Self-assessment by elderly people-a means of identifying unmet need in primary care

Abstract

The objective of this research was to assess the value of a self-completed questionnaire in identifying unmet needs amongst elderly patients in primary care. The setting was one general practice in Liverpool. A questionnaire was sent to all patients aged 75 and over on the practice age-sex register (n=498). Responses were compared with existing practice records. Measures were: self-reports of need with 18 questions covering social support, disability, recent life stresses and mood changes; recent contact with members of the practice team; perceived need to see members of the practice team; and evidence in practice records of recent contact and of awareness of elderly patients’ reported needs. There was an 84% response rate. Respondents reported a median score of three problems each (interquartile range 2–5), especially in social support, mobility, bereavement, illnesses and mood states. For people reporting six or more problems, practice records noted less than 50% of problems relating to social support, bereavement and memory. Amongst all respondents, those reporting problems with disability, recent illness and depressed mood were more likely to have been in recent contact with the primary care team than those who did not report such problems. Three further problems-social isolation, bereavement and memory loss-were not associated with increased likelihood of recent contact with the practice team, but were significantly associated with respondents’ expressed need to see a member of the practice. The self-completed questionnaire highlighted gaps in the primary care team's awareness of and response to elderly patients’ social and psychological problems.