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Background: Dutch hospitals are required to screen older patients for the risk of developing functional decline using the Safety Management System (VMS) which assesses four domains associated with functional decline; fall risk, risk of delirium, malnutrition, and physical impairment., Purpose: The aim is twofold, first to compare the VMS frailty instrument as a frailty screener with existing frailty instruments and second to provide an overview of the available evidence., Methods: We performed a literature search to identify studies that used the VMS instrument as frailty screener to asses frailty or to predict adverse health outcomes in older hospitalized patients. Pubmed, Cinahl, and Embase were searched from January 1 st 2008 to December 11th 2023., Results: Our search yielded 603 articles, of which 17 studies with heterogenous populations and settings were included. Using the VMS, frailty was scored in six different ways. The agreement between VMS and other frailty instruments ranged from 57 to 87%. The highest sensitivity and specificity of VMS for frailty were 90% and 67%, respectively. The association of the VMS with outcomes was studied in 14 studies, VMS was predictive for complications, delirium, falls, length of stay, and adverse events. Conflicting results were found for hospital (re)admission, complications, change in living situation, functional decline, and mortality., Conclusion: The VMS frailty instrument were studied as a frailty screening instrument in various populations and settings. The value of the VMS instrument as a frailty screener looks promising. Our results suggest that the scoring method of the VMS could be adapted to specific requirements of settings or populations., (© 2024. The Author(s).)

Background: With the ageing population, there is a stronger focus on supporting older people to live independently as long as possible. One of the important factors to take into consideration for independent living older adults is frailty. This manuscript aims to provide insight into the relation between the different domains of frailty (physical, social and psychological or a combination), health outcomes and wellbeing aspects for independent living older adults., Methods: This cross sectional community-based study included independent living older adults of 65 years and over who are member of a welfare organisation. The questionnaire contained items on background characteristics, health, quality of life, frailty (Tilburg Frailty Indicator), activities and loneliness. A multivariate analysis, one Way ANOVA's and chi-square tests with post-hoc analyses were used to identify significant differences between the following outcomes: Age, gender, marital status, living situation, income, health perception, number of conditions, activities of daily living, home care and informal care, Quality of life, loneliness, going outside, meeting people and the different domains of frailty., Results: 1768 (35.1%) participants completed the questionnaire. 68.9% of the respondents was frail on one or multiple domains and 51.6% of the respondents was frail based on the total score on the TFI. Social frailty (18.4%) was most often present followed by 10.3% for frailty on all three domains of the TFI. All variables tested, except for income, showed significant differences between the different domains of frailty., Conclusion: Distinguishing the different domains of frailty provides information about the older adult's needs which is valuable for policymakers and care providers, to anticipate to the increasing number of independent living older adults and deliver them tailored care and support to contribute to their independent living situation and wellbeing.

The growth in the numbers of older adults needing long-term care has resulted in rising costs which have forced the Dutch government to change its long-term care system. Now, the local authorities have greater responsibility for supporting older adults and in prolonging independent living with increased support provided by the social network. However, it is unclear whether these older adults have such a network to rely upon. The objective of this study was to gain insight into the providers of formal and informal care to older adults, and to assess possible differences between older adults who are frail and those who are not. In addition, we investigated their care and support needs. We used data from a quantitative survey using a cross-sectional design in different regions of the Netherlands from July until September 2014 (n = 181). Frailty was measured using the Tilburg Frailty indicator. To analyse the data chi-square tests, crosstabs and odds ratios were used for dichotomous data and the Mann-Whitney U-Test for nominal data. The number of formal care providers involved was significantly higher (median = 2) for those deemed frail than for those not deemed frail (median = 1), U = 2,130, p < .005. However, more than one-third of the respondents deemed frail did not get the care or support they needed (33.7%). There was a significant positive association between being frail and having an informal care provider (χ 2  = 18.78, df = 1, p < .005). However, more than one-third of those deemed frail did not have an informal care provider (36.8%). One-third of older adults deemed to be frail did not have their needs sufficiently addressed by their care network. For a substantial part of this group of older adults, the informal network seems to be unable to support them sufficiently. Additional attention for their needs and wishes is required to implement the policy reforms successfully., (© 2018 John Wiley & Sons Ltd.)

Insight into risks concerning older adults living independently from their own perspective and their care provider's perspective is essential to address issues that may threaten their independent living. The most often mentioned perceived risks by older adults and their care providers in different regions in the Netherlands were: loneliness, falls, budget cuts in Dutch long-term care and not being able to call for help. The different perspectives of the respondents show a wide variety in risks, but also some similarities. The perspective of the frail older adults is required to gain insight into the priority of their perceived risks. An additional finding was the reluctance shown by the older adults to ask others in their social network for help. Results imply that possible preventive measures should not only focus on the medical or physical domain because older adults are likely to have other priorities to maintain self-reliance and live independently.

Introduction: The Dutch healthcare inspectorate (IGZ) supervises the quality and safety of healthcare in the Netherlands. Owing to the growing population of (community dwelling) older adults and changes in the Dutch healthcare system, the IGZ is exploring new methods to effectively supervise care networks that exist around frail older adults. The composition of these networks, where formal and informal care takes place, and the lack of guidelines and quality and risk indicators make supervision complicated in the current situation., Methods and Analysis: This study consists of four phases. The first phase identifies risks for community dwelling frail older adults in the existing literature. In the second phase, a qualitative pilot study will be conducted to assess the needs and wishes of the frail older adults concerning care and well-being, perception of risks, and the composition of their networks, collaboration and coordination between care providers involved in the network. In the third phase, questionnaires based on the results of phase II will be sent to a larger group of frail older adults (n=200) and their care providers. The results will describe the composition of their care networks and prioritise risks concerning community dwelling older adults. Also, it will provide input for the development of a new supervision framework by the IGZ. During phase IV, a second questionnaire will be sent to the participants of phase III to establish changes of perception in risks and possible changes in the care networks. The framework will be tested by the IGZ in pilots, and the researchers will evaluate these pilots and provide feedback to the IGZ., Ethics and Dissemination: The study protocol was approved by the Scientific Committee of the EMGO+institute and the Medical Ethical review committee of the VU University Medical Centre. Results will be presented in scientific articles and reports and at meetings., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)