Unmet Care Needs in the Oldest Old Primary Care Patients with Cognitive Disorders: Results of the AgeCoDe and AgeQualiDe Study

Stein, Janine; Pabst, Alexander; Luck, Tobias; Lühmann, Dagmar; Heser, Kathrin; Jessen, Frank; Bickel, Horst; Mösch, Edelgard; Pentzek, Michael; Fuchs, Ângela; Wiese, Birgitt; Mamone, Silke; König, Hans‐Helmut; Brettschneider, Christian; Werle, Jochen; Scherer, Martin; Maier, Wolfgang; Weyerer, Siegfried; Riedel‐Heller, Steffi G.; AgeCoDe,

doi:10.1159/000478850

Cited by 23 publications

(11 citation statements)

References 33 publications

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“…In line with this, our study suggests that loss experiences are strongly associated with a higher number of unmet psychological and physical care needs after holding other factors constant. Our study also confirms previous results on risk factors for increased unmet needs including a higher age, marital status, depression, decreased social engagement and more severe morbidity [ 15 , 25 , 41 – 43 ]. Thus, the current and earlier findings highlight the importance of the implementation of tailored intervention programs targeting at high-risk older adults with recent loss experiences.…”

Section: Discussionsupporting

confidence: 92%

Unmet care needs in the oldest old with social loss experiences: results of a representative survey

et al. 2020

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Background Loss experiences such as the loss of a spouse, a close relative or significant others become more likely in old age and may be strongly related to specific unmet health care needs. These unmet needs may often remain undetected and undertreated followed by a negative impact on well-being and social role functioning. The present study aims at exploring the relationship between loss experiences and specific unmet care needs in old age. Methods As part of the study „Need assessment in the oldest old: application, psychometric examination and establishment of the German version of the Camberwell Assessment of Need for the Elderly (CANE)”, the adapted German version of the CANE was used in a population-representative telephone survey in a sample of 988 individuals aged 75+ years. Loss experiences within the last 12 months were assessed within the structured telephone survey. Descriptive and interferential statistical analyses were run in order to examine the association between loss experiences and occurring unmet care needs. Results Overall, 29.7% of the oldest old reported at least one social loss with other relatives losses being the most frequent (12.5%), followed by non-family losses (10.7%). A significant relationship between loss experiences and a higher number of unmet care needs was observed, especially for close family losses. Other risk factors for unmet care needs were age, marital status, depression, social support and morbidity. Conclusions This study provides, for the first time in Germany, data on the association between loss experiences and unmet needs. These findings may substantially contribute to the development of loss-specific interventions, effective treatment and health care planning for the bereaved elderly.

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Section: Discussionsupporting

confidence: 92%

Unmet care needs in the oldest old with social loss experiences: results of a representative survey

et al. 2020

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“…Some predisposing and enabling PWD and caregiver characteristics were also independently associated with unmet needs in care recipients. Less education, less income and non-white race are factors that we and others (Black et al, 2013;Hinrichsen and Ramirez, 1992;Scholzel-Dorenbos et al, 2010;Zhor et al, 2018;Stein et al, 2017) have previously identified as significant correlates of unmet needs in PWD. Education and income may be enabling factors for obtaining information on and/or access to dementia-related services.…”

Section: Discussionsupporting

confidence: 50%

Unmet needs in community-living persons with dementia are common, often non-medical and related to patient and caregiver characteristics

Black

Johnston

Leoutsakos

et al. 2019

Int. Psychogeriatr.

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Objective:Understanding which characteristics of persons with dementia (PWD) and their caregivers are associated with unmet needs can inform strategies to address those needs. Our purpose was to determine the percentage of PWD having unmet needs and significant correlates of unmet needs in PWD.Design:Cross-sectional data were analyzed using bivariate and hierarchical multiple linear regression analyses.Setting:Participants lived in the greater Baltimore, Maryland and Washington DC suburban area.Participants:A sample of 646 community-living PWD and their informal caregivers participated in an in-home assessment of dementia-related needs.Measurements:Unmet needs were identified using the Johns Hopkins Dementia Care Needs Assessment. Correlates of unmet needs were determined using demographic, socioeconomic, clinical, functional and quality of life characteristics of the PWD and their caregivers.Results:PWD had a mean of 10.6 (±4.8) unmet needs out of 43 items (24.8%). Unmet needs were most common in Home/Personal Safety (97.4%), General Health Care (83.1%), and Daily Activities (73.2%) domains. Higher unmet needs were significantly related to non-white race, lower education, higher cognitive function, more neuropsychiatric symptoms, lower quality of life in PWD, and having caregivers with lower education or who spent fewer hours/week with the PWD.Conclusions:Unmet needs are common in community-living PWD, and most are non-medical. Home-based dementia care can identify and address PWD’s unmet needs by focusing on care recipients and caregivers to enable PWD to remain safely at home.

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“…In terms of needs assessment, there are often discrepancies in perspectives of different assessors. As shown in this study, typically, community-dwelling people with dementia report a significantly lower number of (unmet) needs than their informal carers 26–28. The causes of such discrepancy could be as follows: being unaware of difficulties, lacking knowledge regarding the existence of services, barriers to accessing them, and unsatisfactory service offerings.…”

Section: Discussionmentioning

confidence: 67%

Does the Meeting Centres Support Programme reduce unmet care needs of community-dwelling older people with dementia? A controlled, 6-month follow-up Polish study

Mazurek

Szczęśniak

Lion

et al. 2019

CIA

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IntroductionIn Poland we lack a multidisciplinary and coordinated system of care for people with dementia, which would take the form of an evidence-based pathway and the number of reports on the holistic approach to caring for people living with this diagnosis is very low.Aim of the studyThe aim of the study was to investigate whether the Meeting Centres Support Programme (MCSP) is effective in meeting the needs of older people with dementia.Participants and methodsThis was done by comparing the experiences of people with dementia themselves and that of their carers at baseline and at follow-up, after 6 months of participation in MCSP or Usual Care (UC).ResultsThe study included 47 people diagnosed with mild-to-moderate dementia (n=24, MCSP group; n=23, UC control group) and 42 informal carers (n=22, MCSP group; n=20, UC control group), all living in Wroclaw in Poland and involved in the European JPND-MEETINGDEM project. To assess cognitive functioning and severity of dementia, the Mini-Mental State Examination and Global Deterioration Scale were used. The needs were assessed using the Camberwell Assessment of Need for the Elderly. The most frequently reported unmet needs at baseline both by the persons with dementia and their carers included activities of daily living, psychological distress, and the need for company. Compared to the UC group the unmet needs were reduced considerably in the MCSP group providing convincing evidence that MCSP is effective in reducing unmet needs over a 6-month period.ConclusionMCSP may be regarded as a good example of comprehensive post-diagnostic support for patients with mild-to-moderate dementia as well as their informal carers.

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Unmet Care Needs in the Oldest Old Primary Care Patients with Cognitive Disorders: Results of the AgeCoDe and AgeQualiDe Study

Cited by 23 publications

References 33 publications

Unmet care needs in the oldest old with social loss experiences: results of a representative survey

Unmet care needs in the oldest old with social loss experiences: results of a representative survey

Unmet needs in community-living persons with dementia are common, often non-medical and related to patient and caregiver characteristics

Does the Meeting Centres Support Programme reduce unmet care needs of community-dwelling older people with dementia? A controlled, 6-month follow-up Polish study

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