Identification of community-residing individuals with dementia and their unmet needs for care.
BACKGROUND
Innovative approaches to the widespread delivery of evidence-based dementia care are needed. The aims of this study were to determine whether a telephone screening method could efficiently identify individuals in the community in need of care for dementia and to develop a multidimensional needs assessment tool for identifying the type and frequency of unmet needs related to memory disorders in the home setting.


METHODS
This was a cross-sectional evaluation of 292 community-residing individuals aged 70 and older in Maryland. Participants were given a brief cognitive telephone screen. A subsample (n=43) received a comprehensive in-home assessment for dementia and dementia-related needs. Cognitive, functional, behavioral, and clinical factors were assessed. The Johns Hopkins Dementia Care Needs Assessment (JHDCNA) was used to identify unmet needs related to dementia.


RESULTS
Telephone screening for the sample took 350 h, and 27% screened positive for dementia. Virtually all participants with dementia who received an in-home assessment had at least one unmet need, with the most frequent unmet needs being for a dementia workup, general medical care, environmental safety, assistance with ADL impairments, and access to meaningful activities. Caregivers, when present, also had a number of unmet needs, with the most common being caregiver education about dementia, knowledge of community resources, and caregiver mental health care.


CONCLUSIONS
Effective and efficient means for identifying community-residing individuals with dementia are needed so that dementia care interventions can be provided to address unmet care needs of patients and their caregivers.
Johnston
D
D
Division of Geriatric Psychiatry & Neuropsychiatry, The Johns Hopkins University School of Medicine, 550 North Broadway/Suite 308, Baltimore, Maryland, USA. Djohnst4@jhmi.edu
Samus
Q M
QM
Morrison
A
A
Leoutsakos
J S
JS
Hicks
K
K
Handel
S
S
Rye
R
R
Robbins
B
B
Rabins
P V
PV
Lyketsos
C G
CG
Black
B S
BS
D000368:Aged; D000369:Aged, 80 and over; D003156:Community Mental Health Services / Q000458:organization & administration; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008396:Maryland; D008403:Mass Screening / Q000379:methods; D020380:Needs Assessment; D013689:Telephone