Reablement conversations: with Laura Coleman

In this episode, Hilary O’Connell and Laura Coleman, Practice Advisor for aged care and dementia at Avivo, discuss what short-term reablement means in practice, and how it can encourage older people to regain and maintain their independence.  

“Reablement for me means that people actually have an opportunity to decide what’s next for them. They may only need support for a very short time to get over an injury, so that is their opportunity. They don’t have to lock in for the rest of their lives to get support. And that’s really important…

… It helps a customer feel encouraged, this is possible, I can do it, I can get back; to where I was before my injury. So, it is a way of encouraging people to be positive, and not being independent by people. It can only be good.” Coleman says. O’Connell and Coleman also discuss practical examples of everyday reablement with clients, and how it is different to domestic care

Discover more reablement resources at keepable.com.au

Transcript

SPEAKER_01: 0:00

Well, hello and welcome to ILA's conversations about reablement, where we talk to people from different backgrounds and roles across the aging and aged care sector and get their perspectives on reablement. My name is Hilary O'Connell and I'm the principal advisor of healthy aging and reablement here at ILA. Today I'd like to welcome Laura Coleman. Laura is the practice advisor for aged care and dementia at Avivo, a not-for-profit aged disability and mental health community care organization here in West Australia. Laura has extensive experience within a not-for-profit community care setting and is a strong advocate of the adoption of reablement. So I'd like to welcome Laura and thank you for joining me today to talk about all things reablement. Before we start, Laura, anything else that you'd like to say about yourself, about my introduction, or is there anything else you'd like to add to that that I might have missed?

SPEAKER_00: 1:06

No, no. Thank you, Hilary. That sounded that sounded pretty good and accurate. I'm not, as we've pointed out, I'm not old. I've just had a lot of experience in the community care um field. So yeah, thank you.

SPEAKER_01: 1:21

Great. All right, well, we'll get going then on some of the um questions that I sort of um would like to ask you, which are obviously all reablement related. So the first one is what does short-term reablement mean to you, or what does reablement mean to you, and particularly what does it mean from a short-term perspective?

SPEAKER_00: 1:41

Reablement for me um means that people actually have an opportunity to decide what's next for them. They may only need support for a very short time to get over an injury, so that's their opportunity. They don't have to lock in to the rest of their life with support, and that's really important. I think that it helps them overcome that initial injury, it helps them with a little bit of support get back to where they were with somebody who's supporting them, not doing for them. It helps, I'm sure it helps you as a customer feel encouraged that this is possible. I can do it, and I can get back to where I was before my injury, and I can ask for support again if I want, if I really do want extra support at any time. So it's a way of encouraging people to be positive, to not be dependent on people, um, others to help them do certain things. So it can all it can only be good, it can only be encouraging.

SPEAKER_01: 2:50

Excellent. And when when you say um an injury, could that also be someone who's had a recent um health events or something like that? It's not just a someone who's had perhaps a fall or a fracture, it could be someone who's a recent heart attack or or or anything along those lines, or a decline in in their current condition of some sort.

SPEAKER_00: 3:12

Absolutely, yes. Some people can just go through periods in their life where things are just not quite right one way or another. And this helps people to think about it in a different way, and actually encourages that. Come on, we can you can do this. Lovely. Great.

SPEAKER_01: 3:30

So, how do you think, and you've sort of partly answered it already, how do you think reablement can help an older person?

SPEAKER_00: 3:38

It just encourages people that um particularly older people in the world today, may feel like you know, they're just at the bottom of the ladder, and you know, I can't do, I can't do a you know, just the whole negative thing because they're old, they can't do things that they may have used to have done. Um, so it encourages people, but it is possible. Just a little bit of support, maybe it's physio OT, or you know, just a bit of domestic domestic support can help them get over a hump in that road that they travel and that they can. Age makes no difference.

SPEAKER_01: 4:16

For some people. Do you feel like it can help people get back to um doing some of the activities for themselves again or getting out and about again? Because obviously reabunt's not just about um helping someone to uh return to their previous physical function, it's also about improving someone's mental health and their sort of social health in some ways, getting them back to those social connections that are so important.

SPEAKER_00: 4:44

Yes. I think people, I think as a whole, as people, we can um lose that ability just to connect again because of well, look at the pandemic. You know, you were locked in, you were locked away for two years or whatever it was. And you can some people can just their confidence will be lowered and lowered and lowered until they just say, I can't do, I can't go out, I can't meet people again. And that's what's really important that they do start to get back to, particularly after COVID, how things were before meeting people. We know that social isolation is a big killer. We know that that actually, I think I read somewhere that it, you know, it's as bad as smoking 15 cigarettes a day. So it is important that you, you know, life doesn't stop when you become 65 all of a sudden. Or if you're living with a disability, that life stops because you've got some sort of disability, um, that you can make it what you want to make it. You just might need a little bit of support.

