Which unmet needs contribute to behavior problems in persons with advanced dementia?
The Unmet Needs Model states that problem behaviors of people with dementia result from unmet needs stemming from a decreased ability to communicate those needs and to provide for oneself. The purpose of this study is to describe the unmet needs of persons with dementia exhibiting behavior problems. Eighty-nine residents with dementia from six Maryland nursing homes were assessed by research assistants and nursing assistants for their unmet needs using multiple assessment tools. Three unmet needs per resident were identified on average, with informants rating boredom/sensory deprivation, loneliness/need for social interaction, and need for meaningful activity as the most prevalent needs. Discomfort was associated with higher levels of verbally agitated behaviors (e.g., complaining). Based on results and independent ratings of pain, the authors estimate notable under-detection of discomfort and pain by both types of informants. The study demonstrates methodologies for uncovering unmet needs among persons with dementia and highlights the importance of developing programs that address those unmet needs, especially social and activity needs of nursing home residents. The detection of pain, and possibly that of discomfort, may require a different methodology.
Herczeg Institute on Aging, Minerva Center for the Interdisciplinary Study of End of Life, and Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, P.O.B. 39040, Ramat Aviv, Tel Aviv 69978, Israel; Innovative Aging Research, Silver Spring, MD 20902, USA; George Washington University Medical Center, Washington, DC 20037, USA. Electronic address: Jiska@post.tau.ac.il.
Jiska
J
Cohen-Mansfield
Innovative Aging Research, Silver Spring, MD 20902, USA.
Maha
M
Dakheel-Ali
Innovative Aging Research, Silver Spring, MD 20902, USA.
Marcia S
MS
Marx
Innovative Aging Research, Silver Spring, MD 20902, USA.
Khin
K
Thein
Innovative Aging Research, Silver Spring, MD 20902, USA.
Natalie G
NG
Regier
D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000523:psychology*; D005260:Female; D006301:Health Services Needs and Demand; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008396:Maryland; D009735:Nursing Homes; D010146:Pain / Q000523:psychology; D000066553:Problem Behavior / Q000523:psychology*; D011595:Psychomotor Agitation / Q000523:psychology
Nonpharmacological interventions; Older persons; Unmet needs model