CAPABLE Aging

Unmet Need
The aging population is growing in the United States at an unprecedented rate, and is the greatest user of health care, costing approximately $250 billion in Medicaid each year. With the elderly population to double by 2030, prevalence of age-related chronic illness and disability will increase along with its cost to health care, there is unmet need for the development, testing and implementation of strategies for aging individuals that focus on decreasing the severity of the functional consequences for chronic illness. Nursing home care can approximate to $6,000 per month for an individual which is difficult for low-income older adults to afford. There is a need for methods able to improve self-care so that an aging adult can maintain their independence and health at home, thus reducing medical costs and delaying the need for nursing-home care or hospitalization.
 
Technology Overview
CAPABLE Aging is Community Aging in Place, Advancing Better Living for Elders and is a coordinated series of manualized home visits with older adults to improve their ability to function at home through a combination of home repair, home modification, nurse visits and occupational therapy visits over the course of five months. The program aims to aid aging individuals with chronic illness in performing self-care activities such as bathing, dressing, and navigating their home. The program also helps to set long-term goals for the improvement of independence and functionality through a novel initial assessment. With the team of a nurse, occupational therapist, and handyman; aging individuals can aim to achieve long-term functionality goals. Cost analyses done for the first 250 participants show that the cost of registered nurse visits, occupational therapist visits, handyman repair and coordination cost was approximately $3,300 per participant for four months compared to the higher cost of $6,000 per month for nursing home care. The CAPABLE program saves more than $10,000 for Medicare in decreased outpatient and hospital costs. Data gathered for the Center for Medicare and Medicaid Services Innovation Center implementation of CAPABLE show that 79% of participants improved their self-care over the course of five months, the number of self-care tasks that participants had difficulty with were halved on average, and participants experienced a decrease in depressive symptoms similar to that of antidepressant medication.
 
Stage of Development
The CAPABLE program has been introduced to 12 cities in five states.
 
Publications
 
*Szanton, S.L. et al. Journal of the American Geriatrics Society 59(12), 2314-2320, 2011
 
Szanton, S.L., et al. Contemporary Clinical Trials 38(1), 102-112, 2011
 
Szanton, S.L. et al.  Journal of the American Geriatrics Society 63(2), 371-374, 2015 PMC4498670
 

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