Evaluation of a wellness and reablement approach in Australia: Learnings from a pilot project.

Abstract

Australian health and aged care reforms mandate a wellness and reablement (W&R) approach with services and the workforce needing to adjust their way of working with older people, to actively promote independence and participation in life's activities. Studies exploring the older person's perspective are sparse. This study aims to understand the older person's experience of a W&R approach, supplemented with experiences of staff trained in the approach. The study evaluates a W&R approach implemented across three community-based sites of a large Australian aged care provider. Staff from participating sites underwent training and were asked to use a W&R approach with at least one older person. Eighteen older people aged 65+ were engaged in the 4-month programme. Semi-structured interviews with older people and staff were conducted on completion of the programme. The W&R approach showed variable benefits and experiences of older people related to goal setting and outcomes. Overall, older people were unfamiliar with goal setting or displayed negative attitudes. Negative emotional responses to health decline and ageing, such as apathy, frustration, embarrassment and sense of helplessness, were identified as barriers to goal pursual. In contrast, enabling factors, such as assistive equipment, staff and social connection, triggered positive emotional responses, which acted as protective factors and enhanced goal pursual. Staff knowledge and understanding of the W&R approach also influenced older people's experience and outcomes. These findings recommend a stronger focus on the social and emotional aspects of W&R and co-developing goals in line with the older person's sense of wellbeing. This approach supports the multiple dimensions of W&R and aligns with principles of positive and healthy ageing. Additional training for staff should be provided, with ongoing mentoring and support from W&R champions. Ensuring that goals are meaningful and valuable to individual older people will enhance successful goal pursual and improve outcomes.