The CAPABLE Program Helps Low-Income Seniors Age in Place

The Community Aging in Place, Advancing Better Living for Elders (CAPABLE) program—funded by the Center for Medicare and Medicaid Innovation—is associated with decreased difficulty with activities of daily living (ADLs) and improved symptoms of depression for older, low-income residents, according to researchers in Health Affairs. Between 2012 and 2015, the authors recruited adults to participate in CAPABLE; participants were age 65 or older, eligible for both Medicare and Medicaid, had difficulties performing most ADLs, lived in a house, and did not suffer from a cognitive impairment. The 234 participants, observed for five months, worked with an occupational therapist and registered nurse and received services from a handyman. The therapist and nurse each established three goals for participants and identified physical barriers in the home to achieving those goals, which the handyman addressed. The combination of these three support systems focused on “problems that are unaddressed in the traditional health care models, which ultimately leads to avoidable health care utilization.” By proactively addressing these structural problems in the home, participants can age in place.

Key findings:

• After working with the three support systems for five months, 75 percent of participants reported improvements in their basic ADLs, such as dressing or bathing, with which they had previous difficulties. On average, participants went from having difficulties with 3.9 ADLs to 2.
• Problems with instrumental ADLs, such as shopping, decreased from 4.1 to 2.9 activities.
• CAPABLE reduced the number of hazards in the home from 3.3 to 1.4.
• Symptoms of depression improved for more than half of all participants.