title: Empowered or overpowered? Service use, needs, wants and demands in elderly patients with cognitive impairments.
abstract: BACKGROUND
  Examination of clinical practice reveals that current treatment options are often not sufficiently utilized by patients suffering from dementia or mild cognitive impairment.
  
  
  OBJECTIVE
  This study aimed to investigate to what extent and in what way these patients utilize the available treatment options, as well as to identify factors and reasons that play a role in the non-utilization of these options.
  
  
  METHODS
  Semi-structured interviews by telephone were held with the patients' caregivers.
  
  
  RESULTS
  Counseling, medication, activities and home care were the options that were most frequently utilized by the 252 patients and caregivers who were included in the study. Group guidance and admissions were the main treatment categories that had not been utilized (although they were proposed). The most important reasons given were refusal by the patient and the fact that help was not necessary yet according to the caregiver. Burden of care and cognition were the most important factors in predicting which of the treatment options were not utilized.
  
  
  CONCLUSIONS
  Most patients and caregivers are not aware of the treatment options available to them. Awareness of these options is necessary to avoid situations in which patients and caregivers find themselves with their backs against the wall and the need for care support has become an acute necessity. Health care professionals should play an important role with regard to this empowerment.
authors.affiliation: Department of Psychiatry & Neuropsychology, University Hospital Maastricht/Alzheimer Center Limburg, Maastricht, The Netherlands.
authors.forename: Claire A G
authors.initials: CA
authors.lastname: Wolfs
authors.forename: Marjolein E
authors.initials: ME
authors.lastname: de Vugt
authors.forename: Mike
authors.initials: M
authors.lastname: Verkaaik
authors.forename: Paul-Jeroen
authors.initials: PJ
authors.lastname: Verkade
authors.forename: Frans R J
authors.initials: FR
authors.lastname: Verhey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003072:Cognition Disorders / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D017060:Patient Satisfaction; D011209:Power, Psychological; D011795:Surveys and Questionnaires