When older adults don't get the care they need, their safety and health may be in jeopardy. In a 1994-1997 National Health Interview Survey, roughly 22% of the older adults surveyed said they had at least some unmet care needs. And those who had unmet needs for help with two or more activities of daily living (ADLs)-activities such as bathing, cooking and eating, and using the toilet -were more likely to report discomfort, distress, going hungry, dehydration, falls, injuries and other health problems than those who didn't need such help or who got the help they needed.
New Research in the Journal of the American Geriatrics Society
To find out how unmet care needs might affect the likelihood that older patients with dementia will be admitted to a nursing home or die, US researchers followed 5,831 dementia patients and their caregivers over the course of 18 months. The researchers interviewed the caregivers every 6 months, asking about the extent to which the patients got needed care, and whether they had moved to nursing homes or died.
The researchers found that dementia patients who had more unmet needs for help with ADLs were more likely to be moved to nursing homes or to die than those who did not have as many unmet needs for help with such activities. In fact, the researchers report, unmet needs for help with ADLs may better predict which dementia patients are at risk of being admitted to nursing homes or dying than standard tests of their mental and functional abilities.
Checking with those caring for dementia patients to find out whether patients need additional assistance with ADLs may help doctors and other health care providers identify those patients at increased risk of nursing home admission or death. It could also help health care providers come up with strategies that could help these patients.
What Should I Do?
Learning about how to care for someone with dementia and getting the support you need care can help make sure that that person's needs are met, improve the quality of the care you provide, and make care-giving less stressful.
If you care for someone with dementia, talk to his or her health care provider. Ask for advice on providing care and on finding information and support. If the person for whom you're caring needs help with ADLs, but you're unable to provide that care, let his or her health care provider know. They may be able to point you toward resources in your area that may be able to help. You may, for example, be able to find adult day care in your community. Adult day care provides a wide variety of social and support services in a group setting. These services may range from simple non-skilled custodial care to more advanced skilled services. For example, a registered nurse may be available for assistance with medication management. (In general, custodial adult day care is not covered by Medicare, although some costs may be covered by Medicaid or other insurers.)
For more information about dementia, including caring for someone with dementia, visit http://www.healthinaging.org/agingintheknow/chapters_ch_trial.asp?ch=59#assistance
For more information about care-giving at home and community-based services, visit http://www.healthinaging.org/agingintheknow/chapters_ch_trial.asp?ch=14
The summary above is from the full report titled, "Unmet Care Needs and Key Outcomes in Dementia." It is in the December 2005 issue of the Journal of the American Geriatrics Society (Volume 53, Issue 12). The report is authored by Joseph E. Gaugler, PhD, Robert L. Kane, MD, Rosalie A. Kane, MD, and Robert Newcomer, PhD.