Skip to main content

Advertisement

Log in

What are the caregivers’ needs on dementia care? An integrated qualitative and quantitative assessment

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Dementia is one of the main causes of disability later in life. Interventions in support of patients with dementia aim at granting the highest level of independence in activities of daily living and at delivering the required facilities; formal and informal caregivers represent the interface between patients and health services. The aims of our study were to assess caregivers’ perceived needs and to relate them to their own socio-cultural features and to patients’ clinical characteristics. During three consecutive months, 50 caregivers of patients with dementia were interviewed about their needs in the assistance of subjects with dementia by means of three structured questionnaires (Caregiver Needs Assessment [CNA], Zarit Burden Inventory [ZBI], Neuropsychiatric Inventory–Questionnaire [NPI-Q]) and of two open-ended questions. Higher scores of CNA (suggestive of more needs) were associated with a major burden in caregiving and were related to a more severe behavioral and psychological profile of patients with dementia. ZBI was highly correlated with NPI distress score. Among caregivers, the children of patients reported more needs, particularly about information on disease and how to cope with it. CNA emerged as a complete and reliable instrument, with need for safety being the only item missing from the questionnaire and identified by means of the open-ended questions. Our results showed how the use of simple and brief instruments can increase the communication between health operators and caregivers and could thus improve the quality of formal and informal assistance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Cova I, Markova A, Campini I, Grande G, Mariani C, Pomati S (2017) Worldwide trends in the prevalence of dementia. J Neurol Sci 379:259–260. https://doi.org/10.1016/j.jns.2017.06.030

    Article  PubMed  Google Scholar 

  2. Gitlin LN, Kales HC, Lyketsos CG (2012) Nonpharmacologic management of behavioral symptoms in dementia. JAMA 308:2020–2029. https://doi.org/10.1001/jama.2012.36918

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. Andersen R, Newman JF (1973) Societal and individual determinants of medical care utilization in the United States. Milbank Mem Fund Q Health Soc 51:95–124

    Article  PubMed  CAS  Google Scholar 

  4. Andersen RM (1995) Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav 36:1–10

    Article  PubMed  CAS  Google Scholar 

  5. Black BS, Johnston D, Rabins PV, Morrison A, Lyketsos C, Samus QM (2013) Unmet needs of community-residing persons with dementia and their informal caregivers: findings from the maximizing independence at home study. J Am Geriatr Soc 61:2087–2095. https://doi.org/10.1111/jgs.12549

    Article  PubMed  PubMed Central  Google Scholar 

  6. Jurgens FJ, Clissett P, Gladman JR, Harwood RH (2012) Why are family carers of people with dementia dissatisfied with general hospital care? A qualitative study. BMC Geriatr 12:57

    Article  PubMed  PubMed Central  Google Scholar 

  7. Dello Buono M, Busato R, Mazzetto M et al (1999) Community care for patients with Alzheimer’s disease and non-demented elderly people: use and satisfaction with services and unmet needs in family caregivers. Int J Geriatr Psychiatry 14:915–924

    Article  Google Scholar 

  8. Rosa E, Lussignoli G, Sabbatini F, Chiappa A, di Cesare S, Lamanna L, Zanetti O (2010) Needs of caregivers of the patients with dementia. Arch Gerontol Geriatr 51:54–58. https://doi.org/10.1016/j.archger.2009.07.008

    Article  PubMed  CAS  Google Scholar 

  9. Rossi Ferrario S, Vitaliano P, Zotti AM et al (2003) Alzheimer’s disease: usefulness of the family strain questionnaire and the screen for caregiver burden in the study of caregiving-related problems. Int J Geriatr Psychiatry 18:1110–1114. https://doi.org/10.1002/gps.1021

    Article  Google Scholar 

  10. Moroni L, Sguazzin C, Filipponi L, Bruletti G, Callegari S, Galante E, Giorgi I, Majani G, Bertolotti G (2008) Caregiver need assessment: a questionnaire for caregiver demand. G Ital Med Lav Ergon 30:B84–B90

    PubMed  CAS  Google Scholar 

  11. Jennings LA, Reuben DB, Evertson LC, Serrano KS, Ercoli L, Grill J, Chodosh J, Tan Z, Wenger NS (2015) Unmet needs of caregivers of individuals referred to a dementia care program. J Am Geriatr Soc 63:282–289. https://doi.org/10.1111/jgs.13251

