SOCIABLE Seniors Optimizing Community Integration to Advance Better Living With ESRD

Questionnaires:

Participants will be asked to answer questions about:

• social support and social functioning
• pain and depression
• physical function

Study intervention:

Participants will be randomly assigned (by chance, like the flip of a coin) to one of two groups: participant either will receive SOCIABLE (Seniors Optimizing Community Integration to Advance Better Living with ESRD) services now, or will receive the same services in six months from now. Participants have a 50:50 chance of getting into each group

SOCIABLE services involve receiving visits with a nurse interviewer. Participants will decide how you want to improve your social function and social support.

Participants will also receive:

• a group of services called CAPABLE which include home visits from a nurse (RN) and an occupational therapist (OT) and a handyman for repairs if you need them and
• help with improving social support

All participants will receive 10 home visits (6 OT, 4 RN) plus minor home repairs and assistive devices over a 4 month period of time.

Inclusion criteria

• 60 years and older
• End Stage Renal Disease on In-Center Hemodialysis for at least 6 months
• Functional limitations (difficulty in at least one of the following: bathing, dressing, walking across a room, grooming, getting on or off the toilet, getting on or off the bed);
• Low socioeconomic status (less than high School education, or household income <$25,000/year)
• Signed informed consent

Exclusion criteria

• Inability to understand the informed consent process and give consent via signed written consent form