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Decreasing health disparities with older adults: The CAPABLE studies

This study explores the effectiveness of the CAPABLE intervention in improving the health outcomes of older adults. The intervention focuses on individual strengths and deficits and supports client-directed self-care goals through the involvement of a handyman, nurse, and occupational therapist. Results show improvements in activities of daily living and instrumental activities of daily living limitations, as well as reductions in depressive symptoms and home hazards. The study also highlights the importance of addressing function in medical care for older adults and the potential for scalable interventions through various payor possibilities.

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Decreasing health disparities with older adults: The CAPABLE studies

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  1. Decreasing health disparities with older adults: The CAPABLE studies Sarah L. Szanton, PhD ANP FAAN Associate ProfessorJohns Hopkins School of Nursing Associate Director for Policy, Center for Innovative Care in Agingsszanto1@jhu.edu September 22,2016

  2. Mrs. B

  3. Her Hazardous floor

  4. Relative Risk of Being in the Top 5% of Health Care Spenders, 2006

  5. CAPABLE • Focused on individual strengths and deficits and goals in self-care (ADLs and IADL) • Client-directed as opposed to client-centered • Handyman, Nurse and Occupational Therapist • OT: 6 visits, RN:4 visits, Handyman: $1300 budget over 4 months

  6. Month 1 Month 2 Month 3 Month 4

  7. Before After

  8. Exhibit 1. Changes from Baseline to Follow-up in Activities of Daily Living Limitations and Instrumental Activities of Daily Living Limitations

  9. Exhibit 2. Changes from Baseline to Follow-up in Depressive Symptoms and Home Hazards

  10. Addressing Function Poor function is costly It’s what older adults care about It’s virtually ignored in medical care Modifiable

  11. Payor Possibilities CMS committed to scaling if meets Triple Aim Accountable Care Organizations Medicare Advantage PACE Medicaid waivers Maryland Hospital Waiver

  12. Questions and discussion

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