Table 1.

CAPABLE Intervention Team Roles

Problem Area	Role	Interventions	Outcomes
My knees hurt every day PAIN	OT	▪Assess for environmental and mechanical factors that may be exacerbating joint pain ▪Teach range of motion exercises that may alleviate pain	▪Pain is reduced to a level such that client is now standing to cook and can walk down the front stairs if those are the goals she identified.
	Handyman	▪Install stairway rails outside and inside home
	RN	▪Assess pain levels with and without activity ▪Review current medication regimens and assess for adequacy / adherence ▪Encourage dialogue with PCP to review current analgesia regimens and dosing ▪Suggest non-pharmacologic therapies to decrease pain
Problem Area	Role	Interventions	Outcomes
I feel weak especially when standing while cooking FATIGUE & WEAKNESS	OT	▪Assess how client performs task ▪Suggest sitting to perform task ▪Educate in Energy Conservation Techniques (ECT) ▪Design activities to increase standing tolerance ▪Assess equipment needs (order & train)	▪Client acquires additional nutrition ▪ADLs enabled
	Handyman	▪Make recommended modifications in kitchen e.g. move chair/table near sink ▪Install lower shelves as necessary
	RN	▪Deliver patient education regarding nutrition & cycle of weakness, frailty ▪Suggest easily accessible sources of protein and complex carbohydrates ▪Assess for orthostatic hypotension ▪Implement strength protocol e.g. Tai Chi, CDC/NIA exercises, strength bands
Problem Area	Role	Interventions	Outcomes
I can’t go down my front steps STRENGTH & BALANCE	OT	▪Assess how client performs task ▪Identify availability of alternate entrance/exit ▪Educate about safe environment ▪Determine equipment needs (order & train) ▪Assess need for home health PT	▪Client able to go to community activities ▪Increased strength and community engagement ▪Increased QOL
	Handyman	▪Installs hand-rails on both sides of steps
	RN	▪Assess use of medications that may include dizziness as side-effect ▪Work with client on strength, balance ▪Practice safe methods for going up and down stairs with client
Problem Area	Role	Interventions	Outcomes
I’m afraid of falling FEAR OF FALLS	OT	▪Teach problem solving strategies for getting up from the floor ▪Teach how to explain to someone how to assist them to get up ▪Teach home safety to prevent falls ▪Practice proper reaching techniques with client ▪Assess equipment needs (order & train)	▪Client able to perform more ADLs without fear of falling which increases activity and strength and forestalls further decrease in ADL ability
	Handyman	▪Install grab bars ▪Order reach tools
	RN	▪Initiate strength & balance exercises with client ▪Encourage range of motion exercises ▪Practice safe navigation of stairs with client