New insights from the Danish preventive home visit trial

Excerpt

This issue contains a series of analytic papers stemming from a recent Danish controlled trial of preventive home visitation for community living elders. The senior author, Carsten Hendriken, is a long-time pioneer developer and evaluator of systematic preventive home visit programs. In the early 1980s, Hendriksen and colleagues performed the classic Roedovre study in suburban Copenhagen, which showed that quarterly preventive home visits can reduce mortality, nursing home admissions and hospital visits, while improving function and actually saving money (Hendriksen et al. 1984). Over subsequent years, Drs. Hendriksen, Schroll, Avlund, Vass and colleagues have continued the Danish preventive home visit study tradition and expanded the scope and substance of the programs with a number of interesting follow-up studies. These valuable studies and reports helped convince the Danish government (as well as those of a few other countries) to institute a national policy of preventive geriatrics incorporating home visitation. Beginning in 1998, Danish national policy has required two annual home visits to every person aged 75 and older with the goal of preserving independence and functional ability by support of personal resources and networking. These visits are usually carried out by nurses and deal with both health and social issues, although the exact details of local programs have been left fairly flexible. As a result of the flexibility, there has been much variability among municipalities as to program characteristics, what components are included, and how much emphasis is placed on medical concerns (Vass et al. 2002). …