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To examine the impact of home modifications on self-rated ability in everyday life from various aspects for people ageing with disabilities. Therefore, it is important that home modifications be installed as soon as possible after the need has been identified. For each consecutive month the person waited for their home modification the difficulty of performing everyday life tasks increased. Furthermore, to be effective home modifications need to be installed in a timely fashion. Home modifications are effective in decreasing difficulty in performing everyday life tasks up to six months after the installation. One confounding factor, number of months waiting for home modification, had an impact on difficulty in everyday life. Participants in the intervention group reported a significantly lower level of difficulty in everyday life tasks compared with those in the comparison group.

The data were first subjected to Rasch analysis and a random coefficient model was used. The sample consisted of 103 persons aging with disabilities and in need of home modifications, divided into an intervention group and a comparison group. To investigate longitudinal impacts of home modifications on the difficulty of performing everyday life tasks for people aging with disabilities, and to investigate whether other factors had any additional impacts on difficulty in everyday life tasks for people receiving home modifications.

CAPABLE has the potential to leverage current health care spending in Medicaid waivers, Accountable Care Organizations and other capitated systems to save the health care system costs as well as improving low income older adults’ ability to age at home with improved life quality. Careful cost tracking and analysis using intervention data and claims data will enable direct measurement of the cost impact of the CAPABLE approach. Secondary outcomes are sustained decrease in self care disability as well as improvement in instrumental ADLS, strength, balance, walking speed, and health care utilization. The primary outcome is decreased disability in self-care (ADL). Both groups receive up to 10 home visits over 4 months.

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The CAPABLE (Community Aging in Place, Advancing Better Living for Elders) trial is a randomized controlled trial in which low income older adults with self-care disability are assigned to one of two groups: an interdisciplinary team of a nurse, occupational therapist, and handyman to address both personal and environmental risk factors for disability based on participants’ functional goals, or an attention control of sedentary activities of choice. This paper presents the rationale and design for a randomized clinical trial of a novel interdisciplinary program to reduce disability among low income older adults based on a previous pilot trial of the same design showing strong effect. As the population ages, it is increasingly important to test new models of care that improve life quality and decrease health costs.

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