How to: reablement means treating client as a ‘well person, not a sick patient’

Alzheimer’s Queensland focuses on what the person can do, not what they can’t, reports Jackie Keast in this new series showcasing how leading aged care providers have embedded wellness and reablement approaches.

Alzheimer’s Queensland focuses on what the person can do, not what they can’t, reports Jackie Keast in this new series showcasing how leading aged care providers have embedded wellness and reablement approaches.

As part of its organisational philosophy, Alzheimer’s Queensland (AQ), which is both a peak body representing people with dementia and a service provider, focuses on supporting clients to continue engaging with interests and life in their local community.

In that sense, adjusting to the new requirements to adapt a wellness and reablement approach didn’t require dramatic changes to operations as the organisation was already working that way, according to community services manager Caylie Field.

“We’ve certainly embraced it because it’s the core of what we have always done,” Ms Field told AAA ahead of her presentation at the upcoming Active Ageing Conference.

caylie field
Caylie Field

“People are well. They may have chronic diseases, but they still should be treated as a well person, a whole person – not a sick patient.”

Ms Field, who manages AQ’s Ipswich Multi-Service Centre, said that when a client comes into respite, staff focus on finding out their story and interests. From there, they work together to design recreational goals – as opposed to clinical goals – based around outings or activities clients would like to do or continue, whether it be going on a fishing trip, or to a local craft club.

“We don’t do assessments of all the things you are unable to do. We find out how much you can do, how much help you need to do that well, and do that better,” she said. “Regardless of their condition or chronic disease, everyone has the ability to make physical, social and emotional gains based on that wellness approach.”

For example, Ms Field has one client with Parkinson’s disease and dementia who, up until a year ago, volunteered as a driver for a local community centre. Recognising that he still wanted to give back, Ms Field and her team have supported him to reconnect with a volunteer role through Meals on Wheels.

“We drive the car, and he does the deliveries,” she said.

AQ’s respite cottages are also set up like a household to offer people with dementia familiarity and few restrictions are placed on what they can do. This makes people comfortable and diminishes risks – enabling them to continue with everyday activities, said Ms Field.

“If you start modifying equipment, a person with dementia isn’t going to recognise that,” she said. “Put an actual proper china cup in a person’s hand, they know it’s a cup. Whereas if you put a plastic cup in their hand with a hot drink in it, that will be very confusing.”

Ms Field said while the official shift to a wellness and reablement approach was for the most part semantics, it had reinforced AQ’s model and encouraged consideration of further opportunities, such as in time-limited interventions.

“I think the wellness approach is moving us all in the right direction, to thinking very differently about older people… their ability and absolute strength in contributing to our community.”

Working with families

Ms Field said families often reported significant improvements in their loved one’s wellbeing, including improved sleep patterns and reduced sundowning.

However, one of AQ’s challenges was ensuring they worked closely with families to support them in facilitating their loved one to participate everyday at home, she said.

One of the things that is heartbreaking and very difficult for families is a loved one not being able to do jobs – set the table, cook dinner or mow the grass,” she said. “We go in and provide some supports to see how part of a task can still be done.”

Ms Field said they encouraged families to break tasks into smaller steps and do them together. “That gives carers the ability to see their loved ones a little differently, and see still ability in their lives,” she said.

The Active Ageing Conference 2016, hosted by Australian Ageing Agenda, takes place on 4 August at Swissotel, Sydney

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Tags: active ageing 2016, Alzheimer’s Queensland, reablement, respite, wellness,

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