Zi Lin

To mitigate the dangers that come with living independently for aging adults in the United States, one researcher has proposed a solution called CAPABLE, which aims to enhance the capabilities of aging adults by providing them with home support. 

At the Yale School of Public Health Dean’s Lecture & Program on Aging Seminar, which took place on Nov. 3, Sarah Szanton, dean of Johns Hopkins School of Nursing, presented CAPABLE, a proposal on how to prevent accidents that can occur with independent living for aging adults. CAPABLE integrates the work of an occupational therapist, registered nurse and a handy worker to modify homes to enhance the aging adult’s capabilities and provide home support. They will additionally provide goals and direct-action plans that will aid in increased independence and safety. 

“Functional disability, as marked by the inability to perform tasks needed to live independently, becomes increasingly common with advancing age and is strongly linked to multiple adverse health outcomes, such as depression, social isolation, hospitalization, nursing home placement, and death,” Brian Fitzek, a knowledge translation specialist who works with Szanton, wrote in an email to the News. 

With the country’s elderly population projected to increase in the coming years, developing supportive living environments and improving their quality of life can help reduce expenses on hospital care and medications. 

Researchers, physicians and nurses are beginning work to counteract this, shown by a recent galvanization of the medicine community to support geriatrics. Recently, the largest ever donation in its history was given to the Yale School of Nursing in which six million dollars was gifted in order to kickstart a professorship for geriatrics.

“This population is vulnerable to advanced chronic disease, unintentional injuries such as falls, and neurodegenerative diseases like Alzheimer’s and Parkinson’s disease,” Ann Kurth, dean of the Yale School of Nursing, wrote in an email to the News. “As people age, their metabolic response to medication and other treatments changes over time and requires close monitoring and adjustment.”

Aging adults can also face challenges from standing for extended periods of time, back pain associated with uncomfortable movements and joint pain associated with arduous tasks. 

Szanton proposes that modifications to living environments through the help of nurses, occupational therapists and handymen over the course of 10 in-home visits can bring ease to the lives of the elderly and make their daily tasks safer. 

According to Fitzek, an occupational therapist can teach a client to use a tub safely by selecting the proper adaptive equipment and coaching them to conserve their energy. The nurse can address medical or condition-related factors that could affect balance, such as pain and medication management. Finally, the handyworker can make structural improvements to the living space, such as installing grab bars and repairing broken flooring.

These visits may also be instrumental in educating the patient on medications and proper management of them. Health literacy degrades over time with aging adults, and it is important to maintain it in order to prevent complications coming from taking out of date or unnecessary medications or not keeping up with prescriptions. 

“One of the biggest things that I see in my profession is polypharmacy, the use of multiple, potentially unnecessary, medications,”  Elizabeth Cohen, lecturer at the Yale School of Nursing, wrote in an email to the News. “While living independently and managing their own medications, aging adults may experience complications from their medications ranging from increased risk of side effects or decreased adherence to important medications to increased health costs and reduced ability to perform independent activities of daily living.”

According to Szanton, CAPABLE can reduce “the impact of functional impairment and disability, enhance motivation and self-efficacy, reduce health disparities, improve emotional health, and reduce hospitalizations and nursing home days.” 

In addition to the improvement in the ability to maintain self-care and activities of daily life, CAPABLE has been shown to improve instrumental ADLS, strength, balance, walking speed and health care utilization. 

CAPABLE is currently offered at more than 40 sites across the United States and continues to expand into new areas.

Correction, Nov. 18: The article has been corrected to reflect the correct spelling of Sarah Szanton’s name. 

MANAS SHARMA