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Review
. 2022 Feb;30(2):e469-e477.
doi: 10.1111/hsc.13230. Epub 2020 Nov 17.

Safety risks among frail older people living at home in the Netherlands - A cross-sectional study in a routine primary care sample

Manon Lette  1   2   3 , Annerieke Stoop  1   2   4 , Giel Nijpels  1 , Caroline Baan  2   4 , Simone de Bruin  2 , Hein van Hout  1
Affiliations
Review

Safety risks among frail older people living at home in the Netherlands - A cross-sectional study in a routine primary care sample

Manon Lette et al. Health Soc Care Community. 2022 Feb.

Abstract

Frail older people face a range of problems and risks that could undermine their ability to live safely at home. A comprehensive overview of these risks, from a multidimensional perspective, is currently lacking. This study aims to examine the prevalence of risks in multiple domains of life among frail older people living at home. We used cross-sectional data from 824 people aged 65 years and older, who received a comprehensive geriatric assessment (the interRAI Home Care [interRAI-HC]) between 2014 and 2018, as part of routine care from 25 general practices in the region of West-Friesland, the Netherlands. The interRAI-HC identifies amenable risks related to people's clinical conditions, functioning, lifestyle and behaviour, and social and physical environment. Descriptive statistics were used to examine population characteristics (age, gender, marital status, living arrangements and presence of chronic conditions) and prevalence of risks. Most common risks were related to people's clinical conditions (i.e cardio-respiratory health, urinary incontinence, pain), functioning (i.e. limitations in instrumental activities of daily living and mood) and social environment (i.e. limitations in informal care and social functioning). More than 80% of frail older people faced multiple risks, and often on multiple domains of life simultaneously. People experiencing multiple risks per person, and on multiple domains simultaneously, were more often widowed and living alone. The multidimensional character of risks among frail older people living at home implies that an integrated approach to care, comprising both health and social care, is necessary. Insight in the prevalence of these risks can give direction to care allocation decisions.

Keywords: care of elderly people; health needs assessment; multi-disciplinary; primary care; risk assessment; risk in community care.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

FIGURE 1
FIGURE 1
Number of chronic conditions per person among people who received an interRAI Home Care assessment in primary care practices in West‐Friesland, the Netherlands (N = 824). Chronic conditions include cancer, congestive heart failure, coronary heart disease, chronic obstructive pulmonary disorder, dementia, diabetes and stroke
FIGURE 2
FIGURE 2
Prevalence of triggered CAPs among older people who received an interRAI Home Care assessment in primary care practices in West‐Friesland, the Netherlands (N = 824). CAPs stand for Client Assessment Protocols, which are validated algorithms that alert the assessor to specific problems and risks that can be addressed
FIGURE 3
FIGURE 3
Number of triggered CAPs per person among people who received an interRAI Home Care assessment in primary care practices in West‐Friesland, the Netherlands (N = 824, total number of CAPs = 22). CAPs stand for Client Assessment Protocols, which are validated algorithms that alert the assessor to specific problems and risks that can be addressed
FIGURE 4
FIGURE 4
Combinations of triggered risk categories among people who received an interRAI Home Care assessment in primary care practices in West‐Friesland, the Netherlands (N = 824). A risk category was triggered when one or more Client Assessment Protocols in that category presented a trigger
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