Wellness and reablement resources for CHSP providers

“Older Australians are not the only ones who benefit from Wellness and Reablement. Evidence suggests there are also significant benefits to service providers, caregivers, and the broader community.”
Quote from the 2018 Nous Group Report – Wellness and Reablement – Summary of consultations across the Home Care Sector

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A short history of the development of Wellness and Reablement within the Home and Community Care Sector

Australia has for over twenty years been seeking to develop, deliver and embed both targeted reablement programs and more generic wellness and reablement service delivery approaches as a key focus of home and community care.

We have compiled a short history to show the journey undertaken across Australia from 1999 until the present time. Some of this information has been extracted directly from the Unpacking Reablement work undertaken by the Australian Association of Gerontology (AAG – updated 2022) and supplemented with additional information and links.

Ref: Fact sheet 2 Australian approaches to reablement in the home support and care program Nov 2022.

Please note: this section is focused primarily on the delivery of wellness and reablement service delivery work practices by home and community care providers, therefore the history of wellness and reablement as part of the home support assessment process by the Regional Assessment Services (RAS) and Aged Care Assessment Services (ACAT) is not detailed.

The role of the assessment services is clearly stipulated in the My Aged Care Assessment Manual 2018 stating that wellness and reablement processes need to be embedded in the assessment and support process and that both RAS and ACAT assessors will work with the client to establish a support plan that reflects the client’s strengths and abilities, areas of difficulty, and the support that will best meet their needs and goals. This includes the consideration of formal and informal services as well as reablement pathways.

This short history includes:

Organisation specific programs (such as the Home Independence Program and The Personal Enablement Program) developed by Silver Chain in Western Australia (WA) and operated from 2004 – 2018
State based responses (such as the WA HACC Wellness Approach and the Victorian Active Service Model)
Australian Government reports and reviews recommending the introduction and embedding of wellness and reablement, such as the 2011 Productivity Commission Inquiry Report Caring for Older Australians, the 2017 Legislated Review of Aged Care Report (Tune Report) and the 2021 Royal Commission into Aged Care Quality and Safety
Australian Government initiatives and resources providing direction to the aged care sector such as 2015 Living well at Home – CHSP Good Practice Guide, 2023 – 2024 Commonwealth Home Support Program Manual and the 2020 Wellness and Reablement Digital Site

Wellness and Reablement as significant paradigm shifts are a win-win. A win for older people by supporting individuals to remain as able, independent and engaged as possible in their community and a win-win for government and society as it can free up resources for those who require regular and longer support.

Why Wellness and Reablement is important

To support the ageing population, there is growing evidence that we need to improve health and wellbeing across all ages. Early intervention and the adoption of preventative approaches are vital. This enables people to plan ahead, so they can minimise functional decline and their future need for care. (WHO, World report on ageing and health, 2015). Click here for more from WHO on ageing.

For organisations that provide aged care services, there is an expressed intent to maintain and enable the functional ability of those who are in receipt of support, but in practice, the objective can raise significant challenges to ensure there are opportunities provided to all clients. For this to occur organisations need to make sure that every interaction with a client whether, in person, via technology, or the written word has an enabling focus.

Response to the Wellness and Reablement approach for many organisations has gone beyond reform and change management to become embedded within the organisation’s culture. This takes determination and a belief across all parts of the business – from support workers to volunteers to board members. This approach incorporates the belief that every consumer has a right to opportunities that fulfill their physical, mental and spiritual potential, no matter where they are on life’s journey. An organisation’s shared beliefs and values will impact the client’s ability to achieve good outcomes and remain living in their place of choice but it also is dependent on the lens through which each individual views the clients they are supporting.

Do they see the client as an individual who needs ‘help’ which is their role to provide or do they view the client as someone with the potential to make gains in their ability, no matter how small that gain is, with their support? A fundamental ageist response from staff when working with clients receiving aged care services is one of the biggest challenges to embedding wellness and reablement successfully within service delivery.