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bédard M, Molloy DW, Squire L, Dubois S, Lever JA, O'Donnell M (2001) The Zarit burden interview: a new short version and screening version. The Gerontologist 41:652–657

    Article  PubMed  Google Scholar 

  13. Chattat R, Cortesi V, Izzicupo F, del Re ML, Sgarbi C, Fabbo A, Bergonzini E (2011) The Italian version of the Zarit burden interview: a validation study. Int Psychogeriatr IPA 23:797–805. https://doi.org/10.1017/S1041610210002218

    Article  Google Scholar 

  14. Kaufer DI, Cummings JL, Ketchel P, Smith V, MacMillan A, Shelley T, Lopez OL, DeKosky ST (2000) Validation of the NPI-Q, a brief clinical form of the neuropsychiatric inventory. J Neuropsychiatr Clin Neurosci 12:233–239

    Article  CAS  Google Scholar 

  15. Folstein MF, Folstein SE, McHugh PR (1975) Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198

    Article  PubMed  CAS  Google Scholar 

  16. Hughes CP, Berg L, Danziger WL (1982) A new clinical scale for the staging of dementia. Br J Psychiatry 140:566–572. https://doi.org/10.1192/bjp.140.6.566

    Article  PubMed  CAS  Google Scholar 

  17. Katz S, Ford AB, Moskowitz RW et al (1963) Studies of illness in the aged: the index of ADL: a standardized measure of biological and psychosocial function. J Am Med Assoc 185:914. https://doi.org/10.1001/jama.1963.03060120024016

    Article  CAS  Google Scholar 

  18. Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9:179–186

    Article  PubMed  CAS  Google Scholar 

  19. Salvi F, Miller MD, Grilli A, Giorgi R, Towers AL, Morichi V, Spazzafumo L, Mancinelli L, Espinosa E, Rappelli A, Dessì-Fulgheri P (2008) A manual of guidelines to score the modified cumulative illness rating scale and its validation in acute hospitalized elderly patients. J Am Geriatr Soc 56:1926–1931. https://doi.org/10.1111/j.1532-5415.2008.01935.x

    Article  PubMed  Google Scholar 

  20. Cova I, Clerici F, Rossi A, Cucumo V, Ghiretti R, Maggiore L, Pomati S, Galimberti D, Scarpini E, Mariani C, Caracciolo B (2016) Weight loss predicts progression of mild cognitive impairment to Alzheimer’s disease. PLoS One 11:e0151710. https://doi.org/10.1371/journal.pone.0151710

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  21. Bulmer MG (1979) Principles of statistics. Dover, New York

    Google Scholar 

  22. Borson S, Scanlan JM, Sadak T, Lessig M, Vitaliano P (2014) Dementia services mini-screen: a simple method to identify patients and caregivers in need of enhanced dementia care services. Am J Geriatr Psychiatry 22:746–755. https://doi.org/10.1016/j.jagp.2013.11.001

    Article  PubMed  Google Scholar 

  23. Steiner V, Pierce LL, Salvador D (2015) Information needs of family caregivers of people with dementia. Rehabil Nurs n/a-n/a 41:162–169. https://doi.org/10.1002/rnj.214

    Article  PubMed  Google Scholar 

  24. Pierce L, Hocking MC, Schwartz LA, Alderfer MA, Kazak AE, Barakat LP (2016) Caregiver distress and patient health-related quality of life: psychosocial screening during pediatric cancer treatment. Psychooncology 26:1555–1561. https://doi.org/10.1002/pon.4171

    Article  PubMed  Google Scholar 

  25. Dal Bello-Haas VPM, Cammer A, Morgan D et al (2014) Rural and remote dementia care challenges and needs: perspectives of formal and informal care providers residing in Saskatchewan, Canada. Rural Remote Health 14:2003–2004

    Google Scholar 

  26. Lampley-Dallas VT, Mold JW, Flori DE (2001) Perceived needs of African-American caregivers of elders with dementia. J Natl Med Assoc 93:47

    PubMed  PubMed Central  CAS  Google Scholar 

Download references

Acknowledgements

We thank the Associazione per la Ricerca sulle Demenze (ARD) ONLUS for making this study possible.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ilaria Cova.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cova, I., Travi, N., Maggiore, L. et al. What are the caregivers’ needs on dementia care? An integrated qualitative and quantitative assessment. Neurol Sci 39, 1085–1091 (2018). https://doi.org/10.1007/s10072-018-3332-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-018-3332-3

Keywords

Navigation