Updated Analyses of Trends in Use of Assistive Devices. Major Findings From the Original Study

Between 1984 and 1999, the proportion of chronically disabled community residents using assistive devices, with or without help, for all activities doubled to nearly 30 percent; the proportion relying solely on help fell. Almost 1 million more elders were using devices with at least one activity in 1999 than in 1984.

Most of the increase in device use was in independent device use. Nearly one-quarter of disabled elders managed all chronic disabilities with only devices in 1999, and almost two-thirds used devices independently for at least one activity.

Bathing was the only activity with a strong upward trend in independent use of devices and a similarly strong downward trend in sole use of help, but significant increases in independent use of devices occurred for all four mobility-related ADLs--bathing, getting around inside, transferring, and toileting--and for getting around outside.

Simple devices for mobility, bathing, and toileting--walkers, canes and crutches, tub or shower seats, and raised toilet seats--continued to be the most common devices and saw the largest increases, although wheelchairs and scooters also nearly doubled in prevalence.

In 1999, about one in four chronically disabled community residents used only devices for all disabilities; nearly 60 percent used a combination of help and devices; and only about 15 percent reported using only help with all chronic disabilities.

Persons managing all chronic disabilities with only devices were less disabled than persons using both help and devices, particularly with respect to mobility and the frequency with which accommodation was needed; those using only help were far less disabled than those using devices.

Essentially none of the group using only devices reported unmet need for help with ADLs, compared with about one in five persons using both help and devices, and about one in ten persons receiving only help.

Persons managing all disabilities with devices were most likely to live alone, and to live in some type of senior housing, while persons using both devices and help were most likely to live in an explicit community residential care setting, such as assisted living.

Persons using only help were most likely to live with a spouse and far less likely than persons using devices to have any environmental accommodations, such as railings or raised toilet seats, or to consider them desirable.

Both groups using devices were older and relatively similar in gender distribution compared with persons using only help, who were more likely to be male.

Persons relying solely on devices had higher education and income than either group using help.

Hours of care received in the last week rose with disability level and generally were higher for the group using both help and devices than for the group using only help.

Frequency of need for accommodations, especially for mobility or transfer was important; hours of help were more than doubled for respondents reporting they needed accommodation for any ADL most of the time.

Persons with at least three ADLs who used devices with help received far more hours of care than persons performing at least one activity only with devices; they also received more hours than similarly disabled persons receiving only help.