1. RHODA MEADOR, PHD ASSOCIATE DIRECTOR OUTREACH AND EXTENSION, COLLEGE OF HUMAN ECOLOGY CORNELL INSTITUTE FOR TRANSLATIONAL RESEARCH ON AGING Project Home Evaluation

2. Evaluation Perspective Neutral External, independent

3. Rationale/Significance Feedback for Project Home  Design modifications  Future funding opportunities Replication of Similar Programs  Barriers  Strategies for overcoming barriers

4. Design Rigorous, multi-method Components  Quantitative (Costs, formal and informal support, hospitalizations and emergency department visits, medical history, mental health, cognitive and behavioral health, mobility, use of assistive devices, number of medications, Activities of Daily Living, Instrumental Activities of Daily Living, and quality of life)  Qualitative (barriers and case studies)

5. Sample  Participants (n=60) 36 were discharged for some period of time into the community, and 24, although determined to be eligible for transition to the community, did not  Comparison group (n=16) challenges in recruitment, limitation is small sample size  Agencies that served clients Data collection time period  For up to one year

6. Results Cost  Data source-service providers  Information limited, but suggested that Project Home clients who transitioned to the community were spending far less money on home care and other services than the cost of the nursing home, and doing so while living in accordance with their wishes.

7. Results Outcomes  Medicaid status was the only statistically differentiating factor between clients who returned to the community and those who remained in long-term care  Functional status, social characteristics, and emotional well- being were not statistically significant.  This indicates that, apart from financial resources, transition to the community was possible for all types of clients.

8. Barriers to going home Three main themes in the case notes summarize the majority of the barriers to community living faced by clients  medical complexity  lack of social support  limited housing options

9. Conclusions Most striking finding-the complexity of each client’s situation  The differences in health, social, and material resources argues against a systematized approach being as useful as the tailored, person-centered approach that this intervention provided.  The success of this intervention cannot be replicated by enacting a codified system; is success was in its ability to respond flexibly to client needs.