Social Rehabilitation (Enablement) Trial

Funding body
Silver Chain Foundation ($100,000 originally, $200,000 for further 2 yrs)
RM Gibson Research Fund, Australian Association of Gerontology ($5,000)

Project description
Social Rehabilitation is a service model that was developed and piloted by Age Concern UK as one of a range of services to help older people sustain their independence and retain a sense of control over their lives. The aim of Age Concern UK‘s Social Rehabilitation program was “to complement health and social care services for older people by providing a structured input to help support the achievement of desired social roles and activities, and thereby improve the psychological as well as the social well being of service users”. The program offered a time-limited program of support, based on a comprehensive assessment of an individual’s needs and aspirations, in which trained volunteers assist the older person to achieve their specific goals.

This project is a trial of the Age Concern UK Social Rehabilitation service model. The trial includes a rigorous evaluation of client outcomes and program processes. The outcomes achieved in terms of levels of loneliness, depression and goal achievement for individual participants are examined at program completion and at a subsequent three month follow up.

The trial commenced in January 2006 and progress was reviewed after twelve months. This review showed that although the program was achieving positive client outcomes in terms of reduced depression and loneliness and increased well being, the way that the service had been delivered needed to be refined. A proposal for an extension of the trial for a further two years in order to allow a refined model to be implemented and tested was therefore developed and presented to Silver Chain. This proposal was accepted and funding for a further two year trial of the refined model, renamed Social Enablement, was approved.

Project update
The new Team Leader commenced in the role in October 2008. As of March 2009 there are eighteen volunteers who have been trained to work in the program; eighteen clients who have successfully completed the program; six clients who are linked to volunteers and still participating in the program and another five clients who have been referred and will begin the program once assessed. Attrition of clients taking part in the research has been somewhat higher than expected as fourteen clients commenced the program but later withdrew. There have also been seventeen clients referred who were found to be either unsuitable or ineligible for the program. They were referred to more appropriate services.

To be as rigorous as possible, the trial was designed as a randomised controlled trial, with clients being randomly allocated to receive the intervention immediately or to be in the control group who wait three months before participating in the program. However as the program has had a lower number of referrals than expected but has been extremely successful in recruiting volunteers, and we were concerned that volunteers might become dissatisfied and be lost to the program if they were not being utilised, we decided to suspend randomisation of clients to the control group. For the last six months all clients referred to, and found eligible for, the program started working with a volunteer as soon as arrangements were made by the Team Leader. It was intended that random allocation to groups would be reinstated once the number of client referrals outweighed the number of volunteers able to assist clients. However despite implementing strategies to try to increase the number of referrals to the program, this was not achieved before recruitment to the trial was scheduled to end, which occurred at the start of September. Data are still being collected for clients still current on the program, as well as follow up data on those who have recently completed, but no new referrals are being accepted. The trial is scheduled for completion in the first quarter of next year.

Data analysis on the impact on the program on participants’ levels of depression, loneliness, social support and personal wellbeing will commence in late October. This follow up data collection will be completed in late January 2010. A complete report on the findings of the trial are found below. A paper on the results of the previous Social Rehabilitation pilot and design of the randomised controlled trial will be published shortly. A presentation on the progress of the service model of the Social Enablement Program was given at the Hammond Care National Conference on Depression in the Elderly and a presentation on the results of the randomised controlled trial of the Social Enablement Program will be presented at the Australian Association of Gerontology’s National Conference in Canberra November 2009.

Related links
Results of the Social Enablement Randomised Controlled Trial [PDF]
Full Report

The Implementation of a Volunteer Model of Social Support for Older Home-Care Clients [PDF]
Conference: HammondCare's 5th National Conference on Depression in the Elderly
Presenter: Ms Candice Patterson

A Randomised Controlled Trial of Silver Chain's Social Enablement Program - Background and Methodology [PDF]
Conference: Emerging Researchers in Ageing (ERA) Nov 2008
Presenter: Ms Candice Patterson

Social Enablement - A New Model for Reducing Loneliness and Depression in Older People Receiving Home Care [PDF]
Conference: ACSA National Community Care Conference May 2008
Presenter: Prof Gill Lewin

For further information please contact
Prof Gill Lewin
Research Director
Email GLewin@silverchain.org.au