Reducing Disability Via a Bundled Bio-Behavioral-Environmental Approach

Reducing Disability Via a Bundled Bio-Behavioral-Environmental Approach

The purpose of the study is to determine whether a combination of occupational therapy visits, nursing visits, and handyman repair are effective in helping low income older adults avoid costly health care services

We will recruit low-income age 65 or older

-principally African-American, adults from the Baltimore Department of Housing Energy Assistance Program.

-We will interview them at home and randomize participants to either the treatment (CAPABLE intervention) or control (attention-control) group. Participants in the treatment group will receive up to 10 in-home sessions -- 6 visits with an occupational therapist and 4 visits from a nurse - and $1200 in safety and modification services from a licensed handyman. Each treatment participant will receive each intervention component but interventionists will systematically tailor content to the participants' risk profile and goals based on protocols.

Inclusion Criteria:

• at least 65 years old
• cognitively intact
• difficulty with at least one activity of daily living or two instrumental activities of daily living
• less than 175% of the Federal Poverty level
• be able to stand with or without assistance
• agree to study participation

Exclusion Criteria:

• hospitalized more than three times in the last year
• receiving in home rehabilitation
• have a terminal diagnosis with less than one year life expectancy
• plan to move in less than one year