Reablement in Action: Shifting Long-Term Care Focus

CAPHRI’s research line Ageing and Long-term Care (ALTC) has taken a pioneering role in reablement research in the Netherlands. Under the guidance of Vice-Chair dr. Silke Metzelthin, the team has dedicated nearly fifteen years to this area, beginning with her PhD research, which was subsequently expanded internationally.

Collaboration with the Limburg Living Lab in Ageing and Long-term Care led to the creation of the first Dutch reablement programme, Blijf Actief Thuis (Stay Active at Home), which drew on international expertise and was tailored to the Dutch context. This programme was trialled in a cluster randomised controlled trial at MeanderGroep Zuid-Limburg and served as the subject of the first Dutch PhD thesis on reablement.

CAPHRI has also played a crucial role in establishing clear definitions for reablement. In 2018, dr. Metzelthin led a Delphi study that produced a widely cited international definition. Further research—including two subsequent PhD projects—resulted in the Dutch definition and the I-MANAGE model. In the Dutch context, 

reablement is now defined as a time-limited intervention for anyone with care needs, delivered by an interdisciplinary team working in close partnership with the individual and their social network. The intervention addresses both resources and barriers, gives explicit support to informal carers, and is tailored and evaluated at regular intervals, ideally leading to discontinuation of care once independence is regained.

Over the past years, ALTC researchers have evaluated reablement programmes in a variety of settings, including the home, hospitals and nursing homes, with findings confirming that reablement is not only feasible and effective, but also cost-effective.

In West and Midden-Brabant, more than 1,000 clients participated in the Langer Actief Thuis programme. More than half regained their independence, and over a quarter required less professional care. In Kerkrade, adjustments to household support services for 393 clients resulted in a 17% reduction in support needs, and higher levels of client satisfaction.

A cluster randomised controlled trial in nursing homes revealed that professionals inspired clients to remain active more effectively, with these effects persisting three months after the intervention. Notably, the intervention proved cost-effective, yielding a cost saving of €584 per client over six months. Joint research with UMC Utrecht in hospitals demonstrated that the mean length of stay was 3.3 days shorter for the intervention group, while the proportion of patients discharged to home was higher than in the control group (38% compared to 29%).

CAPHRI researchers have published more than thirty-five peer-reviewed articles on reablement in prominent journals and have contributed two chapters to an international reablement textbook. They are also active members of the international ReAble Network, which connects over fifty researchers across twelve countries.

The ALTC team regularly publishes in national journals and recently produced a Reablement Compass—a practical guide summarising findings and best practices for those seeking to implement reablement outside academia. The team members are regularly consulted by the media, speak at national conferences, and provide ongoing advice to long-term care providers, insurers, municipalities, and the Dutch Ministry of Health, Welfare and Sport (VWS).

Recognition of reablement’s value has led the Ministry of Health, Welfare and Sport to allocate €3.2 million about reablement for knowledge collection and dissemination. Dr Metzelthin contributed to the design of the corresponding ZonMw programme. CAPHRI now leads the national evaluation of sixteen ZonMw-funded reablement projects and has helped set up a national reablement network. In partnership with network members, the team also produced a policy brief containing concrete recommendations for expanding reablement further across the Netherlands. The brief, endorsed by more than thirty organisations, influenced the Hoofdlijnenakkoord Ouderenzorg (National Care Agreement), which now identifies reablement as a key priority for sustainable care.

In collaboration with Zuyd Professional, CAPHRI’s Limburg Living Lab scaled up implementation of the ZELF-programme—an evidence-based reablement programme now used by thirteen organisations across the Netherlands. Efforts are also underway to embed reablement in vocational, applied and academic curricula, ensuring that future professionals are equipped with the necessary competencies.

Dr Silke Metzelthin launched the ReableDEM research group in 2023, bringing together experts from England, Australia, Sweden, Norway and Denmark to promote the global implementation of reablement, including for vulnerable groups such as people living with dementia, who are often excluded from these services. The collaboration has already produced a position paper, policy brief and a collection of dementia care resources. In 2025, dr. Silke Metzelthin and her international collaborators received a grant of 1,8 million Euros to continue the work of the ReableDEM research group, including also partners from Germany, Turkey and the Czech Republic.

Through this comprehensive and ongoing programme, CAPHRI has made a substantial and widely recognised contribution to advancing the evidence base for reablement—integrating scientific understanding into daily care practice, shaping national policy and embedding reablement in professional education. These achievements establish a firm foundation for a sustainable long-term care system that places autonomy, participation and meaningful ageing at its core.