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Preliminary findings: After inexpensive home intervention, 80 percent of elder participants see daily life, health improved 

Older adults who have difficulty with such daily activities as bathing, grooming, cooking, eating, or just getting to the bathroom often end up in hospitals or nursing homes, spending a disproportionately huge number of healthcare dollars, according to a report conducted for the U.S. Department of Health & Human Services. For far less money, perhaps 80 percent of these same elders could be made more self-reliant and healthy and also less depressed, suggest the preliminary findings of a study led by Sarah L. Szanton, PhD, ANP, FAAN, of the Johns Hopkins School of Nursing.

An intervention called CAPABLE – for Community Aging in Place, Advancing Better Living for Elders – involves home visits with an occupational therapist, a registered nurse, and a handyman to work together with older adults to identify mobility and self-care issues in their homes and fix or modify them. As part of Szanton’s study, the team made 10 visits of 60 to 90 minutes to each home over a five-month period. By making small adjustments, from installing handrails or lowering shelves to implementing a system that helps the client remember to take medicines at the proper time each day, CAPABLE makes it more likely that older adults will be able to stay in their homes longer, improving health outcomes and decreasing medical costs.

“We find that working with older adults on their own goals while making small changes to the home environment is powerful medicine,” says Szanton, who launched the program in Baltimore, MD and has since seen it piloted in Michigan among lower-income older adults on Medicaid and Medicare. Her study, Preliminary Data from Community Aging in Place, Advancing Better Living for Elders, a Patient-Directed, Team-Based Intervention to Improve Physical Function and Decrease Nursing Home Utilization: The First 100 Individuals to Complete a Centers for Medicare and Medicaid Services Innovation Project, appears in The Journal of the American Geriatrics Society.

In a population of 100 low-income older adults on Medicaid and Medicare who participated in the CAPABLE study:

  • 79 percent improved their self-care over the course of five months.

  • The average participant improved by cutting disability in half (i.e., the number of self-care tasks that are difficult for the participant were halved).

  • Participants experienced a decrease in depressive symptoms similar to that of taking an anti-depressant medicine.

The Centers for Medicare and Medicaid Services Innovation Center funds projects such as CAPABLE that have potential to affect the “triple aim,” a framework for decreasing costs while improving health and quality of life.

Learn more about these preliminary findings.

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