Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-29T12:07:22.423Z Has data issue: false hasContentIssue false
  • English
  • Français

The needs of people with dementia in care homes: the perspectives of users, staff and family caregivers

Published online by Cambridge University Press:  17 April 2008

Martin Orrell ,
Geraldine A. Hancock ,
Kumari C. Galboda Liyanage ,
Bob Woods ,
David Challis  and
Juanita Hoe
Martin Orrell*
Affiliation:
Department of Mental Health Sciences, University College London, U.K.
Geraldine A. Hancock
Affiliation:
Department of Mental Health Sciences, University College London, U.K.
Kumari C. Galboda Liyanage
Affiliation:
Mascalls Park, North East London Mental Health Trust, Brentwood, Essex, U.K.
Bob Woods
Affiliation:
Dementia Services Development Centre, University of Wales Bangor, Bangor, U.K.
David Challis
Affiliation:
Personal Social Services Research Unit, University of Manchester, Manchester, U.K.
Juanita Hoe
Affiliation:
Department of Mental Health Sciences, University College London, U.K.
*
Correspondence should be addressed to: Professor Martin Orrell, Department of Mental Health Sciences, University College London, Charles Bell House, 67–73 Riding House Street, London, W1W 7EJ, U.K. Phone: +44 (0)20 769 9452; Fax: +44 (0)20 769 9426. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: People with dementia in care homes are at risk of having their views ignored and decisions are often made on their behalf by care home staff and family carers. The aim of this study was to compare the ratings of needs of older people with dementia living in care homes, as assessed by the older person themselves, a family caregiver, and the staff of the care home.

Method: The Camberwell Assessment of Need for the Elderly (CANE) was completed for 238 residents with dementia by care staff. In addition, 149 users and 81 family caregivers also completed the assessment of the person's met and unmet needs.

Results: Many users were able to report their met and unmet needs despite having moderately severe dementia. The views of the person with dementia were commonly in agreement with the staff and family carers' views. However, user and carer pairs had the lowest average percentage agreement of 63% compared to that of 77% between user and staff pairs. In particular, users reported relatively higher unmet needs for psychological distress, company and information, and high unmet needs for daytime activities and eyesight/hearing problems.

Conclusions: Users' views on their needs should be sought even when the person has dementia and lives in a care home. Reliance solely on assessment by staff or carers may lead to under recognition of unmet needs.

Keywords

needsCANEdementiaolder peoplecare homes
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 5 , October 2008 , pp. 941 - 951
Copyright
Copyright © International Psychogeriatric Association 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexopoulos, G. S., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1988). Cornell scale for depression in dementia. Biological Psychiatry, 23, 271–284.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn Washington, DC: American Psychiatric Association.Google Scholar
Bagley, H. et al. (2000). Recognition of depression in long term care facilities for older people. Journal of Clinical Nursing, 9, 445–450.CrossRefGoogle Scholar
Ballard, C. et al. (2001). Quality of care in people with dementia in private sector and NHS facilities for people with dementia: cross sectional survey. BMJ, 323, 426–427.CrossRefGoogle ScholarPubMed
Department of Health (2001a). The National Service Framework for Older People. London: HMSO.Google Scholar
Department of Health (2001b). Fit for the Future? National Required Standards for Residential and Nursing Homes for Older People. London: Department of Health. Available at www.doh.gov.uk/pub/docs/doh/fitfuture.pdf.Google Scholar
Dunn, G. (2004). Statistical Evaluation of Measurement Errors. 2nd edn. London: Arnold.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Hancock, G. A., Reynolds, T., Woods, B., Thornicroft, G. and Orrell, M. (2003). The needs of older people with mental health problems according to the user, the carer, and the staff. International Journal of Geriatric Psychiatry, 18, 803–811.CrossRefGoogle Scholar
Hancock, G., Woods, R., Challis, D. and Orrell, M. (2006). The needs of older people with dementia in residential care. International Journal of Geriatric Psychiatry, 21, 43–49.CrossRefGoogle ScholarPubMed
Hoe, J., Hancock, G., Livingston, G. and Orrell, M. (2006). Quality of Life of people with dementia in residential care homes. British Journal of Psychiatry, 188, 460–464.CrossRefGoogle ScholarPubMed
Holmquist, I-B., Svensson, B. and Hoglund, P. (2003). Psychotropic drugs in nursing and old-age homes: relationships between needs of care and mental health status. European Journal of Clinical Pharmacology, 59, 669–676.CrossRefGoogle ScholarPubMed
Hughes, C. P., Berg, L., Danziger, W. L., Coben, L. A. and Martin, R. L. (1982). A new scale for the staging of dementia. British Journal of Psychiatry, 140, 566–572.CrossRefGoogle ScholarPubMed
Jacques, I. and. Innes, A. (1998). Who cares about care assistant work? Journal of Dementia Care, Nov/Dec, 33–37.Google Scholar
Levin, E., Sinclair, I. and Gorbach, P. (1989). Families, Services, and Confusion in Old Age. Aldershot: Avebury.Google Scholar
Mahoney, F. I. and Barthel, D. W. (1965). Functional evaluation: the Barthel Index. Maryland State Medical Journal, 14, 62–65.Google ScholarPubMed
Mozley, C. et al. (2004). Towards Quality Care: Outcomes for Older People in Care Homes. Aldershot: Ashgate.Google Scholar
Orrell, M. and Hancock, G. (2004). CANE: Camberwell Assessment of Need for the Elderly. London: Gaskell.Google Scholar
Orrell, M., Hancock, G., Hoe, J., Woods, B., Livingston, G. and Challis, D. (2007). A randomised controlled trial to meet the needs of people with dementia living in residential care. International Journal of Geriatric Psychiatry, 11, 1127–1134.CrossRefGoogle Scholar
Pattie, A. H. and Gilleard, C. T. (1979). Clifton Assessment Procedures for the Elderly (CAPE). Sevenoaks: Hodder & Stoughton.Google Scholar
Reynolds, T. et al. (2000). Camberwell Assessment of Need for the Elderly (CANE): development, validity, and reliability. British Journal of Psychiatry, 176, 444–452.CrossRefGoogle ScholarPubMed
Shankar, K. K., Walker, M., Frost, D. and Orrell, M. W. (1999). The development of a valid and reliable scale for rating anxiety in dementia (RAID). Aging and Mental Health, 3, 39–49.CrossRefGoogle Scholar
Social Care Institute for Excellence (2002). Assessing Mental Health Needs of Older People: A Practice Guide. Available at www.elsc.org.uk.Google Scholar
van der Roest, H. G., Meiland, F. J. M., Maroccini, R., Comijs, H. C., Jonker, C. and Dröes, R. M. (2007). Subjective needs in people with dementia: a review of the literature. International Psychogeriatrics, 19, 559–592.CrossRefGoogle ScholarPubMed