Our homes are not only spaces where we conduct our daily activities, but also special places that hold life’s major milestones and the everyday laughter of family and friends. As the walls and surfaces of our homes are adorned with photos and mementos, they are where we want to stay. As we get older and our needs and goals change, so must our home environment ensure ongoing comfort, safety, and dignity in the places where our most precious memories are held.

To help older adults continue to live in their home and safely meet their goals, University of Pittsburgh researcher, Dr. Ava Giatras, from Dr. Pamela Toto's team in the Department of Occupational Therapy, recently presented highlights from an ongoing study by University of Pittsburgh and University of Wisconsin-Madison researchers. This study found that when using the human-centered, evidence-based CAPABLE approach, home modifications and equipment costs averaged $1,000 and $130, respectively. These low-cost and quickly implemented changes are made based on direct expert observation of participants' homes by an interprofessional team, personalization through direct participant input, and evaluation of what will provide improvement in each older adult’s day-to-day activities.

The presentation titled “Becoming More CAPABLE: Characterizing Home Modifications That Promote Aging in Place” was presented at the AOTA INSPIRE 2025 Annual Conference & Expo held in Philadelphia.

Direct Observation and Participant Input Make CAPABLE Impactful

Older adults tend to spend nearly 75% of their time inside their homes, and every person’s needs are different. The CAPABLE program, which stands for Community Aging in Place—Advancing Better Living for Elders, allows for personalized design and participant input through home visits and direct modifications to the home by an interprofessional team of an occupational therapist, a registered nurse, and a handy worker over the course of four months. For example, to meet the goals of daily life, older adults and their care partners may need some minor modifications to the design of the home environment, including handheld shower heads, handrails, motion-activated lighting, and non-slip mats.

The ability to continue living at home (i.e., age in place) provides a sense of independence, freedom, self-worth, identity, comfort, and an active role in the community. The CAPABLE program, developed by Dr. Sarah Szanton, Dean of the Johns Hopkins School of Nursing, helps seniors with lower incomes age in place, and as of 2022, reports that nearly 5,000 clients have participated in this free program.

Preventing Falls Through Design Saves Hospital Trips and Money

For older adults and their care partners, maintaining dignity, autonomy, safety, and comfort is essential. Additionally, there are potential savings to the individual and the medical system overall. The CAPABLE National Center reports that for every $3,000 invested in the program to make participants' homes safer, there is a $30,000 return on investment in medical costs in addition to reduced symptoms of depression and improved functionality.

The importance of this research by Dr. Toto’s team at UPitt and the CAPABLE program is more relevant now than ever. By 2030, all people from the “Baby Boomers” generation will be over 65 years. Luckily, with this interprofessional expert review, individual input, and a few minor modifications, both us and our homes can become more CAPABLE.

Photo of smiling older adult and child at home. Photo credit by Cal Gao by Unsplash. — *Image: Cal Gao/Unsplash*

References

Giatras, A., Perepezko, K., Valente, K., Toto, P., Fields, B., & Blanchflower, M. (2025, April 5) Becoming More CAPABLE: Characterizing Home Modifications That Promote Aging in Place [Conference presentation]. AOTA Inspire 2025 Annual Conference & Expo, Philadelphia, PA, United States. https://doi.org/10.5014/ajot.2025.79S2-CA13

Szanton, S. L., Leff, B., Li, Q., Breysse, J., Spoelstra, S., Kell, J., Purvis, J., Xue, Q., Wilson, J., & Gitlin, L. N. (2021). CAPABLE Program Improves Disability in Multiple Randomized Trials. Journal of the American Geriatrics Society. 69, 3631-3640. https://doi.org/10.1111/jgs.17383

Toto, P. E., Alchin, T., Yanes, C., Park, S., and Fields, B. E. (2023). Implementing CAPABLE With Care Partners Through an Area Agency on Aging: Identifying Barriers and Facilitators Using the Consolidated Framework for Implementation Research. The Gerontologist, 63(3), 428-438. https://doi.org/10.1093/geront/gnac097

We Can Change Our Homes as We Age: Becoming More CAPABLE

Rewriting the Origins of Ovarian Cancer: The Role of Stromal Support Cells