Innovative Program at the Johns Hopkins School of Nursing:
The Community Aging in Place –Advancing Better Living for Elders (CAPABLE) study is a client-centered home-based intervention to increase mobility, functionality, and capacity to “age in place” for low-income older adults. CAPABLE is comprised of an occupational therapist intervention, a client-centered nurse intervention and safety and access handyman services. Each service synergistically builds on the others by increasing the participants’ bio-psycho-functional capacity to function at home. This is theorized to avert costly health utilization by increasing medication management, problem-solving ability, strength, balance, nutrition, and home safety, while decreasing isolation, depression, and fall risk.
Related Story on boston.com:
The environment in which you live can be as disabling as a disease, and too often, older Americans wind up in a nursing home not because they’re super-sick but because they can’t get through their days safely at home.
Now a major research project will bring handymen, occupational therapists and nurses into the homes of 800 low-income seniors in Baltimore to test if some inexpensive fix-ups and strategies for daily living can keep them independent longer, and save millions in taxpayer dollars spent on nursing home care.
‘‘Very small changes can make a big difference,’’ said Sarah Szanton, a Johns Hopkins University associate nursing professor who leads the project. ‘‘We’re not saying, ‘What’s your blood pressure?’ We’re focusing on function: What do they want to do?’’
Losing independence is a leading fear as people age. But a recent poll shows that too few comprehend the changes in lifestyle needed to offset the chronic illnesses and gradual slowdown that hit just about everyone in the 70s, 80s and beyond.
The four-month intervention costs about $4,000 per participant, including the home modifications and specialists’ salaries. The average cost for nursing home care in the U.S. is $6,700 a month, so even a modest delay could add up fast. Szanton will track participants long term and, based on results from an earlier pilot test of 40 high-risk seniors, hopes to delay nursing home entry by up to a year in this frail population.