Older Adults with Disabilities Can Age Well in Place

Forty percent of community-dwelling older adults in the US have a disability. This can make the goal of aging-in-place even harder to achieve especially for lower-income individuals.  A six month long program called "Community Aging in Place: Advancing Better Living for Elders (CAPABLE)" was developed by researchers from John's Hopkins and other Universities in order to help combat this problem. Their goal is to address issues in the built-environment as well as individual factors that hinder low-income older adults from easily aging-in-place.

The Journal of the American Geriatrics Society recently reported a study of the success of this program. The study recruited 40 older adults who had difficulty performing at least one activity of daily life (ADL.) All of the participants were at least 65 years old, and scored at least a 24 on the Mini-Mental State Exam. All of the participants were selected from people on a waiting list for home-based social services in Baltimore, MD.

The control group of 16 participants were given up to ten 60 minute in-home sessions consisting of relaxing activities. The other 24 participants were given services from the CAPABLE program.   Environmental factors focused on decreasing fall risks and increasing personal mobility. Individual factors were assessed with a combination of self-care, mood management training, strength training, and doctor-patient communication skills. Next, they were given nursing and occupational therapy designed to meet each persons individual needs and minor home renovations that made the home more accessible for them to use. The average home renovation cost $1,285, with individual participants receiving anywhere from $149 to $2,185 worth of home renovations. 

At the end of the six months, the control and the group serviced with the CAPABLE program group were evaluated on the level of difficulty with completing ADLs, fall risk, and health-related quality of life. It was found that the participants of CAPABLE showed a significant decrease in ADL difficulty and fall risks, as well as an increase in health-based quality of life, when compared to the control group. Though the program does incur a more significant cost initially, it has the potential to reduce long-term nursing and medical care costs by promoting healthy and safe aging-in-place and improving health-related quality of life.

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