title: A model of consequences of need-driven, dementia-compromised behavior.
abstract: OBJECTIVE
  To extend the original need-driven, dementia-compromised behavior (NDB) model by explaining the consequences of behavioral symptoms for the person with dementia.
  
  
  METHODS
  Literature is reviewed and the consequences of expressing needs through need-driven, dementia-compromised behaviors are posited. The consequences of need-driven, dementia-compromised behavior (C-NDB) theory is proposed as a framework to improve understanding of the person with dementia and the consequences of behavioral symptoms and unmet needs.
  
  
  RESULTS
  Instead of normative verbal communication, people with significant dementia commonly communicate need via non-normative behaviors, making it difficult for caregivers to know that the person has a need and the extent of such need. Not meeting needs of people with dementia affects the person with dementia, care factors, and contextual factors. Cascading effects occur in which not meeting the original need results in new needs and behavioral symptoms.
  
  
  CONCLUSIONS
  This framework indicates the consequences of expressing need behaviorally rather than verbally and shows that caregiver actions might moderate the events that lead to many needs being unresolved. Suggestions are made regarding future research questions deduced from the model.
authors.affiliation: University of Wisconsin-Milwaukee, Milwaukee, WI 53201-0413, USA. ckovach@uwm.edu
authors.forename: Christine R
authors.initials: CR
authors.lastname: Kovach
authors.forename: Patricia E
authors.initials: PE
authors.lastname: Noonan
authors.forename: Andrea Matovina
authors.initials: AM
authors.lastname: Schlidt
authors.forename: Thelma
authors.initials: T
authors.lastname: Wells
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D003704:Dementia / Q000150:complications*; D004328:Drive; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D001523:Mental Disorders / Q000209:etiology / Q000451:nursing / Q000523:psychology; D016294:Models, Nursing; D008960:Models, Psychological; D009633:Nonverbal Communication; D024802:Nurse's Role; D009726:Nurses / Q000523:psychology; D009730:Nursing Assessment; D017063:Outcome Assessment, Health Care; D010687:Philosophy, Nursing; D014705:Verbal Behavior