Health and financial benefits of reablement highlighted

New research has added to the growing body of evidence showing the positive impacts and cost savings associated with reablement services, with the authors calling for such services to be central in Australia’s reformed aged care system.

The study found that those receiving a reablement service compared to conventional home care were less likely to require home care services for several years after.

This reduced use of home care services was found to save around $12,500 per person over nearly five years.

Reablement services, also known as restorative services, are early intervention short-term services focused on helping older people improve their functional independence, social participation and quality of life. While there is mounting evidence showing the benefits of the services, few studies have looked at how long those benefits last.

The research, conducted by Professor Gill Lewin, Silver Chain Group’s research director, Assistant Professor Helman Alfonso, University of Western Australia, and Dr Janine Alan, Adjunct Associate Professor Curtin University, was published in the Clinical Interventions in Aging journal.

The researchers examined the home care service records over 57 months of 10,300 individuals who received Silver Chain’s Home Independence Program (HIP) or Personal Enablement Program (PEP) compared to the Home and Community Care (HACC) services. The study cohort consisted of 2,586 HIP clients, 5,450 PEP clients and 2,332 HACC clients.

HIP, which is targeted at older people who are referred from the community, is a short-term individualised service that promotes engagement in daily living activities and can include strength balance, endurance programs, falls prevention, continence and nutrition management. HIP usually has a 12-week limit.

PEP, which is targeted at older people discharged from hospital, also has an enablement focus, however it can also provide post-acute nursing if required. It also differs by having an 8-week limit.

Reduced need and cost benefits 

The study found that receiving the reablement services, compared to a conventional home care service, reduced the likelihood of using any home care service for the next three years and the need for a personal care service for nearly five years.

“We also compared the home care costs over a period of almost five years and found the costs associated with those who received either HIP or PEP were substantially less than those who received HACC services or more conventional home care,” said Professor Lewin.

According to the research paper, the median cumulative cost of all home care services in the restorative service groups was half the cost of the conventional home care HACC groups at three months and less than one third of the cost for those followed up for nearly five years.

“The median cumulative cost of home care in the reablement groups was $2,364 and $2,563 at three years and $4,579 and $4,793 at 57 months for PEP and HIP respectively, compared with $11,365 and $17,306 in the conventional HACC group,” the researchers wrote.

“This translates to a median saving per person of $9,001 for PEP clients and $8,802 for HIP clients after three years and $12,727 and $12,513 respectively after nearly five years.”

Central to reformed system

The researchers noted that the Productivity Commission’s recommendations for aged care reforms, and subsequent government response, were based on the “growing evidence of the effectiveness of reablement home care services in assisting older people to improve their ability to function and reduce their need for ongoing services.”

The routine provision of reablement, rather than a conventional service, when someone is referred for home care could make a significant contribution to containing the cost challenges associated with Australia’s ageing population, they wrote.

“It is therefore important for all Australians that this is a key component within the design of the Living Longer Living Better program.”

According to Silver Chain, its HIP service was the first home care reablement service in Australia.

Read the full paper: ‘Evidence for the long term cost effectiveness of home care reablement programs’