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.

Inclusion Criteria:

• Aged 65 years or older and assessed as Long-Term Care (LTC) need level 2 or above.
• Regularly attending adult day care services at least two days per week, with no anticipated termination of services during the study period (approximately three months).
• Short Portable Mental Status Questionnaire (SPMSQ) results indicating intact, mild, or moderate cognitive impairment, with the ability to understand simple instructions and participate in activities with assistance.
• Able to ambulate independently (assistive devices permitted), with a Short Physical Performance Battery (SPPB) score < 9, indicating functional decline and high risk of falls.
• A score ≥ 9 on the Short Falls Efficacy Scale International (Short FES-I), indicating at least moderate fear of falling.
• Willing to participate in the study and able to provide written informed consent.

Exclusion Criteria:

• History of fracture, major fall, or need for acute medical treatment within the past three months, or deemed by a physician to be unsuitable for moderate or higher levels of physical activity.
• Presence of acute psychiatric symptoms that prevent participation in assessments or study procedures.
• Severe visual or hearing impairments that interfere with activity participation or assessment.
• Currently receiving other intensive rehabilitation or participating in another research intervention.
• Demonstrates a clear lack of willingness to participate in the intervention or is unable to complete the three-month observation period.