Unmet Long-Term Care Needs of Elderly People in the Community; A Review of the Literature

Abstract

ABSTRACT The extent of unmet need, or the extent to which needed assistance is unavailable or insufficient, is an important issue in public policy and financing of health and support services. This article reviews the research literature to assess how unmet need is measured, and the extent of unmet needs among elderly people in the community. Measurement difficulties include variable definitions and measures of need across studies, the relative dearth of studies which undertake to measure unmet needs, and varying methodologies used to estimate need and unmet need. In addition, some measures of status and need, such as cognitive impairment and care giver burden are excluded from many estimates. Estimates of unmet need range from around 2 percent to about 35 percent of community dwelling elders, depending on what is included or excluded from the definition. Unmet need is associated with higher disability levels and living alone. The literature suggests that estimates of future unmet need will be mitigated by declining disability levels and increased use of assistive devices among the elder population.