SPEAKER_01: 5:47

And when what do you think short-term reablement looks like when you're working with an older person as opposed to doing something for them? What does it look like from if you're talking to some of your support staff in the organization, those frontline staff? What what what do they need to do or how do they need to think differently?

SPEAKER_00: 6:07

So if we go to visit a customer that we've never seen before, for instance, there can be two things you can do in there. You can go in and say, I'm just here to do your cleaning today, whereas everything you sit down and I'll make you a cup of tea later. And that's just a task focused um mindset. Or you can go in and say, you know, hello, you can sit down, have a chat for five minutes, say, okay, how how about we do we get through what we have to get through today between us? What could you do? And you and then you know, once the person's told you that, you can follow through with, well, okay, I'll do that then. And then we can have time to have a chat, and then we can that's where a relationship will build, and that's where you, as a support worker, will actually have more joy at doing what it is you're doing with with people. The biggest thing I hear today is I'm not doing any more cleaning. Mindset changed from doing with people instead of for them. I'm absolutely convinced will change that mindset. But it's it's an ongoing, it's an ongoing thing of learning for everybody.

SPEAKER_01: 7:23

So uh from a support worker perspective, it's not not going in and taking over too much for someone, helping them helping people do some things for themselves and and sort of almost stepping back a little bit where possible.

SPEAKER_00: 7:39

Yeah. Or even saying, I'll do the shopping. You just sit down, I'll do your shopping, and I'll come, you know, I'll bring it back and put it away for you. Um and probably the person's perfectly capable for doing a lot of that themselves, but we're not allowing, we are not allowing customers to voice what it is they can do long before they've said what they can't do.

SPEAKER_01: 8:01

Okay, that sounds good. Do you um have an example of when uh reablement has worked and when it hasn't in your organization or previous examples, and then what made it successful or unsuccessful?

SPEAKER_00: 8:17

Look, I've got one story that will always stay with me. Um it was shortly afterwards. I'd had some online meetings and just talking to a bunch of support workers that uh about wellness and reablement and going through some PowerPoints and so on that um Keep Able or ILA put together for us. And it they go through it initially, the support workers thinking, oh, it's just something else to do. But it only takes one person to listen and actually think this is a good idea, this could be different for me. So that person went to with they had the team had a referral for an a lady who was living with dementia, who lived in a retirement village with her husband, and she needed some domestic support. So after because the because the support worker gone through that process of listening to how different it could look. So, you know, it it's encouraging, not doing for, doing with, she went into the home. And sorry, I'll go back a step because actually she went to the assessment with her coordinator and heard exactly what was said at that assessment. So she knew she goes, went to the house, and initially the lady was very reserved and not saying a whole lot, but her husband was saying, Well, there you go off, you go and do the cleaning, that you'll find it here, there, and everywhere. And she went, Oh, so wait a minute. What we agreed at the beginning was that we would do it together and that we'd build that together, and your wife would be um keeping active and doing. He wasn't keen, but she did. The support worker encouraged the lady to do a little bit, so they actually walked around the house together and they did what they were doing together with whatever the lady could do herself. That went on for several weeks until one day, and over those weeks, the difference was the lady herself singing around the home with the support worker, carrying out all the stuff that she probably had done for the last 79 years or whatever, and enjoying what she was doing and connecting probably with herself from what she she what she used to do.

SPEAKER_01: 10:40

And moving more as well, moving more active, which yeah and being encouraged movement is medicine, but you know, it's moving and moving, and using your body is so important.

SPEAKER_00: 10:50

Yeah. And she was feeling like, I suppose, that that there was a purpose for her now again. Because what from what it looked like in the home, um the husband won well, that's what he told us uh a while later. He the support worker knocked at the door and he arrived and he said, There's the cleaning things, we're going out for a while. And again, the support worker was brave enough to say it's not what we agreed. So I'm just going to leave it for now and then I'll have a conversation with you later. They lived in a village, and this is the biggest problem. They lived in a village, and he said, Um, everybody else in this village has a cleaner, so that's what I want, a cleaner. I don't want my wife doing anything. She can just she she's just she'll just stay put. So that was the worked and didn't work because we couldn't, you know, he wasn't going to play. It's awful when, but that's the port worker when she saw how active the lady was, how happy she was, what she was remembering through the years. There was a real positive vibe in there, and the cleaning was getting done between them. But he wouldn't, he just wouldn't have that. Um, so that our relationship with them ended, unfortunately. And I really don't know where they are now. Um but that was a shame. So it worked, but then it didn't work.

