The goal of Comfortably Home is to help seniors live independently – and safely – in their own homes. The professional team makes minor repairs and basic accessibility and safety improvements at no cost for qualified homeowners. The team works with each homeowner to create a customized work plan to meet their needs and preferences. Participants receive 1) a safety check, 2) adaptability upgrades, 3) minor maintenance repairs, and/or 4) one-time safety modifications of their choosing. The per-household cost was expected to be no more than $3,200. Enrollment of participants in Sagadahoc County, Maine began October 1, 2015 with implementation of the pilot phase occurring throughout the next year and ending December 31, 2016. During this period, the program served 54 households.
During the initial visit with participants, an interview and home assessment collected baseline data on 1) fall prevalence and severity as well as home hazards that contribute to falls; 2) fire risk factors and safety measures; 3) 911 calls, hospital visits and hospital admissions; 4) level of mobility and independence; 5) isolation; and 6) financial stability.
Intake data was analyzed for the 54 people who qualified for the Comfortably Home program and who did not voluntarily withdraw, die, or move before completing the six-month assessment. Data does not include 13 people who did not qualify for or participate in the program, including eight that opted out before having any work done due to reasons such as declining health or finding alternative ways (usually family) to make needed repairs. The interview and baseline evaluation were conducted in person using participant self-report. All participants were reassessed using the same approach at six months from end of participation. A brief, phone-based check-in was administered at 3 months from end of participation.
1. Fall Prevention
GOAL: Reduce the number and severity of falls related to home hazards by 20%.
OUTCOME: Participation in the Comfortably Home program was associated with a reduction in falls by 85% and the severity of falls by 91%.
Notes: There was an average of 1.57 falls in the year prior to participation; this was reduced to an average of .33 falls in the six months following participation. At baseline, when people fell, there was a 43% chance that the fall would result in a significant injury. When people reported a fall at the 6-month follow up, there was a 22% chance that the fall would result in a significant injury.
2. Fire and Safety Prevention
GOAL: Reduce the number of home fire risk factors and actual home fires by 20%.
OUTCOME: Participation in the Comfortably Home program was associated with an 87% reduction in close calls related fires.
Notes: The following is a sampling of work completed.
- Number of smoke detectors added, replaced or fixed: 81
- Number of CO detectors added, replaced, or fixed: 40
- Number of grab bars installed: 118
- Number of hand railings installed: 30
- Number of shower wands installed: 28
GOAL: Reduce the number of participant 911 calls, hospital visits, and hospital admissions by 15%.
OUTCOME: Participation in the Comfortably Home program is associated with a 54% reduction in hospitalizations and ER visits.
4. Increased mobility and independence
GOAL: Improve participants’ ability to perform instrumental activities of daily living (IADL) by 20%.
OUTCOME: Participation in the Comfortably Home program is associated with an 86% improvement in participant’s ability to perform IADLs.
5. Level of Isolation
GOAL: The number of participants who feel or are isolated because of physical or psychosocial barriers will decrease by 15%.
OUTCOME: Isolation, despite the difficulty of the measure noted above, decreased by 44% for people who participated in Comfortably Home.
6. Financial stability
GOAL: 35% of participants will report a relief of financial burdens as a result of participation in Comfortably Home.
OUTCOME: 96% of participants at follow-up indicated that participation in Comfortably Home had relieved some of their financial burdens.
7. Cost of Participation
The average cost of program participation was $1,532 for Bath Housing services and an additional $1,483 for those households that also received services from Habitat for Humanity.