The needs of people with dementia in care homes: the perspectives of users, staff and family caregivers.
BACKGROUND
People with dementia in care homes are at risk of having their views ignored and decisions are often made on their behalf by care home staff and family carers. The aim of this study was to compare the ratings of needs of older people with dementia living in care homes, as assessed by the older person themselves, a family caregiver, and the staff of the care home.


METHODS
The Camberwell Assessment of Need for the Elderly (CANE) was completed for 238 residents with dementia by care staff. In addition, 149 users and 81 family caregivers also completed the assessment of the person's met and unmet needs.


RESULTS
Many users were able to report their met and unmet needs despite having moderately severe dementia. The views of the person with dementia were commonly in agreement with the staff and family carers' views. However, user and carer pairs had the lowest average percentage agreement of 63% compared to that of 77% between user and staff pairs. In particular, users reported relatively higher unmet needs for psychological distress, company and information, and high unmet needs for daytime activities and eyesight/hearing problems.


CONCLUSIONS
Users' views on their needs should be sought even when the person has dementia and lives in a care home. Reliance solely on assessment by staff or carers may lead to under recognition of unmet needs.
Orrell
Martin
M
Department of Mental Health Sciences, University College London, UK. m.orrell@ucl.ac.uk
Hancock
Geraldine A
GA
Liyanage
Kumari C Galboda
KC
Woods
Bob
B
Challis
David
D
Hoe
Juanita
J
D000203:Activities of Daily Living; D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D003072:Cognition Disorders / Q000453:epidemiology / Q000523:psychology; D003704:Dementia / Q000453:epidemiology / Q000451:nursing* / Q000523:psychology*; D015577:Geriatric Assessment; D006299:Health Services for the Aged / Q000592:standards / Q000706:statistics & numerical data; D006707:Homes for the Aged / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data*; D009740:Nursing Staff / Q000523:psychology / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D012112:Residential Facilities / Q000458:organization & administration* / Q000706:statistics & numerical data; D012931:Social Environment; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology