Affiliations: [a] German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Greifswald, Germany | [b] Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany | [c] German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Rostock, Germany | [d] Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany | [e] Department of Epidemiology of Health Care and Community Health, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
Correspondence:
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Correspondence to: Dr. Tilly Eichler, German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Ellernholzstrasse 1-2, Greifswald D-17489, Germany. Tel.: +49 3834 86 7591; Fax: +49 3834 86 19551; E-mail: tilly.eichler@dzne.de.
Note: [1] These authors contributed equally to this work.
Abstract: Background:To provide an optimal care for persons with dementia (PWD), their individual unmet needs have to be identified and comprehensively addressed. Objectives:Present analyses aim to describe the number and types of unmet needs of German primary care patients screened positive for dementia and factors associated with the number of unmet needs. Methods:DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania) is a general practitioner-based, cluster-randomized controlled intervention trial. Analyses are based on the baseline data of 227 PWD (≥70 years, living at home) of the intervention group who had screened positive for dementia (DemTect<9) and received a standardized computer-assisted needs assessment. Results:PWD had on average 8.77±5.04 unmet needs (Range = 0–31). More than 90% of the PWD had three or more unmet needs. Unmet needs were identified across all predefined 26 subcategories. The majority of unmet needs occurred in the domains “nursing treatment and care” (38%), “social counseling and legal support” (20%), and “pharmacological treatment and care” (15%). More impairment in the activities of daily living was the only factor that was significantly associated with a higher number of unmet needs, independent of age, gender, living situation, presence of an informal caregiver, cognitive impairment, and depression. Conclusions:Present results demonstrate that community-dwelling PWD had a broad range of varying unmet needs. These findings emphasize the importance of a comprehensive needs assessment that allows the identification of individual needs as the basis for a tailored intervention— such as Dementia Care Management— that can address these needs.
Keywords: Dementia, needs assessment, primary health care, randomized controlled trial
