Health conditions and unmet needs for assistance to perform activities of daily living among older adults with dementia in Chile

Zhou, Yi; Slachevasky, Andrea; Calvo, Esteban

doi:10.1002/gps.4879

Cited by 11 publications

(7 citation statements)

References 44 publications

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“…Regardless of this variety, a higher dependency on and need for services is common among people with different types of memory disorders [10][11][12]. Previous research shows that higher needs entail unmet needs; hence, people with dementia have more unmet needs than people without dementia [22]. In a study of community-dwelling older people with cognitive impairment and their informal caregivers in the United States, almost all of the older people had at least one unmet need [23].…”

Section: Discussionmentioning

confidence: 99%

Unmet care needs are common among community-dwelling older people with memory problems in Finland

Aaltonen

Aerschot

2019

Scand J Public Health

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Aims: Ageing in place has become a policy priority. Consequently, residential care has been reduced, and more older people with multiple care needs reside at home with the help of informal care and home care services. An increasing share of these people has memory disorders. We examined the extent to which memory problems, in addition to other individual characteristics, are associated with unmet care needs among community-dwelling older people. Methods: The study employed cross-sectional survey data from community-dwelling people aged 75+ collected in 2010 and 2015, analysed using binary logistic regression analysis. The study population consisted of people who had long-term illnesses or disabilities that limited their everyday activities ( N = 1928). Nine per cent reported substantial memory problems. Of these, 35.7% had a proxy respondent. Results: People with memory problems have more care needs than those with other types of disability or illness. They receive more care but still have more unmet needs than others. About a quarter of people with memory problems reported that they did not receive enough help. This result did not change significantly when the proxy responses were excluded. Even a combination of informal and formal home care was insufficient to meet their needs. Conclusions: Insufficient care for people with memory problems implies a serious demand for further development of home care services. The care needs of this population are often complex. Unmet needs represent a serious risk to the well-being of people with memory disorders, and may also create an extensive burden on their informal caregivers.

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Section: Discussionmentioning

confidence: 99%

Unmet care needs are common among community-dwelling older people with memory problems in Finland

Aaltonen

Aerschot

2019

Scand J Public Health

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“…Unmet needs are not distributed equally. Some subgroups such as those without a partner and with low socioeconomic position experience more unmet needs [6][7][8][9]. Some studies have also found sex differences in unmet needs among people with dementia; in a Chilean study unmet needs were more frequent among men [8] whereas in a Polish study they were more frequent among women [10].…”

Section: Introductionmentioning

confidence: 97%

A Longitudinal Study of Functional Unmet Need Among People with Dementia

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Wittenberg

et al. 2021

JAD

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Background: Understanding the changes of unmet need in dementia may enable effective targeting of help and allow people to stay in their homes longer. Objective: We investigated changes in unmet need and functioning over a 4-year period and the role of socio-demographic factors in these changes among people with dementia. Methods: 234 community-dwelling people with dementia at baseline were studied in three consecutive waves (four years) of the English Longitudinal Study of Ageing (ELSA). Unmet needs (self/informant-reported limitations for which no help was received) and functional limitations (self/informant-reported difficulties in activities/instrumental activities of daily living and mobility) were modelled with latent growth curves. Sex, age, partnership, and socioeconomic status at baseline were used as predictors. Admission to a care home was an additional outcome. Results: Unmet needs increased over time, especially among those who initially had more functional limitations. Unmet needs contributed to faster decline in functional capability, except among those with many limitations initially. The major driver of increased unmet needs was not having a partner (direct effect). Age, sex, and wealth contributed indirectly via the initial level of functional limitations and/or unmet need. Those with several functional limitations but few unmet needs were most likely to move to a care home. Conclusion: Unmet need increases over time in those with dementia with mitigating effects of having a partner and initial levels of functioning. Meeting needs at early stages of dementia, especially for those living alone and when functional limitations are low may help slow functional decline.

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“…Several studies have reported the factors associated with unmet needs and inequalities in receiving help among people with dementia or cognitive impairment. In a Chilean study, those with dementia living in the community were less likely to receive help if they were men and if they had a lower level of education (1). In the community in the United States, higher unmet needs among those with dementia were associated with non-white ethnicity, lower income, less impairment in activities of daily living, and more symptoms of depression (5).…”

Section: Introductionmentioning

confidence: 99%

“…People with impaired cognitive function (ranging from poor performance in memory and orientation tasks to the neurodegenerative disorder dementia) often have greater needs for assistance in daily activities compared to older people without cognitive di culties (1)(2)(3). Unmet needs are frequently observed among people with dementia, with over 90% having at least one unmet need (4)(5)(6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Are There Inequalities in the Receipt of Help Among People With Dementia or Cognitive Impairment? Results From the English Longitudinal Study of Ageing

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Dixon

et al. 2020

Preprint

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Background: In addition to inequalities related to gender, age and socio-economic background, poor cognitive function may affect receipt of help and impair quality of life. We investigate whether people with dementia or low cognition with a disadvantaged background, experience more unmet need and/or more unrequired help than older people with similar levels of functional limitation, and associations with quality of life. Methods: We studied people aged 50+ in the English Longitudinal Study of Ageing. Cognitive status was divided into three groups: dementia (by physician diagnosis and/or proxy questionnaire, n=405); low cognition but no dementia (lowest quartile in the mean of z-scores of orientation, immediate recall and delayed recall, n=4,520); and intact cognition (n=10,264). Counts of unmet need (not receiving help for the need) and unrequired help (receipt of help without the respective need) were used as outcomes in two-part regressions. Quality of life (CASP-19) was a continuous outcome in a linear regression. Socio-demographic factors (gender, age, having partner/child and socioeconomic status), functional limitation, and their interaction with cognitive status were included in the models. Results: People with dementia or low cognition at lower levels of functional limitation had more unmet need and received more unrequired help. At higher levels of functional limitation, unmet needs were more frequent among the cognitively intact while unrequired help did not differ by cognitive status. Women, younger individuals, and those with a partner had fewer unmet needs but received more unrequired help, mostly among the cognitively intact. Higher socioeconomic status was associated with fewer unmet needs and unrequired help regardless of cognitive status. Both unmet need and unrequired help were associated with poorer quality of life independent of cognitive status. Conclusions: Unmet need may be a particular challenge in early dementia. Unrequired help that may decrease autonomy is a problem at all levels of cognition. Lower socioeconomic status undermines the receipt of sufficient help. Our results highlight the importance of a good-quality timely diagnosis of dementia, comprehensive and accurate needs assessment, and person-centred care planning to identify those with unmet need and receiving unrequired help in order to improve their quality of life.

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Health conditions and unmet needs for assistance to perform activities of daily living among older adults with dementia in Chile

Abstract: The results from this study call for action by practitioners and policymakers to foster caregiver training, increase supportive services, and advance care planning for PWD.

Cited by 11 publications

References 44 publications

Unmet care needs are common among community-dwelling older people with memory problems in Finland

Unmet care needs are common among community-dwelling older people with memory problems in Finland

A Longitudinal Study of Functional Unmet Need Among People with Dementia

Are There Inequalities in the Receipt of Help Among People With Dementia or Cognitive Impairment? Results From the English Longitudinal Study of Ageing

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