Unmet care needs in the oldest old with social loss experiences: results of a representative survey

Janine Stein,Margrit Löbner,Alexander Pabst,Steffi G Riedel-Heller,Hans-Helmut König

doi:10.1186/s12877-020-01822-2

Abstract

BackgroundLoss experiences such as the loss of a spouse, a close relative or significant others become more likely in old age and may be strongly related to specific unmet health care needs. These unmet needs may often remain undetected and undertreated followed by a negative impact on well-being and social role functioning. The present study aims at exploring the relationship between loss experiences and specific unmet care needs in old age.MethodsAs part of the study „Need assessment in the oldest old: application, psychometric examination and establishment of the German version of the Camberwell Assessment of Need for the Elderly (CANE)”, the adapted German version of the CANE was used in a population-representative telephone survey in a sample of 988 individuals aged 75+ years. Loss experiences within the last 12 months were assessed within the structured telephone survey. Descriptive and interferential statistical analyses were run in order to examine the association between loss experiences and occurring unmet care needs.ResultsOverall, 29.7% of the oldest old reported at least one social loss with other relatives losses being the most frequent (12.5%), followed by non-family losses (10.7%). A significant relationship between loss experiences and a higher number of unmet care needs was observed, especially for close family losses. Other risk factors for unmet care needs were age, marital status, depression, social support and morbidity.ConclusionsThis study provides, for the first time in Germany, data on the association between loss experiences and unmet needs. These findings may substantially contribute to the development of loss-specific interventions, effective treatment and health care planning for the bereaved elderly.

Highlights

Loss experiences such as the loss of a spouse, a close relative or significant others become more likely in old age and may be strongly related to specific unmet health care needs
Loss experiences and grief can be accompanied by unmet care needs in old age, that often remain undetected and can negatively affect well-being and role functioning [4]
The telephone survey was implemented by USUMA, a leading market, opinion and social research institute in Germany as part of the project “Needs assessment in the oldest old: application, psychometric examination and establishment of the adapted German version of the Camberwell Assessment of Need for the Elderly (CANE)” funded by the German Research Foundation (DFG)

Summary

Introduction

Loss experiences such as the loss of a spouse, a close relative or significant others become more likely in old age and may be strongly related to specific unmet health care needs. These unmet needs may often remain undetected and undertreated followed by a negative impact on well-being and social role functioning. The definition of care needs is based on the “capacity-to-benefit-concept“, covering the ability of individuals to benefit from healthcare provision According to this concept, care needs are assumed to exist if there is potential for an effective treatment or health gain. Unmet care needs exist, if there is currently no adequate intervention for it, the wrong type or the wrong level of help

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