingdom
Details
Presentation Type
Paper Presentation in a Themed Session
Theme
Public Policy and Public Perspectives on Aging
KEYWORDS
REABLEMENT, POLICY ANALYSIS, COHERENCE AND SUSTAINABILITY, WELFORM REFORM, INTEGRATED CARE