SPEAKER_01: 12:14

Yes, because it's about the the mindset and the attitude, and then how do we um support people who don't understand the benefits of helping someone do things for themselves? You know, um, how do we actually support that so people take it on more and want to sort of actually almost demand reablement rather than demand a domestic assistance service that actually people understand the benefits of actually doing things, moving, carrying, you know, obviously within safety confines and all of those things sort of thing. But um, yeah, it's a it's a difficult one. So that worked and it didn't work.

SPEAKER_00: 12:51

And it didn't work. And I don't think that um I think what I make clear is that when you're going in to assist somebody in their home with some domestic um stuff, you are probably always going to do the heaviest stuff. So make no doubt about that at all. But your job in there is to encourage the person that you're working with to do as much for themselves as they can. And you'll do what you're doing. And there should always be a little bit of time for a cup of tea and a chat then, as you're doing it together. And let's face it, people are doing stuff every day for themselves. So it's a mindset of, you know, well, I'm just going to get a cleaner and I can sit back. That doesn't help really either.

SPEAKER_01: 13:33

But for some people, it the doing the housework themselves or doing things like laundry themselves might actually be the only activity that they have all day. Exactly, exactly. Yeah. And that in itself is important for people getting up, moving around.

unknown: 13:47

Yeah. Okay.

SPEAKER_00: 13:48

I remember saying to a support worker once actually that, you know, um working with this lady she was working with, well, maybe you can say when you go in, look, I'll get on and do what I'm doing, and then you can make us a cup of tea, and we can have a chat at the end of it. And the support worker said, You're just very cruel, Laura. How can you make an old lady make you a cup of tea? So that conversation ended up in a completely different way with that. Um, did it make an impact on the support worker? I'm not too sure, but she looked at it from a different point of view all of a sudden. Right. Just because you're old does not mean you can't do things. That's right, that's right.

SPEAKER_01: 14:25

Uh do you ever sort of um try any assistive technology? And by that I mean perhaps within the housework perspective, might be long-handled dustpan and brushes or long-handled bits and pieces. Do you ever sort of try any of that? Yeah. Lightweight vacuums and things like that?

SPEAKER_00: 14:43

We do. Um, and again, in some teams it will work, in other teams it won't work. But there is so much that's different in today's world than it was 20 years ago. Just mopping, for instance. If your customer has a real heavy mop with a big bucket and so on, then you know they may not be able to do that. But you look at a modern mop that's light and easy, it's got a spray in the handle with whatever you're doing, so much easier. And encouraging people, and some people have actually changed then and said, Oh, okay. We do get requests all the time in um for um assistance in what kind of vacuum cleaner. Right. Yeah. To use it is much, much lighter and much easier. So that's that's a slow process of and again it's support worker confidence, it's them knowing the alternatives and them knowing that it's not or them understanding that it's not about just going in and doing whatever it is you're doing, but what could make it easier for the customer.

SPEAKER_01: 15:46

Yes, yeah. Okay. Which has given me an idea for perhaps development of cut of some resources around that sort of low, low-level AT that would help with some of that areas and being able to have that um available on Keep Able. Yeah. So we'll we'll have a look at that. It's given me an idea. Okay. We're nearly at the end, Laura. I can know what I know you you're gonna be wanting your lunch soon. If you had any advice for an organization who was looking at um delivering a reablement service, what would your advice be?

SPEAKER_00: 16:20

I would say it's probably gonna take a bit of time, you're not gonna do it overnight. But what I'd say is that that just that whole story around looking at the person and not the funder, not the task, not the just look at the person first, work with people, and I would absolutely say it's never, ever, ever, ever just about cleaning. There is so much support workers can do in customers' homes with their eyes, with their ears, and you know, the relationship that they build that can make a huge difference to people at the end of the day. So it's never, ever, ever just about cleaning. Okay. And I know that your support workers will be happier at the end of the day in the work that they're doing if they're doing it together with the customer.

unknown: 17:11

Yes.

SPEAKER_00: 17:11

They will. I don't have any doubt about that at all.

SPEAKER_01: 17:15

And I think that that's been in shown in quite a bit of research research as well, that actually working in this way helps with um staff retention. That's right. Because people do feel more fulfilled in what they're doing and you know, recognized in the role that they're actually playing in supporting people. So all right. Well, I think that that sounds like a great place to conclude um our conversation. Uh, I think we've covered a number of topics, including how reablement can help people retain their independence, how support staff play a key role in this, and some great examples of when working this way works and when it isn't quite so successful. Um I'd like to say thank you again to Laura Coleman from Avivo for joining me today. And for those of you listening, I hope you've enjoyed the conversations. To find out more about reablement, do please visit our Keepable site at keepable.com.au. Thank you, Laura, for your time today. Thank you, Hilary.