title: Care dependency and nursing care problems in nursing home residents with and without dementia: a cross-sectional study.
abstract: OBJECTIVE
  Chronic diseases, like dementia, can lead to care dependency and nursing care problems. This study aims to compare the degree of care dependency and the prevalence of nursing care problems (pressure ulcer, incontinence, malnutrition, falls, restraints) between residents with and without dementia and between the stages of dementia.
  
  
  METHODS
  A cross-sectional design was chosen and a total of 277 residents with and 249 residents without dementia from nine Austrian nursing homes were assessed by staff using standardized instruments.
  
  
  RESULTS
  Significantly more residents with than without dementia are completely or to a great extent care dependent (54.5 vs. 16.9 %). The comparison of care dependency between the stages of dementia indicates a large difference between moderate and severe dementia (completely care dependent: 9.3 vs. 44.3 %). The comparison of the assessed nursing care problems between residents with and without dementia reveals a significant difference only with regard to incontinence (urinary: 84.2 vs. 53.2 %, fecal: 50.9 vs. 17.7 %, double: 49.1 vs. 14.9 %). Urinary incontinence is high even in early dementia at 64 %, reaching 94 % in severe dementia. Fecal- and double incontinence are comparatively much lower in early dementia (both types 12 %) and rise to more than 80 % (both types) in severe dementia.
  
  
  CONCLUSIONS
  These results highlight areas in which dementia care needs further improvements. The authors suggest maximizing residents' independence to stabilize care dependency and improve incontinence care. Furthermore, longitudinal studies are recommended to deepen insight into the development of care dependency and nursing care problems in dementia residents.
authors.affiliation: Institute of Nursing Science, Medical University of Graz, Billrothgasse 6, 8010, Graz, Austria. sandra.schuessler@medunigraz.at.
authors.forename: Sandra
authors.initials: S
authors.lastname: Schüssler
authors.affiliation: Institute of Health Sciences Education and Nursing Science, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
authors.forename: Theo
authors.initials: T
authors.lastname: Dassen
authors.affiliation: Institute of Nursing Science, Medical University of Graz, Billrothgasse 6, 8010, Graz, Austria.
authors.forename: Christa
authors.initials: C
authors.lastname: Lohrmann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003704:Dementia / Q000453:epidemiology / Q000451:nursing / Q000503:physiopathology*; D003858:Dependency, Psychological; D005242:Fecal Incontinence / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D003668:Pressure Ulcer / Q000453:epidemiology; D015995:Prevalence; D014549:Urinary Incontinence / Q000453:epidemiology*
keywords: Dependency; Incontinence; Prevalence; Quality indicators; Stages of dementia