Community Aging in Place, Advancing Better Living for Elders: A Bio-Behavioral-Environmental Intervention to Improve Function and Health-Related Quality of Life in Disabled Older Adults

Authors


Address correspondence to Sarah L. Szanton, 525 N Wolfe Street, Johns Hopkins University School of Nursing, Baltimore, MD 21205. E-mail: sszanton@son.jhmi.edu

Abstract

Objectives

To determine effect size and acceptability of a multicomponent behavior and home repair intervention for low-income disabled older adults.

Design

Prospective randomized controlled pilot trial.

Setting

Participants’ homes.

Participants

Forty low-income older adults with difficulties in one or more activities of daily living (ADLs) or two or more instrumental activities of daily living (IADLs).

Intervention

The Community Aging in Place, Advancing Better Living for Elders (CAPABLE), coordinated occupational therapy, nursing, and handyman visits, was compared with attention-control visits. The intervention consisted of up to six visits with an occupational therapist, up to four visits with a nurse, and an average of $1,300 in handyman repairs and modifications. Each intervention participant received all components of the intervention clinically individualized to risk profile and goals. Each attention-control participant received the same number of visits as the intervention participants, involving sedentary activities of their choice.

Measurement

Primary outcome: difficulty in performing ADLs and IADLs. Secondary outcomes: health-related quality of life and falls efficacy.

Results

Thirty-five of 40 adults (87%) completed the 6-month trial, and 93% and 100% of the control and intervention group, respectively, stated that the study benefited them. The intervention group improved on all outcomes. When comparing mean change in the intervention group with mean change in the control group from baseline to follow-up, the CAPABLE intervention had effect sizes of 0.63 for reducing difficulty in ADLs, 0.62 for reducing difficulty in IADLs, 0.89 for quality of life, and 0.55 for falls efficacy.

Conclusion

The CAPABLE intervention was acceptable to participants and feasible to provide and showed promising results, suggesting that this multicomponent intervention to reduce disability should be evaluated in a larger trial.

Ancillary