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Community Aging in Place—Advancing Better Living for Elders (CAPABLE)

Written by Diane Archer

As the population ages, many experiments are underway to understand how best to keep people living in their homes as long as possible, sometimes called community aging in place. Not only is nursing home care extremely costly, but most older adults prefer to live at home. And, some experts believe that a few low-cost interventions can keep people in their homes months or even years longer. CAPABLE (Community Aging in Place—Advancing Better Living for Elders) is testing that proposition, helping low-income older adults with chronic conditions increase their mobility and functionality at home.

CAPABLE relies on occupational therapists, nurses, and handymen who can help make a home safer and easier to move around in, to enable older adults to age in place.  The theory is that neither providing supports for individuals nor making changes to the home alone is adequate to help meet the needs of vulnerable older adults at risk of serious disability. But, a small investment–$4,000—in both could make a large difference in their lives and save significant money as well.

Initial study results show that CAPABLE could improve health and daily life for many older adults, while reducing health care costs. Older adults in the study group received 10 one-hour to one-hour-and-a half visits over five months.  The handyman might lower shelves and install handrails.  The nurse might help a person organize her medications to ensure medication compliance.

The study found that 79 percent of the 100 people receiving the CAPABLE intervention improved their self-care in five months and experienced fewer symptoms of depression.  The average participant reduced her disabilities by half and was far better able to take care of herself.

The project was funded by a grant from the Centers for Medicare and Medicaid Services Innovation Center.



  • Don’t forget home healthcare physical therapists, who can come into the home and quickly spot trouble areas, and make practical suggestions.

  • One of the neglected areas for aging in place is transportation. Depending on the community, transportation may be available for near-by medical and dental appointments, but, not necessarily, for anything else, such as a movie or a walk in the park. Once someone can’t drive, for any reason, ranging from physical disability to a medical condition, their activity outside of the home is limited, thus limiting the practicality of aging in place.

    Singles without family or an aging person whose friends have died have many challenges to the transportation issue unless they have assets to hire a driver.

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