Predictors of unmet needs in Chilean older people with dementia: a cross-sectional study

Abstract

Background The needs of people with dementia (PWD) have not been assessed in any Latin American country. Several European countries have already related unmet needs with quality of life, caregiver’s age, burden, stress, anxiety and depression. The aim of this study was to identify met and unmet needs in Chilean older adults with dementia and to determine if those needs were associated with PWD’s, their informal caregivers’ and social factors. Method This was a cross-sectional study. One-hundred and sixty-six informal caregivers and their care recipients were interviewed. PWD was assessed about cognitive function and their caregivers answered instruments about PWD’s needs, functional status and behavioral and psychological symptoms. Caregiver’s burden, depression, anxiety and social support were also evaluated. A stepwise multiple linear regression analysis was performed to determine predictors of unmet needs in Chilean PWD. Results The most frequent met needs were “Looking after home” (81.3%%), “Food” (78.9%) and “Selfcare” (75.3%). Most common unmet needs were “Daily living activities” (39.2%), “Company” (36.1%), and “Memory” (34.9%). Caregivers’ lower age was correlated to a higher number of PWD’s unmet needs (r s = −.216; p < 0.005). Higher PWD’s dependence was associated with higher number of unmet needs (r s = .177; p < 0.05). The best predictors of unmet needs were caregivers’ low level of social support, high burden, young age and high level of anxiety. Conclusion It is necessary to address psychological and social needs of PWD. The fact that PWD’s unmet needs were associated mostly with caregivers’ factors, highlights the importance of considering both, the PWD and their informal caregivers as targets of institutional support. It is expected that recently launched national public policies decrease PWD’s unmet needs by the provision of new services for them and their informal caregivers.

Met and unmet care needs of home‐living people with dementia in China: An observational study using the Camberwell Assessment of Need for the Elderly

“…Tapia et al . showed that patients’ higher unmet needs were associated with caregivers’ low social support, young age and high anxiety 10 . Jhang et al .…”

“…found that PWD in Taiwan required more care to prevent traffic accidents and getting lost 11 . As people with unmet needs reported a lower quality of life, high level of anxiety, increased costs of care, 12,13 depression 10 and challenging behaviors, 9 to provide more appropriate care and support services, it is essential to comprehensively consider the complexity of individual needs, which will assist in targeting services and resources to where PWD most require.…”

“…The scale provides an opportunity to analyze the needs from different perspectives that enable health workers to describe the remediable problems in a wide and detailed way. In addition, it has been translated and used in different countries, such as Poland, 15 Germany, 16 Portugal, 17 Korea 18 and Saudi Arabia, 19 and is used by researchers worldwide to assess PWD's perception of met and unmet needs in various situations 6,9,10,12 …”

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

“…Second, unmet needs were measured with 13 items included in ELSA, which differ from measures used in other studies for investigating unmet need. For instance, the ELSA data does not permit assessment of unmet needs related to speci c areas of unmet need investigated in the previous studies, such as unmet needs in medical care (6), counselling, social integration, dementia diagnosis and treatment (5), or psychological or behavioural factors (7,8). Unrequired help excludes those who did not report any functional di culties: therefore it is possible that some more people would receive unrequired help if it was asked from everyone.…”

“…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). Unmet needs are also common among people with memory problems not amounting to dementia (10).…”