Published in Health Affairs, September 2016. vol. 35 no. 9. pages 1558-1563.
Home-Based Care Program Reduces Disability And Promotes Aging In Place
- 1Sarah L. Szanton (email@example.com) is an associate professor of nursing and of health policy and management at Johns Hopkins University, in Baltimore, Maryland.
- 2Bruce Leff is an associate professor of medicine and nursing at Johns Hopkins University. 3. 3Jennifer L. Wolff is an associate professor of health policy and management at Johns Hopkins University.
- 4Laken Roberts is PhD student in nursing at Johns Hopkins University.
- 5Laura N. Gitlin is a professor of nursing and medicine at Johns Hopkins University.
The Community Aging in Place, Advancing Better Living for Elders (CAPABLE) program, funded by the Center for Medicare and Medicaid Innovation, aims to reduce the impact of disability among low-income older adults by addressing individual capacities and the home environment. The program, described in this innovation profile, uses an interprofessional team (an occupational therapist, a registered nurse, and a handyman) to help participants achieve goals they set. For example, it provides assistive devices and makes home repairs and modifications that enable participants to navigate their homes more easily and safely. In the period 2012–15, a demonstration project enrolled 281 adults ages sixty-five and older who were dually eligible for Medicare and Medicaid and who had difficulty performing activities of daily living (ADLs). After completing the five-month program, 75 percent of participants had improved their performance of ADLs. Participants had difficulty with an average of 3.9 out of 8.0 ADLs at baseline, compared to 2.0 after five months. Symptoms of depression and the ability to perform instrumental ADLs such as shopping and managing medications also improved. Health systems are testing CAPABLE on a larger scale. The program has the potential to improve older adults’ ability to age in place.