Non-use of assistive technology in The Netherlands: a non-issue?

PURPOSE: To obtain insight into the prevalence of the non-use of assistive technology in The Netherlands. Relationships between non-use and possible determinants were also investigated. The results of the study might lead to improvement of products and of the service delivery system for assistive technology. METHOD: A study was performed into user satisfaction and the non-use of 14 categories of assistive technology provided by health care insurers. The design was a survey among a stratified sample of users who had received an assistive device, recruited through a sample of health insurance companies. Two independent samples were selected: one in 2001 and one in 2003. Three aspects of non-use were measured. The total number of respondents was 2272. RESULTS: Ninety-two percent of the respondents used the assistive device at the time of the survey. Less than 1% of the respondents never used the device. A majority of the respondents used the assistive device (about) as much as expected and 6% used the assistive device less than expected. Relationships between non-use and other investigated aspects were found. CONCLUSIONS: The average level of non-use of assistive technology found in this study is less than often reported in the literature and varies between the various categories of assistive technology. Improving the quality of the assistive technology and the services, and providing assistive technology that solves the users' problem as much as possible, could enhance the use of assistive technology provided.

[CBO guidelines to prevent accidental falls in the elderly: how can it be used in the institutionalized elderly?]. / CBO richtlijn preventie van valincidenten bij ouderen: wat kunnen verpleeghuizen hiermee?

Fall incidents occur frequently in the community dwelling elderly and even more in the institutionalised elderly. Fall-related research data indicate positive effects of a multifactorial intervention targeted on prevention of falls and fall-related injuries. In November 2004 the guideline "Prevention of fall incidents in the elderly" developed by The Dutch Institute for Healthcare Improvement (CBO) was published. This guideline pays attention to the risk factors for falling and the prevention of fall incidents in all settings. The highlights for nursing homes are: all nursing home patients are at risk; perform a fall risk assessment to direct fall preventive activities; together with specific fall prevention for the patient general fall prevention for the institute has to be undertaken; a multifactorial approach is indicated. In nursing homes it is possible to perform such approach multidisciplinary.

[Falls in nursing homes: on average almost two per bed per year, resulting in a fracture in 1.3%]. / Valincidenten in verpleeghuizen: gemiddeld bijna 2 per bed per jaar met bij 1.3% een fractuur als gevolg.

OBJECTIVE: To determine how many falls occur annually in Dutch nursing homes and how many fractures are the result of falls. DESIGN: Written questionnaire study. METHOD: All 371 Dutch nursing homes received a questionnaire requesting information on the number of somatic and psychogeriatric beds and the number of falls and fractures as a result of falls in 2000 and 2001. RESULTS: Of the 371 questionnaires, 202 (54%) were returned. These were distributed as follows over the three types of nursing homes: combined: 151 (75%), somatic: 15 (7%), psychogeriatric: 36 (18%). The average capacity of the participating nursing homes was 180 beds. There was an average of more than 300 reported falls per nursing home: 336 in 2000 (SD: 180; median 314) and 311 in 2001 (SD: 165, median 294). On average, there were almost 2 falls per bed per year. The number of falls per bed in the psychogeriatric group was higher than in the somatic group. There was an average of about 4 fractures per year per nursing home as a result of falls: 4.3 in 2000 (SD: 3.7; median 4.0) and 3.6 in 2oo1 (SD: 2.8; median 3.0). The average number of annual fractures due to a fall was about 23 per 1ooo beds. An average of 1.3% of the falls resulted in a fracture. There were no clear differences here between somatic and psychogeriatric patients. CONCLUSION: The reported number of falls per nursing-home bed averaged almost 2 per year, and an average of 1.3% of these falls resulted in a fracture.