Interprofessional homebased reablement intervention for older adults in Sweden: a randomized controlled trial

Reablement has a health promotive perspective. The goal is to enhance or maintain health and functional ability and, thereby, the ability of older adults to live in their own homes. The intervention described in this study was introduced so the older person would remain at home and be given the opportunity to regain or maintain functional ability physically, mentally, and socially to live independently and have optimal health and well-being. This paper aims to report the measured effects of reablement among the older adults in terms of bio-psycho-social health that emerged in the randomized controlled trial (RCT).

A sample of older adults (65+) was studied, consisting of those who applied for homecare in the municipal home service (n = 237), those who received intensive home reablement (IHR) carried out by an interprofessional team, and a control group who received home-based care as usual. Data were collected at three different occasions with validated instruments: at inclusion, after completion of IHR, and 3 months after completed intervention.

Both groups improved significantly at the post-measurement, and this improvement was maintained at the 3-month follow-up regarding: global quality of life (HACT); general health (EQ-5D-5 L); the self-estimates for mobility, hygiene, daily activities, pain/discomfort, anxiety/depression (EQ-5D-5 L); subjective well-being (GP-CORE); self-assessed capacity to perform physical activities as well as satisfaction with performance (COPM); measures of physical activity capacity regarding lower extremities (SPPB); upper extremities (hand dynamometer test). No between group differences were statistically significant. At the 3-month follow-up, the average number of homecare hours was slightly lower in the group that underwent IHR than in the group receiving usual homecare and rehabilitation interventions, but the difference was not statistically certain.

In this RCT with a relatively short follow-up period, IHR was equivalent to traditional homecare regarding older people's self-reported health, physical activity ability and number of homecare hours.

ClinicalTrials.gov (https://clinicaltrials.gov/study/NCT03565614?intr=Reablement&rank=4) Registration number: NCT03565614. Registered on 1 January 2016.