Objective
Improving dementia care in health systems requires estimates of need in the population
served. We explored whether dementia-specific service needs and gaps for patients
and caregivers could be predicted by simple information readily captured in routine
care settings.
Method
Primary family caregivers (n = 215) rated their own current stress, challenging patient
behaviors, and prior-year needs and gaps in 16 medical and psychosocial services.
These were evaluated with other patient and caregiver characteristics in multivariate
regressions to identify unique predictors of service needs and gaps.
Results
Caregiver stress and patient behavior problems together accounted for an average of
24% of the whole-sample variance in total needs and gaps. All other variables combined
(comorbid chronic disease, dementia severity, age, caregiver relationship, and residence)
accounted for a mean of 3%, with none yielding more than 4% in any equation. We combined
stress and behavior problem indicators into a simple screen. In early/mild dementia
dyads (n = 111) typical in primary care settings, the screen identified gaps in total
(84%) and psychosocial (77%) care services for high stress/high behavior problem dyads
vs. 25% and 23%, respectively, of low stress/low behavior problem dyads. Medical care
gaps were dramatically higher in high stress/high behavior problem dyads (66%) than
all others (12%).
Conclusion
The Dementia Services Mini-Screen is a simple tool that could help clinicians and
health systems rapidly identify dyads needing enhanced dementia care, track key patient
and caregiver outcomes of interventions, and estimate population needs for new service
development.
Key Words
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Article info
Publication history
Published online: November 14, 2013
Accepted:
November 6,
2013
Received in revised form:
November 1,
2013
Received:
October 10,
2012
Identification
Copyright
© 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
