The practice of support personnel, supervised by physiotherapists, in Norwegian reablement services

Reablement is a relatively new service targeting people with or at risk of functional decline. The approach is team based, and physiotherapists (PTs), occupational therapists, and nurses have the responsibility to guide and supervise the support personnel, referred to as home trainers (HTs). The aim of this study was to explore how the HTs follow up instructions and supervision by PTs in reablement.

This qualitative study included video recordings of practice and individual interviews in seven Norwegian reablement teams. The analysis involved a triangulation of all data.

The results identified that HTs had the main responsibility to carry out interventions in reablement and were also expected to report back to the therapists if they recognized further need for assessment or adjustments. The content of the practices varied considerably along a continuum from rigidly standardized practices to individually tailored approaches emphasizing quality of movement. This paper presents analyses of two examples representing the two widely different approaches.

Practitioners and health authorities should be aware of the broad variation in reablement services in Norwegian municipalities. The results indicate that a standardized approach may be more efficient in the short term, targeting a large population, whereas a tailored approach, valuing quality of movement, is essential to provide high-quality movement training for users with complex rehabilitation needs. The target groups receiving the different reablement methods should be clearly identified.