Recently I was very fortunate to attend the invitation-only International Federation on Ageing 2016 Summit on “Reablement and Older People” in Copenhagen, Denmark. 17 countries were represented, including China, Australia and Nigeria. During this trip I was able to speak to many high level officials about the Silver Spaces age in place home assessment mobile app I created (SilverSpaces.com). This was only recently released and is now being used in over 10 countries. I was the only attendee from the U.S. and experienced an extraordinary opportunity to participate in a dialogue over the definition and goals of reablement.
Before this conference, I (probably like you) had never heard the term “reablement.” So to put things in proper perspective, I shall use information provided to the conference participants:
“The World Health Organization (WHO) outlines a model of healthy ageing in its 2015 World Report on Ageing and Health that consists of two primary factors: an individual’s intrinsic capacity and functional ability. …Even if an individual’s intrinsic capacity is diminished, the person may be able to do the things that matter to them if they live in a supportive, enabling environment. This reflects the concept of maximizing functional ability, which, according to the WHO is the ultimate goal of healthy ageing.”
In this context, “intrinsic capacity” is defined as “all the physical and mental capacities that an individual can draw on at any point in time.” So reablement seeks to maximize the way health and social services are delivered to an aging population to help each person achieve the highest level of intrinsic capacity possible. To take this further, as an older person’s intrinsic capacity diminishes, an enabling city/state/country will provide the supports necessary to empower each aging adult to live life to the fullest, whatever that means to them individually.
The 2015 WHO report mentioned above blatantly states:
“Comprehensive public health action on population ageing is urgently needed. This will require fundamental shifts, not just in the things we do, but in how we think about ageing itself. The World Report on Ageing and Health outlines a framework for action to foster healthy ageing built around the new concept of functional ability. Making these investments will have valuable social and economic returns, both in terms of health and wellbeing of older people and in enabling their on-going participation in society.”
While a myriad of topics were discussed, two that the group centered on were the positive impact timely interventions can have on dementia and diabetes. There is much evidence to support that people with dementia have the ability to “adapt, adjust and change,” keeping them valued members of our communities. Services to those affected by dementia need to better reflect this. The cost (both financial and life quality) that diabetes has on society as a whole and the long-term implications of this disease was also a part of the group’s discourse. Enhanced proactive risk identification and an ever increasing awareness by care professionals to intercept and manage diabetes earlier in the disease state will be an essential part of improved health care overall. (Note: Globally one in every nine healthcare dollar was spent on diabetes care in 2014. More than 25% of people over 65 around the world have diabetes.)
Key to reablement is allowing each individual to identify what their own strengths and weaknesses are, regardless of whether they are physical or mental. To live life to the fullest means to focus on what we feel is important in our lives, what brings us joy and what we want to continue to do (perhaps with assistance) that brings meaning to our time on earth.
What I found to be most intriguing were the different ways in which the participating countries either were or were attempting to create this supportive environment. Heavily discussed were the types of services and supports provided, funding (or lack of it), barriers to successful implementation of these services and how we can best share information on these issues. But the one point eminently agreed to by the group is that we need to ASK the person what it is they value, NOT tell them. For it is what is important to that person that we want to preserve.
It becomes obvious that it is very important for us to listen closely to each other’s experiences in order for us to have a complete understanding of how we can best share successes and failures in reaching this valued goal to “enable people to be and to do what they have reason to value.”
Summary: World Report on Ageing and Health. Geneva: World Health Organization, 2015. Print.
Final Report: Reablement and Older People. International Federation on Ageing, 2016. Print.