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. 2015 Jul 30;228(1):59-64.
doi: 10.1016/j.psychres.2015.03.043. Epub 2015 Apr 14.

Which unmet needs contribute to behavior problems in persons with advanced dementia?

Jiska Cohen-Mansfield  1 , Maha Dakheel-Ali  2 , Marcia S Marx  2 , Khin Thein  2 , Natalie G Regier  2
Affiliations

Which unmet needs contribute to behavior problems in persons with advanced dementia?

Jiska Cohen-Mansfield et al. Psychiatry Res. .

Abstract

The Unmet Needs Model states that problem behaviors of people with dementia result from unmet needs stemming from a decreased ability to communicate those needs and to provide for oneself. The purpose of this study is to describe the unmet needs of persons with dementia exhibiting behavior problems. Eighty-nine residents with dementia from six Maryland nursing homes were assessed by research assistants and nursing assistants for their unmet needs using multiple assessment tools. Three unmet needs per resident were identified on average, with informants rating boredom/sensory deprivation, loneliness/need for social interaction, and need for meaningful activity as the most prevalent needs. Discomfort was associated with higher levels of verbally agitated behaviors (e.g., complaining). Based on results and independent ratings of pain, the authors estimate notable under-detection of discomfort and pain by both types of informants. The study demonstrates methodologies for uncovering unmet needs among persons with dementia and highlights the importance of developing programs that address those unmet needs, especially social and activity needs of nursing home residents. The detection of pain, and possibly that of discomfort, may require a different methodology.

Keywords: Nonpharmacological interventions; Older persons; Unmet needs model.

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Conflict of interest statement

Conflicts of Interest: The authors have no actual or potential conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Unmet needs model of problem behaviors. (c) Cohen-Mansfield, 2009.
See this image and copyright information in PMC

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