The purpose of this project is to continue to develop, implement, and evaluate a unique reablement intervention, ASSIST 2.0. ASSIST 2.0 is designed based on the research group's knowledge of reablement, including a feasibility study that tested ASSIST 1.0.
The research question is: Can older adults receiving ASSIST 2.0 improve their performance and satisfaction in daily life activities, self-efficacy, frailty, perceived health, quality of life and a person-centered approach?
The project will determine the differences in the reablement intervention (ASSIST 2.0) compared to regular home care in terms of older adults' performance in daily activities, self-efficacy, frailty, perceived health, quality of life and perceived person-centered approach. ASSIST involves an on-line education for healthcare professionals (Occupational and Physical therapists) and home care staff. In ASSIST 2.0, older adults will identify problems in performing necessary and desired daily activities. Home care staff, under the guidance of healthcare professionals, will support older adults in performing these activities. Home care staff will receive supervision and mentoring in the form of support for reflections from the healthcare professionals to ensure adherence to the reablement method.
The project includes an evaluation of the effects of ASSIST 2.0 compared to regular home care and is designed as a pragmatic clinical trial (PCT) with recruitment through two home care units in Stockholm and two home care units in Uppsala. There will be an intervention group (IG) receiving ASSIST 2.0 and a control group (CG) receiving regular home care at each location. The ASSIST 2.0 involves occupational therapists and physiotherapists working at the intervention units and responsible for training and supervising the home care staff. All staff working with ASSIST (IG) will participate in an on-line educational package developed by the researchers including practical and theoretical aspects of reablement, reflection and a person-centered approach.
ASSIST 2.0 reablement consists of the following components: a) an intervention aimed at older adults to help them perform daily activities they need and want to do. This will be achieved through optimal support from home care staff, b) an on-line education provided by the researchers for all staff in the art and science of reablement, c) training and support through mentorship and coaching provided by occupational and physical therapists for home care staff to ensure the proper delivery of reablement. and d) support for communication between older adults, their relatives, home care staff, and healthcare professionals.
To study the effects of ASSIST 2.0 in the IG compared to a CG, 1001 older adults living at home and in need of home care, and their possible relatives, will be recruited and followed for one year. Quantitative and qualitative methods will be used to evaluate the intervention. Standardized instruments will be used to assess the older adults' a) perceived performance and satisfaction in daily life activities, b) independence in activities of daily living (ADL), c) fragility, d) self-efficacy, e) overall quality of life and f.) perceived person-centered approach. For the significant others, a) caregiver burden and b) provision of informal care will be assessed. For both older adults and relatives, a) perceived life satisfaction and b) levels of anxiety and depression will be assessed. The experiences of the intervention will be explored through qualitative interviews with the participating older adults, their relatives, healthcare professionals, and home care staff.
1. An effect calculation is based on our feasibility study. The outcome measure Canadian Occupational Performance Measure showed that for a 95% chance of demonstrating a real treatment effect (95% power), 50 older adults will be included in each group, with a calculation for dropouts.