Embracing Reablement as an Essential Support Approach for Dementia Care in the 21st Century: A Position Paper

Abstract

Silke F Metzelthin,1,2 Jette Thuesen,3,4 Hanne Tuntland,5 Magnus Zingmark,6 Yun-Hee Jeon,7 Hanne Kaae Kristensen,8,9 Lee-Fay Low,7 Christopher J Poulos,10,11 Jackie Pool,12 Miia Rahja,13 Erik Rosendahl,14 Marjolein E de Vugt,15 Clarissa Giebel,16 Maud JL Graff,17 Linda Clare18 1Department of Health Services Research, Maastricht University, Maastricht, the Netherlands; 2Living Laboratory in Ageing and Long-Term Care, Maastricht, the Netherlands; 3REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Nyborg, Denmark; 4Department of Clinical Research, University of Southern Denmark, Odense, Denmark; 5Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway; 6Department of Occupational Therapy, Institution of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden; 7Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; 8Centre for Innovative Medical Technology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; 9Health Sciences Research Centre UCL University College, Odense, Denmark; 10Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia; 11HammondCare, Sydney, NSW, Australia; 12Dementia PAL, Southampton, UK; 13Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia; 14Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden; 15Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, Mental Health and Neuroscience Research Institute, Maastricht University, Maastricht, the Netherlands; 16Department of Primary Care and Mental Health, University of Liverpool & NIHR Applied Research Collaboration North West Coast, Liverpool, UK; 17Department of Rehabilitation & Department of IQ health, Radboudumc Alzheimer Center, Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands; 18University of Exeter Medical School and NIHR Applied Research Collaboration South-West Peninsula, Exeter, UKCorrespondence: Silke F Metzelthin, Department of Health Services Research, Maastricht University, Duboisdomein 30, Maastricht, 6229 GT, the Netherlands, Tel [phone], Email [email protected]: The World Health Organization (WHO) recognizes the right of individuals with dementia and their family caregivers to access interventions that enhance their participation in society. Reablement is an approach that enables older people to participate in meaningful daily and social activities. Over the past decade, a growing body of evidence has underscored reablement as a promising approach within dementia care, including positive outcomes for people with dementia and their family caregivers, and cost-effectiveness. However, the dissemination of knowledge about and practical implementation of reablement remain slow. This position paper, authored by the ReableDEM research network, aims to address key issues related to implementing reablement in dementia care. To expedite the adoption of reablement within dementia care, we propose five critical areas of focus: 1) Changing the attitudes and expectations of stakeholders (eg health and social care staff, policy makers, funders) – encouraging people to think about dementia as a disability from a biopsychosocial perspective; 2) Disrupting health and social care - A radical change is needed in the way services are organized so that they are more holistic, personalized and resource-oriented; 3) Investing in capacity-building and creating a supportive environment – the workforce needs to be trained and supported to implement reablement in dementia care; 4) Involving, educating and supporting family caregivers - services and staff that are equipped to provide reablement will be better able to involve family caregivers and the person’s social network; 5) Providing robust evidence about reablement in dementia care by conducting high-quality research with long-term follow-up.Keywords: ageing, sustainability, autonomy, capacity-building, functioning, social participation

Keywords

• ageing
• sustainability
• autonomy
• capacity-building
• functioning
• social participation