期刊
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
卷 61, 期 12, 页码 2087-2095出版社
WILEY
DOI: 10.1111/jgs.12549
关键词
dementia; community-residing; informal caregivers; unmet needs
资金
- Hoffberger Family Fund
- LeRoyHoffberger, Harry and Jeannette Weinberg Foundation
- Rosenberg Foundation
- Hirschhorn Foundation
- Stulman Charitable Foundation
- Meyerhoff Foundation
- Baltimore County Department of Aging
- Blum Family
- Greif Family Fund
- Marvin Schapiro Family Foundation
- Eliasberg Family Foundation
- Moser Family Philanthropic Fund
- Jewish Community Federation of Baltimore
- Jewish Federation of Baltimore
- National Institute of Mental Health
- National Institute on Aging
- Weinberg Foundation
- National Institute on Aging [R01 AG038440, K01 MH085142]
- Forest
- Glaxo-Smith-Kline
- Eisai
- Pfizer
- Astra-Zeneca
- Lilly
- Ortho-McNeil
- Bristol-Myers
- Novartis
- National Football League
- Elan
- Genentech
- NFL Players Association
- NFL Benefits Office
- Avanir
- Zinfandel
- Health Monitor
- ASSOCIATED: Jewish Community Federation of Baltimore
ObjectivesTo determine the prevalence and correlates of unmet needs in a sample of community-residing persons with dementia (PWD) and their informal caregivers. DesignAnalysis of cross-sectional, baseline participant characteristics before randomization in a care coordination intervention trial. SettingBaltimore, Maryland. ParticipantsCommunity-residing PWD (n=254) and their informal caregivers (n=246). MeasurementsIn-home assessments of dementia-related needs based on the Johns Hopkins Dementia Care Needs Assessment. Bivariate and multivariate regression analyses were conducted to identify demographic, socioeconomic, clinical, functional, and quality-of-life correlates of unmet needs. ResultsThe mean number of unmet needs was 7.74.8 in PWD and 4.6 +/- 2.3 in caregivers, with almost all PWD (99%) and caregivers (97%) having one or more unmet needs. Unmet needs in PWD were significantly greater in those with higher cognitive function. Ninety percent of PWD had unmet safety needs, more than half had unmet needs for meaningful activities, and almost one-third had not received a prior evaluation or diagnosis. Higher unmet needs in PWD was significantly associated with nonwhite race, lower income, less impairment in activities of daily living, and more symptoms of depression. For caregivers, more than 85% had unmet needs for resource referrals and caregiver education. Higher unmet caregiver needs was significantly associated with nonwhite race, less education, and more symptoms of depression. ConclusionMany community-residing PWD and their caregivers have unmet dementia-related needs for care, services, and support. Providers should be aware that unmet needs may be higher in minority and low-income community residents, caregivers with lower education, and individuals with early-stage dementia. Identifying and treating symptoms of depression in PWD and caregivers may enable them to address their other unmet needs.
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