Gaps between the subjective needs of older facility residents and how care workers understand them: a pairwise cross-sectional study

Abstract

Background: To promote active daily living and improve the quality of life of older facility residents, it is important that care staff understand their day-to-day activities and needs. However, only a few studies have examined the needs of older residents and how care workers understand them. This study aimed to examine the subjective needs of older residents at aged care facilities, care workers' understanding of these needs, and the gaps that exist between them.Methods: Structured interviews with older residents with no severe cognitive impairment in ten Japanese aged care facilities and a questionnaire survey of care workers were conducted in 2008 regarding resident subjective needs. The questionnaire, which had satisfactory factorial validity, internal consistency, and reproducibility, consisted of seven items on basic activities of daily living (BADL), five items on instrumental ADL (IADL), eight items on environment and lifestyle (EL), and five items on emotion (EM). Pair-wise analyses were performed to compare responses. Results:Responses of 115 pairs were analyzed (residents ≥75 years, 85 %; 21 men, 94 women). Median proportions of residents with IADL (66 %) and EL (69 %) needs were lower compared with those with BADL (83 %) and EM (91 %) needs. Median proportions of care workers understanding IADL (55 %) and EL (60 %) needs were lower compared with those understanding BADL (87 %) and EM (87 %) needs. Less than half of the care workers understood IADL needs for household chores (30 %) and money management (43 %), and an EL need for playing a role (41 %). Conclusions:Gaps were found between resident subjective needs and how care workers understood them. Specifically, care workers underestimated older residents' IADL and EL needs, especially with regard to playing a role. These results highlight the need for care workers to set goals based on each resident's subjective needs and plan strategies for care provision accordingly.

Occupation-based differences in shared perceptions of older resident needs within multidisciplinary care teams: a cross-sectional study of care workers, nurses, and therapists linked to older residents

“…Data from those with markedly missing data (i.e., lack of basic information and/or missing or duplicate responses for more than five of 25 items) were excluded from the analysis. Data from older residents and care workers overlap with those used previously by care workers to assess the perception of subjective needs of the older residents, which suggested that most elderly facility residents had common subjective needs in the areas of BADL and EM, and that proportions of those who expressed needs in the areas of IADL and EL were somewhat low relative to those with needs in BADL and EM areas 15 ) .…”

“…We interviewed the older residents using a questionnaire comprising 25 items as well as items to assess the degree of satisfaction toward daily life. We also conducted a survey of facility staff members using a similar questionnaire comprising 25 items as well as items to assess the degree of satisfaction toward care provision and other questions (January–March, 2008) 15 ) . Four investigators in total, with one playing a central role, unified the method for interviewing the older residents based on the questionnaire.…”

“…Comparisons among hospitalized patients, nursing students, and nurses revealed that nursing students and nurses tend to overestimate patients’ subjective needs in the psychological domain 13 ) . In the area of geriatric care as well, differences have been noted between older facility residents and care staff members in their perception of older resident subjective needs 13 , 14 , 15 ) . Furthermore, older individuals, their families, and their care teams differ in how they construe treatment strategies 16 ) .…”