Reablement Intervention for Older Adults in Day Care Centers

Condition(s) studied

Investigational drug(s) / intervention(s)

Reablement: Based on the principles of reablement care and incorporating the Person-Environment-Occupation (PEO) model, the intervention is designed according to older adults' individual preferences, life experiences, and functional needs. It consists of context-based, function-oriented activities embedded in daily life situations. The intervention is delivered in small groups (5-10 participants per group), where individualized reablement activities are implemented alongside shared tasks tailored to real-life contexts (e.g., community shopping, cooking, or environmental organization). A designated care staff member is responsible for facilitation, assistance, and documentation. The intervention is conducted 2 to 3 days per week, with multiple short activity sessions per day, each lasting approximately 5 to 60 minutes, over a period of 12 weeks, with a total intervention time of approximately 1,000 minutes.

Exercise: The Vivifrail exercise program was adopted, an evidence-based intervention model for older adults developed based on international research (Izquierdo, 2019). Through graded, structured exercise training, the program aims to improve lower-limb muscle strength, balance, and gait function. In this study, it was used as a standardized exercise intervention for comparison with the reablement intervention. The program was delivered in small groups (5-10 participants per group), led by designated care staff. Each participant received exercise training corresponding to their functional level. The intervention was conducted 2 to 3 days per week, with each session lasting 30 to 40 minutes, over a period of 12 weeks, with a total intervention time of approximately 1,000 minutes.

Study summary

This study explores the effectiveness of reablement interventions for older adults with declining mobility in adult day care centers and compares them with traditional exercise interventions. In recent years, reablement has gained increasing attention. It is a person-centered approach that emphasizes goal-oriented training through activities of daily living, combined with interdisciplinary collaboration, to enhance individuals' self-care abilities and participation in daily life. In contrast, exercise interventions are typically structured programs focusing on improving muscle strength, balance, and endurance. While both approaches aim to enhance physical function, they differ in philosophy, implementation context, and motivational mechanisms. Reablement emphasizes meaningful, individualized, and context-based activities, which may enhance motivation and adherence, whereas exercise interventions are more standardized and efficient but may lack relevance to daily life, potentially affecting long-term engagement.

This study adopts a quasi-experimental design to compare the effects of reablement and exercise interventions on mobility, fear of falling, activities of daily living, and subjective well-being among older adults. It also evaluates the feasibility of implementing reablement in day care centers. Additionally, participants' preferences, attendance, and engagement in different intervention approaches are examined to address the current gap in comparative research.

Overall, the findings suggest that incorporating reablement into day care services-through individualized goal setting and interdisciplinary collaboration-can enhance functional performance, quality of life, and independence among older adults. The results also provide important evidence for future long-term care policy and practice, supporting a shift from a care-oriented model to a function-oriented approach, and ultimately promoting aging in place and independent living.

Eligibility

Primary outcome measure(s)

• Mobility — From enrollment to the end of treatment at 12 weeks
  Short Physical Performance Battery. It comprises three tests-balance, 4-meter walk, and chair stands-with scores ranging from 0-12, where lower scores indicate higher disability and frailty.
• Fear of fall — From enrollment to the end of treatment at 12 weeks
  Short Falls Efficacy Scale International. It is a 7-item questionnaire where individuals are instructed to score their concern of falling during an activity on a 4-point Likert scale. Scores range from 7-28, where higher scores indicate higher level of fear of falling.
• Number and severity of falls — From enrollment to the end of treatment at 12 weeks, every week.
  The Fall Record Form is used to document the frequency, location, and severity of the fall incident, and to provide additional details in the remarks section, including any injuries sustained and subsequent management or interventions.

Trial sites (1)

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