Home-Based Care Program Reduces Disability and Promotes Aging in Place

Key Questions Answered
  • How can addressing difficulties with activities of daily living (ADLs) reduce health care utilization and promote aging in place?
  • What’s an example of a program that has shown promising results?
Key Themes and Takeaways

Difficulty with activities of daily living is a major cost driver in health care that is typically overlooked. Addressing this challenge may hold promise for reducing costs and promoting aging in place. This resource reports results from a demonstration project in Baltimore to evaluate Community Aging in Place, Advancing Better Living for Elders (CAPABLE), a program for older adults with physical disabilities.


  • CAPABLE was a five-month program in which participants received home visits to assist with ADLs from an interprofessional care team. The team included an occupational therapist, a nurse, and a handyman.
  • The program targeted functional goals that each participant identified as most important (for example, to get upstairs, take a shower, or walk out the front door).
  • Difficulty with ADLs was reduced significantly for 75 percent of participants, from an average of difficulty with 3.9 activities to 2.0 activities. The practical effect of improving from four to two difficulties with ADLs can be life-changing.
    • Depressive symptoms improved in 53 percent of participants.
    • The improvements occurred across demographic and chronic disease status, suggesting that such programs could play a role in reducing health disparities.
  • The average cost of delivering the program was $2,825 per participant.
Sarah Szanton
Bruce Leff
Jennifer Wolff
Laken Roberts
Laura Gitlin
Population Addressed
Frail Older Adults
Level of Evidence
Promising Evidence
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