Unmet care needs and key outcomes in dementia.
OBJECTIVE
To determine how unmet needs for activity of daily living tasks influenced nursing home placement, death, or loss to follow-up in dementia.


METHODS
An 18-month longitudinal design, with interviews administered every 6 months.


METHODS
Eight catchment areas in the United States.


METHODS
Five thousand eight hundred thirty-one dementia patients and their caregivers were included at baseline.


METHODS
Measures of sociodemographic context of care; functional, cognitive, and behavioral status of care recipients; caregiver stress and well-being; and formal and informal resources served as covariates. The independent variables of interest were unweighted unmet care need scores and unmet need scores weighted by importance and severity in a prior sample of older consumers of long-term care. Outcomes included nursing home placement, death, and loss to follow-up.


RESULTS
Cox regression models suggested that greater unmet need was predictive of nursing home placement, death, and loss to follow-up. These results were apparent when the unweighted and the weighted scores for unmet need with activity of daily living dependencies were used.


CONCLUSIONS
Unmet need may be useful in identifying dementia care recipients at risk for nursing home placement and death. Further study of unmet need is needed to effectively assess and target intervention protocols during the course of dementia.
Gaugler
Joseph E
JE
School of Nursing, Center on Aging, University of Minnesota, Minneapolis, Minnesota 55455, USA. gaug0015@umn.edu
Kane
Robert L
RL
Kane
Rosalie A
RA
Newcomer
Robert
R
D000203:Activities of Daily Living; D000368:Aged; D017028:Caregivers; D003704:Dementia / Q000175:diagnosis / Q000401:mortality; D005260:Female; D006801:Humans; D007326:Institutionalization; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009735:Nursing Homes; D010347:Patient Care Planning; D011379:Prognosis; D016016:Proportional Hazards Models; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology