It started with a simple idea in 2009 when I came to Sara Sandton while I was calling my house as a visiting nurse in West Baltimore.
So Southernton began with 42 elderly Baltimore residents in a NIH-funded pilot clinical trial, sending out a rare team for home visits. Healthcare professionals and home repair workers improved the participants' physical exercise and physical environment, allowing them to age in a home that suits their specific needs.
The 2012 grant from the National Institutes of Health's National Aging Institute launched hundreds of more definitive clinical trials. As the program blossomed, several grants continued, proving that $3,000 per person would save $30,000 by avoiding medical expenses and nursing home admissions.
Decades later, the program, which aged the community, helped thousands of elderly Americans at 45 rural, urban and suburban sites in 23 states and two countries. NIH support is no longer needed. Some states in Massachusetts, Vermont and Colorado are helping with interventions through the Medicaid program.
“NIH was essential for creating, developing, testing and disseminating Capables nationwide,” said Szanton, now dean of the Johns Hopkins University School of Nursing. “You can think of it like this. The researcher's idea is like a seed. The university is the ground on which seeds are planted. The NIH provides water and sunlight to help with that.”
Today, competent seniors work with nurses and occupational therapists for four months, improving mobility and overall health, and convenient workers modifying their homes to deal with a variety of obstacles.
Sandton tells the story of one 79-year-old man who suffered nerve damage during a tour during the Vietnam War. At first, the man greeted the capable team members with “flat emotions, smiles and no sparks in his eyes,” she said.
“The researchers' ideas are like seeds. The university is the ground where seeds are planted. The NIH provides water and sunlight to help grow.”
Sarah Santon
Dean, School of Nursing
“You'll see him and see him depressed,” Zanton said. “But what brought him joy was to come out in front of his back and listen to the birds.”
The only way he could do was for his grandson to lift him out of his wheelchair and bring him back. The man left the house only three times a week for dialysis.
“One of his goals was to get up and go outside to listen to the birds without help,” she said.
After working with a nurse and an occupational therapist for four months, this guy became stronger and more carrying. And with the addition of various bars built into the halls of his home, he was able to move around without the help of his grandson. Eventually, as his pain decreased and his strength increased, the man was able to get out and walk outside to listen to the birds.
“It meant a lot to his dignity,” Sandton said. “He began leaving the house himself for other activities. By the end of four months he had sparkled his eyes and got a ready smile for the occupational therapist and nurse.
“It's just a story,” she added. “This program is very rewarding and can tell a thousand such stories.”
Others use interventions to sail the stairs, go outside, walk for food for the fridge, stand on the stove and cook, and climb into the tub for the bath. Recognizing the promise of one researcher's vision more than a decade ago, if only one NIH grant were not, thousands of other seniors who benefited from their capabilities would not have had such opportunities.
Currently, programs like Capable are helping to remodel the US health system from disease care to preventive care. In October 2022, the Faculty of Nursing handed over a competent national hub, a network of palliative care that is expanding care synergy, hospice, home hygiene, and interventions across the country.
“The importance of NIH research is not just at this point,” Szanton said. “It's going to affect you for years.”
