Rehabilitation training equips blind and deafblind people with the skills they need to live independently, such as cooking without sight, communicating in new ways, or using a long cane to get around. I have written elsewhere about the importance of this for deafblind people. The Care Act emphasises the need for this type of service that can reduce, eliminate or delay the need for long-term care and support.
Yet, the number of people receiving rehabilitation training is falling, as is the number of rehabilitation officers employed by local authorities. Local authority budgets are under severe pressure from government spending cuts and increasing demand for services.
Comments in response to question 3 and question 4 in the consultation on the Care Act regulations and guidance suggest that people working in local authorities are concerned that they will not be able to deliver the expected preventative and reablement services on top of providing services to people with eligible long-term care and support needs.
How, then, can the good intentions in the Care Act be reconciled with this bleak picture of reduced rehabilitation services?
An essential part of the answer has to be increased funding. Local authorities cannot go on meeting increased demand with less money. Government has to provide new additional funding.
But, even if more funding is made available, local authorities, other providers and disabled people, will have to think creatively and embrace change.
There are already some moves towards new models of service provision and creative thinking. For example, a recent study looked at the feasibility of using technology, such as video conferencing, to enable orientation and mobility instructors to coach parents of young blind children to help the children develop early orientation and mobility skills.
Whilst this study was specifically about children, could the same principles be used with adults? Could remote support from a rehabilitation officer, for example, be used to enable communicator-guides, family or friends to promote independent daily living skills amongst people with acquired deafblindness? Perhaps, once a person has learned the basic skills through face-to-face rehabilitation training, they could be given more confidence and encouragement to use them by regular remote contact with a rehabilitation worker or even a trained peer mentor?
Rehabilitation is, for the most part, provided on a one-to-one basis. Whilst this has clear advantages in responding to individual needs, could more be done in groups, allowing trainees to learn from each other, as well as the rehabilitation worker, and so making more time available?
There are no simple answers. Traditional models of rehabilitation services are likely to have their place for many years to come. But, if deafblind people are to get the rehabilitation services they need and deserve, new approaches must be explored and adopted where appropriate.
There are few skills we use every single day of our lives but the skills taught through rehabilitation training are amongst them. We cannot allow rehabilitation services to be squeezed out by budgetary pressures. We must find ways to ensure that the reablement and prevention clauses of the Care Act can be honoured.
Rehabilitation services have been accused of being shaped by political and historical factors, rather than research or forward thinking. It’s time to change that, time to innovate, research what works and what does not, and boldly stride forward. Rehabilitation services must innovate to survive. We must make sure that specialist rehabilitation services are available to all deafblind people who need them, even if those services in the future take a very different form to now.
Liz Ball is Campaigns Involvement Officer at Sense