Actively involved in community (volunteers at church, coordinates events/activities for neighbours in apartment complex Oasis, enjoys swimming twice a week and visiting with friends)
Values independence, looking her best (i.e wearing form fitting clothing to show of figure and the fact she lost 100 lbs)
Stroke Survivor (foot drop and right side weakness), Arthritis, Fibromyalgia , Herniated discs in lower back
Difficulty getting pants over brace, especially bulky strap (Main OPI)
Primarily uses power wheelchair for ambulation and transportation, able to walk short distances within home, has walker to move around building
IFA Reablement for Older Adults
"enable people to be and to do what they have reason to value"
IFA Reablement is considered an "Enabling Society" and works to enable adults to remain social and involved in society through
Goals based on functional capacity and what can be done "safely". Short term goals that can be achieved
Reablement approach allows individual to identify what they VALUE
"Focus on what they can do, not what they no longer are able to do"
Holistic in nature
Aligns with the new approach of WHO healthy aging
Maximize function throughout a lifetime
Fit with IFA Reablement
Canadian Model of Client-Centred Enablement (CMCE)
This includes the 10 enablement skill,
It is value based; goal directed; client centred; encompasses a vision of wellness, health, inclusion and justice; This model outlines an enablement continuum from ineffective enablement -effective. Over all embodies OT
OT's work WITH people rather than do thing 'TO' them or 'FOR' them which make OT a profession that could adopt the reablement approach easier than some other health professions
Focus on performance and engagement. Outline the interaction of the person (physical, cognitive, Affective and spirituality), Occupation (productivity, leisure and self-care), & Environment (physical, social, institutional and cultural) These are key domains or areas where an OT would assess and intervene.
How Do They Compare?
IFA Reablement for Older Adults
Focus on function
Consideration of environmental context
Aims to Enable
Facilitates one's ability to participate, contribute to and be productive and viewed as valued member of society
(Mishra & Barratt, 2016)
Emphasis on autonomy (gaining or restoring)
IFA takes a multi dimensional appraoch to enabling as do OT's. ie OT rarely approach intervention only accessing one determinate or looking with one lens. IFA takes bio psychosocial approach OT would look at whole picture (social cultural,psycho-emotional, physical, cognitive and environmental.
IFA Reablement is a policy to try and inform governments and stakeholder while OT is on the front lines working directly with people putting frameworks to practice
OT has a higher emphasis and focus on occupations. IFA looks at person and environment but does not directly define Occupation as a focus but does elude to a holistic approach as well as ADL's
With IFA Reablement For Older Adults
Miss C. is a highly independent individual who is actively involved in her community. She has overcome her health decline by adapting, remaining autonomous and focusing on what she is able to do. She has a positive outlook which aligns well with the strength based approach the reablement philosophy
Miss C. currently receives assistance from PSW for lower extremity dressing, in particular for her compression socks. She was given an assitive device that did not help, however it was not functional which turned her off of assistive devices. We are creating a new assistive device to help ease the strain of pulling her pants over her brace. We hope it will be funcitonal for Miss C. and that she will not require as much supportive assistance in the future for dressing.
Although Miss C is not a older adult yet the reablement approach is still applicable for her as it can be applied across the lifespan. As Miss C continues to age with her pre-existing conditions she will be able to continue to use her self-management skills to remain aging at home.
McColl, M., Law, M., & Stewart, D. (2015). Theoretical Basis of Occupational Therapy. 3rd ed. published by Slack Incorporated.
Mishra, V., & Barratt, J. (2016). Final report: reablement and older adults. IFA Copenhagen 2016 Summit. Retrieved from:http://www.ifa-copenhagen-summit.com/wp-content/uploads/2016/04/Copenhagen-Summit-Final-Report.pdf
Townsend, E. A., & Polatajko, H. J. (2007). Enabling occupation II: Advancing an occupational therapy vision for health, well-being & justice through occupation. Ottawa: Canadian Association of Occupational Therapists.