For further reading related to Ageism and the negative impact of ageist beliefs on older people please see the articles and links below. Plus discover how ageist you are and how it may impact your work practices.

Ageism
Ageism may manifest in a benevolent form, where support services have a protective response toward older people in their care. While the intentions of service providers are often well-meant, they can undermine the dignity of older people to enable choice and control to fulfill their physical, mental, and spiritual potential. (Australian Human Rights Commission. A Human Rights Perspective on Aged Care, 18 July 2019)
Find out where you sit
A recent WHO report found that every second person holds ageist attitudes. Ageism against older people is stereotyping, discrimination, and mistreatment based solely on a person’s age. Take this fun two-minute quiz to find out where you sit on the ageism spectrum
Aged Care: Human Right or a market opportunity?
People don’t need aged care solely because of their age. Rather, care is required because they develop health conditions that lead to reduced function and independence.  Social isolation and a need for assistance  are consequences of health problems. (Aged Care: Human Right or a market opportunity, Kathy Eagar, October 2020)

Imagine a world without ageism. Watch this enlightening video from Every AGE Counts on Ageism.

People don’t need aged care solely because of their age…

There are benefits of wellness and reablement for organisations

There have been significant benefits highlighted by organisations who have embedded wellness and reablement into their service delivery, these benefits are not only across the whole of organisation but can have a broader impact across the communities connected by clients and their families.

When staff are well informed of the support objectives, are supported to actively work alongside clients and assist them to achieve their support goals, and are empowered and involved to assist with problem-solving for both the client and the organisation their job satisfaction increases.
Where organisations have adopted a model underpinned by a short-term reablement focus the opportunity is presented to provide support to a greater number of clients with the prospect to broaden an organisations’s client base.
Client’s and their families who have been supported to achieve their support goals, currently requiring no support, are more likely to seek any further assistance needed from the same organisation.
In organisations that have adopted a model underpinned by wellness and reablement by placing the client at the centre of all decision making compliance with the Aged Care Quality Standards is supported.

Does your organisation have examples demonstrating the benefits of implementing wellness and reablement that you would like to share? This could include stories of improved staff job satisfaction, more efficient use of resources, a broadened client base as a result of more dynamic short-term targeted support and improved client outcomes and satisfaction.

If you would like to leave any comments or feedback on KeepAble, or let us know of some of your experiences with wellness and reablement, please contribute in our Contact Us/Feedback form below.

There is evidence that reablement programs designed to help people do things for themselves can delay or reduce the need for aged care services.

Resources for Home Care Providers

Here are some useful resources to help your organisation deliver Wellness and Reablement.

Making choices, finding solutions
This guide has been developed so people can make informed decisions when choosing assistive technology and home modification solutions. Review the eBook online.
KeepAble resources to download
This page provides links to all our resources for download on one page. We do suggest reading the supporting articles however to gain a true understanding of the accompanying resource.
It’s time to get serious about goal setting
For those accessing aged care supports, setting goals and planning towards achieving them provides the person a voice, making them and what they wish to achieve the focal point of the support being provided.
Guide to writing support plans
A support plan provides guidance to clients and support staff so they can work together to achieve the client’s goals.
Preparing your annual Wellness and Reablement report
Compiling your annual Wellness and Reablement report requires preparation and ensuring you have collected the right data.
Assistive Technology Essentials (Part one)
The aim of this guide is to build awareness and knowledge among Commonwealth Home Support Programme (CHSP) service providers and the broader aged care sector of the benefits of Assistive Technology (AT) and the role it plays as part of a Wellness and Reablement service delivery approach with improved outcomes for older people.
Assistive Technology Essentials (Part two)
Assistive Technology Essentials Part 2 is a guide for consumers, families, practitioners, and the home support sector that support them. Based on the best available evidence and extensive practice knowledge, this resource is a valuable knowledge translation tool in the rapidly evolving landscape of assistive technology.
Group Social Support – It starts with a conversation
Initial conversations undertaken with clients need to explore how they previously socialised, what prevents them from returning to previous activities, how long has it been, and how they envisage their social network to look in the future.