Interprofessional Collaboration: Improving the Lives of Elderly Patients
Sarah Szanton, Ph.D., RN, ANP, FAAN, a professor at the Johns Hopkins School of Nursing in Baltimore, Md., was recently named an American Academy of Nursing (AAN) Edge Runner for her work as the program’s principal investigator. We spoke with Sarah to learn more about CAPABLE and how it helps older adults “age in place.”
My first job after nursing school was working with migrant farmworkers, and I learned a lot about the social determinants of health. Even though my patients were young men all doing the same job, they were very different in terms of health. My next job was with homeless adults in Baltimore, and then I went back to school to become a nurse practitioner. After that, I started doing house calls for low-income older adults who found it difficult or impossible to come to clinic visits. Based on my experience with that, I decided to get a Doctor of Philosophy (Ph.D.) in order to develop research that would address the health disparities that people in our country face.
CAPABLE is a truly interprofessional model involving occupational therapists, nurses, and handymen. It uses home repair and regular household items to improve people’s functions and decrease their healthcare costs.
For example, someone may want to sleep in their own bed instead of on the couch, but is unable to do so because of muscle weakness, shaky banisters, or crooked stairs. We can address all of those issues to help older adults meet their goals.
Nurses and occupational therapists use their expertise to support the goal-development brainstorming for older adult participants. However, the participants themselves drive the goals and achievements of the program.
As a nurse making house calls in Baltimore, I have seen patients who were unable to walk and had to crawl to the front door to let me in. I realized that hiring carpenters and adding nursing visits could be a good fit, and then came across Laura Gitlin’s work with the ABLE program, which we adapted to become CAPABLE.
When she began the program, it took her 30 minutes to walk down the hall to reach the bathroom. By the end of the four months, she was able to get herself out of bed. The first time this happened, her husband burst into tears.
A few months after she completed the program, her granddaughter called us and said that the whole family, including our former patient, was going to Atlantic City. We were overjoyed and moved beyond words. Our participant had been nodding off on her commode chair all day before we met her, and now she was about to go on a family vacation!
A very important thing for nurses working with older adults is to treat each one as an individual with goals and resilient potential, even up until their last weeks of life.
CAPABLE is now available in 17 locations across nine states. To learn more about the program and how it is helping to improve safety and independence for older adults, visit nursing.jhu.edu.