Consumers often look to invest in accessibility products and home modifications after an adverse event. Decisions are made under emotional pressure, even duress, depending on the circumstances. However, there are many touch points and opportunities for prevention along the continuum of care.
If Sarah Szanton has her way, programs such as CAPABLE would reach more than the 16 cities and rural areas where it is currently in place. CAPABLE stands for Community Aging in Place—Advancing Better Living for Elders.
While making house calls as a nurse practitioner to homebound, low-income older adults in West Baltimore, Maryland, Szanton noticed that environmental challenges were often as pressing as their health challenges. She then explored ways to make it possible for low-income older adults to live in their own homes for a longer period of time.
Szanton, a professor at Johns Hopkins School of Nursing, says the goal of CAPABLE is to improve quality of life, safety and reduce health care costs for seniors who qualify for both Medicaid and Medicare.
The CAPABLE program notes that it takes approximately $3,300 per participant for four months, including up to $1,200 in home repairs, with a larger goal to build a culture of health. Activity of daily living limitations improved in nearly 80 percent of the first 100 people who completed an intervention provided by the program.
The five-month program began about eight years ago. Teams are equipped with an occupational therapist, a registered nurse and a handyman. Szanton sees opportunity to add value to Medicare’s Annual Wellness Visit by incorporating an assessment that could lead to programs similar to CAPABLE that enhance the ability of a person and the environment in which they live, and she says the occupational therapist plays a key role in taking care.
“It is very important for the occupational therapist to listen carefully to the client and their needs. CAPABLE works best when we have conversations about safe choices to age safely in place with clients and then respect and support their decisions,” says Allyson Evelyn-Gustave of the Johns Hopkins Home Care Group and lead occupational therapist for the CAPABLE program. Szanton adds, OTs “are priceless” in the process.
