Use, type, and efficacy of assistance for disability.

OBJECTIVES Personal and equipment assistance are often used to reduce disability. This study predicts use of assistance, type of assistance, and its efficacy (improvement with assistance) for disabilities in personal care and household management tasks. METHODS U.S. community-dwellers aged 55+ are studied using the 1994-1995 National Health Interview Survey Disability Supplement. Three types of assistance are considered: Personal Only, Equipment Only, and Both. Efficacy is measured by comparing the degree of difficulty doing a task with versus without assistance. RESULTS Severe disability in a task and poor overall health/disability status increase use of assistance for the task, and especially both types rather than one. For people using one type of assistance, poor health/disability status is linked with personal help, but high severity is linked with equipment use. These results reflect high needs for assistance and limited potential for physiological improvement, joined possibly by a strong desire for self-sufficiency among persons who are severely disabled. Controlling for factors that route people to different types of assistance, equipment is more efficacious than personal assistance. Equipment may have distinctive technical and psychological advantages; for example, it can be tailored to a person's specific needs, is available when needed, and maintains self-sufficiency. DISCUSSION The results about equipment give impetus to policies that promote development and dissemination of assistive technology.