Home is where the health is
Chronic conditions are prevalent and expensive. They are the leading cause of death and disability in the United States, and up to 90 cents of every health care dollar is spent on treating people with chronic illnesses. For the 60 percent of older adults with two or more chronic conditions, there are many barriers that prevent them from managing their conditions and remaining independent. For many, improving health largely falls outside health care facilities.
If individuals cannot bathe or dress themselves they are less likely to be able to properly manage their diabetes or other chronic illness. Without proper management, there is greater risk of additional complications impacting their health, as well as an increased cost of care.
More than 90 percent of older people say they would rather live in their own homes and communities than move to a nursing home or similar setting. The Community Aging in Place-Advancing Better Living for Elders program (CAPABLE) pairs a nurse, occupational therapist and handyperson with low-income senior citizens to address concerns in the home that may be preventing or prohibiting safety and security.
The team explores the home with the person to identify dangers or challenges and works to remedy them. Often the fix is as easy as adding a second bannister to the stairs to prevent a fall or providing a grabber so the top shelf can easily be reached. By asking the right questions, the team is able to provide quick, inexpensive fixes that allow seniors to safely remain in their own homes, improving their health and quality of life while lowering health care costs.
CAPABLE has found a winning formula to help the older adults maintain their independence and quality of life as they age. Today, there are 29 CAPABLE programs operating in 15 states. According to one study, older people reduced the number of difficulties in daily life by half. And the program has been shown to save $22,000 per person on average.
Sarah L. Szanton, PhD, ANP, FAAN is the co-developer of CAPABLE at Johns Hopkins University School of Nursing. In December 2019 Dr. Szanton participated in the BCBSA sponsored POLITCO Live event: Combating Chronic Conditions which addressed policies, strategies and innovations to improve care for patients with chronic disease. Read our key takeaways here.