Becoming an enabler of everyday activity: Health professionals in home care services experiences of working with reablement

Abstract

Reablement services aim at improving participation in everyday activities at home and in the local community for older adults, focusing on the older adults' resources and goal for participation. Reablement services have been implemented in a number of municipalities in Scandinavia. To our knowledge, there are a few studies focusing on home care service providers experience working within the frame of reablement. To provide knowledge regarding how home care service providers working with reablement in the home care setting describe their experiences. The study had a qualitative design and included five focus group discussions with 25 healthcare professionals working in community health care in two municipalities. The data were analysed using a grounded theory approach. The analysis illustrated how the participants experienced both engagement and challenges working with reablement. This was identified by the two categories: creating sustainable change and negotiating the line between helping and enabling. The first described how increased focus on enabling participation among the service recipients created sustainable changes for the older adults and was considered a positive change for both the recipients and the health professionals. The latter showed how the participants found working with reablement as a process of negotiation. This was what the health professionals found most challenging with reablement. Working within the frame of reablement offered the service providers, a framework for being more flexible in meeting the fluctuating needs of the older adults. This was done by increasingly utilise ones' clinical skills and changing from providing passive care to working on increasing the older persons' participation in everyday activities. Working with reablement also created challenges. This was related to the health professionals perceived expectations of what some of the older adults expected home care to be and caused ambivalence. Nurses and healthcare workers should focus on older adults' resources and goals in order to give services that enhance participation in daily activities.