CAPABLE program improves disability in multiple randomized trials

Abstract

Background: Programs to reduce disability are crucial to the quality of life for older adults with disabilities. Reducing disability is also important to avert unnecessary and costly hospitalizations, relocation, or nursing home placements. Few programs reduce disability and few have been replicated and scaled beyond initial research settings. CAPABLE is one such program initially tested in a randomized control trial and has now been tested and replicated in multiple settings. CAPABLE, a 10-session, home-based interprofessional program, provides an occupational therapist, nurse, and handyworker to address older adults' self-identified functional goals by enhancing individual capacity and home environmental supports. We examine evidence for the CAPABLE program from clinical trials embedded in different health systems on outcomes that matter most to older adults with disability.Methods: Six trials with peer-reviewed publications or reports were identified and included in this review. Participants' outcomes included basic and instrumental activities of daily living (ADLs, IADLs), fall efficacy, depression, pain, and cost savings.

The concept of disability and its causal mechanisms in older people over time from a theoretical perspective: a literature review

“…The CAPABLE intervention targets both modifiable intrinsic (person-based) as well as extrinsic (environmental-based) factors that contribute to disability to achieve clients’ individual goals (Szanton et al 2019 ). Even the CAPABLE intervention, despite the wide implementation, only focusses on the person’s individual capabilities and the optimization of the home environment without inclusion of the community or social environment (Szanton et al 2021 ). Providing interventions that address both the individual and the environment requires new roles and tasks of professionals, strong collaboration among all partners involved in the care process and funding models that facilitate the new way of working.…”

Complexities of care: Common components of models of care in geriatrics

“…Although the workgroup evaluated the literature with appropriate search terms which was guided by the expertise of AGS members, this is not an exhaustive list of successful care models serving older adults with complex care needs. Specific examples of well‐designed models with proven effectiveness that were not reviewed include: CAPABLE, 58 Indiana University Aging Brain Care, 59 INTERACT, 60 OPTIMISTIC, 61 Stanford Chronic Disease Self‐Management, 62 Stepping On falls prevention, 63 and UCLA Alzheimer's and Dementia Care 64,65 …”

Interviews with primary care physicians identify unmet transition needs after ICU

“…Our respondents’ concerns also contribute to the literature identifying financial issues after critical illness [ 15 – 17 ]. Insuring adequate supplies and care may be important targets for recovery [ 18 , 19 ]. Social work follow-up or social welfare consultation after hospital discharge may help alleviate potential financial burdens in some systems [ 18 , 20 ], and such referrals may help alleviate burdens on primary care physicians trying to manage other recovery needs in limited appointment time.…”