Abstract
BackgroundThere is lack of evidence about the unmet needs of people with dementia (PWD) living at home and the predictors of high levels of unmet needs. The main aim of this study was to identify the relationship between unmet needs, social networks and quality of life of PWD living at home.MethodsOne hundred and fifty two community dwelling PWD and 128 carers were interviewed about PWD's needs, social networks, quality of life and other functional and psychological factors. All the interviews with PWD were carried out at their homes. Interviews with carers were undertaken either at PWD's home, their own home or at the health centre. Whenever possible, PWD and carers were interviewed separately. The data collection took place between November 2005 and July 2007. The majority of participants (129, 84.9%) were recruited from National Health Services (NHS) and the rest (23, 15.1%) were recruited from other organisations such as social services and voluntary organizations in the UK.ResultsThe most frequent unmet needs for PWD were daytime activities (77, 50.7%), company (60, 39.5%), and help with psychological distress (47, 30.9%). Higher number of behavioural and psychological symptoms, low-community involvement social networks, having a younger carer and higher carer's anxiety were found to be predictors of higher unmet needs in PWD. Social networks and behavioural and psychological symptoms had an indirect effect on PWD's self-rated quality of life through unmet needs.ConclusionsInterventions aiming to reduce unmet needs, through the treatment of behavioural and psychological symptoms and the involvement of PWD in the community, would potentially improve PWD's quality of life.
Highlights
There is lack of evidence about the unmet needs of people with dementia (PWD) living at home and the predictors of high levels of unmet needs
Participants Demographics and Clinical Characteristics of People with Dementia The demographics and clinical characteristics of PWD are shown on Table 1
PWD living at home had most of their physical and environmental needs met, but many social and psychological were not receiving appropriate support
Summary
There is lack of evidence about the unmet needs of people with dementia (PWD) living at home and the predictors of high levels of unmet needs. The main aim of this study was to identify the relationship between unmet needs, social networks and quality of life of PWD living at home. Unmet needs in PWD have been found to be associated with higher anxiety, depression, and challenging behaviours in care homes [1] as associated with being older, cognitive impairment and living alone in the community [2]. Hoe et al [3] found that, in care homes, higher quality of life rated separately by residents and staff was associated with fewer unmet needs in residents. This relationship has not been studied in a community sample. Wenger [4] found that the most common social network types in PWD were family-dependent (30%), which is reliant upon a few family members with few friends or other be associated with better quality of life and that the relationship between social networks and quality of life will be mediated by unmet needs
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