Using a unique measure of unmet need that taps into several dimensions of informal long-term care, the present study included data from 694 informal caregivers of persons suffering from dementia at different times in the caregiving career (e.g., at home, following institutionalization, following the death of the care recipient). Multivariate regression models found that unmet need for either confidante or formal support had key implications for caregivers’ emotional distress in each of the care situations. The findings suggest that conceptual models should incorporate unmet need as a viable predictor of caregiving outcomes and that assessment of unmet need may provide guidance in the development of more refined psychosocial and community-based intervention protocols.
Branch LG: Assessment of chronic care need and use. Gerontologist. 2000; 40: 390-396.
2.
Allen SM, Mor V: The prevalence and consequences of unmet need: Contrasts between older and younger adults with disability. Med Care. 1997; 35: 1132-1148.
3.
Anderson RT, Bradham DD, Jackson S, et al.: Caregivers’ unmet needs for support in caring for functionally impaired elderly persons: A community sample. J Health Care Poor Underserved. 2000; 11: 412-429.
4.
Hung LC, Liu CC, Kuo HW: Unmet nursing care needs of homebased disabled patients. J Adv Nurs. 2002; 40: 96-104.
5.
Kersten P, McLellan L, George S, et al.: Needs of carers of severely disabled people: Are they identified and met adequately?Health Soc Care Community. 2001; 9: 235-243.
6.
Wilson V: The consequences of elderly wives caring for disabled husbands: Implications for practice. Soc Work. 1990; 35: 417-421.
7.
McWalter G, Toner H, McWalter A, et al.: A community needs assessment: The Care Needs Assessment Pack for Dementia (CARENAPD)—Its development, reliability, and validity. Int J Geriatr Psychiatry. 1998; 13: 16-22.
8.
Reynolds T, Thornicroft G, Abas M, et al.: Camberwell Assessment of Need for the Elderly (CANE). Br J Psychiatry.2000; 176: 444-452.
9.
Walters K, Iliffe S, See Tai S, et al.: Assessing needs from patient, carer, and professional perspectives: The Camberwell Assessment of Need for Elderly people in primary care. Age Ageing. 2000; 29: 505-510.
10.
Delany N, Rosenvinge H: Presenile dementia: Sufferers, carers, and services. Int J Geriatr Psychiatry. 1995; 10: 597-601.
11.
Fortinsky RH, Hathaway TJ: Information and service needs among active and former family caregivers of persons with Alzheimer's disease. Gerontologist. 1990; 30: 604-609.
12.
Philp I, McKee KJ, Meldrum P, et al.: Community care for demented and nondemented elderly people: A comparison study of financial burden, service use, and unmet needs in family supporters. Br Med J. 1995; 10: 1503-1506.
13.
Allen SM: Gender differences in spousal caregiving and unmet need for care. J Gerontol. 1994; 49(4): S187-S195.
14.
Yordi C, DuNah R, Bostrom A, et al.: Caregiver supports: Outcomes from the Medicare Alzheimer's Disease Demonstration. Health Care Financ Rev. 1997; 19: 97-117.
15.
Tornatore JB, Grant LA: Burden among family caregivers of persons with Alzheimer's disease in nursing homes. Gerontologist. 2002; 42: 497-506.
16.
Schulz R, Beach SR, Lind B, et al.: Involvement in caregiving and adjustment to death of a spouse: Findings from the Caregiver Health Effects Study. J Am Med Assoc. 2001; 285: 3123-3129.
17.
Whitlatch CJ, Schur D, Noelker LS, et al.: The stress process of family caregiving in institutional settings. Gerontologist. 2001; 41: 462-473.
18.
Barer BM, Johnson CL: A critique of the caregiving literature. Gerontologist. 1990; 30: 26-29.
19.
Montgomery RJV, Williams KN: Implications of differential impacts of caregiving for future research on Alzheimer's care. Aging Ment Health. 2001; 5: S23-S35.
20.
Walker AJ, Pratt CC, Eddy L: Informal caregiving to aging family members: A critical review. Fam Relat. 1995; 44: 402-411.
21.
Aneshensel CA, Pearlin LI, Mullan JT, et al.: Profiles in caregiving: The unexpected career. New York: Academic Press, 1995.
22.
Pearlin LI, Mullan JT, Semple SJ, et al.: Caregiving and the stress process: An overview of concepts and their measures. Gerontologist. 1990; 30: 583-591.
23.
Gaugler JE, Wackerbarth SA, Mendiondo M, et al.: Characteristics of dementia caregiving onset. Am J Alzheimers Dis Other Demen. 2003; 18: 97-104.
24.
Katz S, Ford AB, Moskowitz RW, et al.: Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function. J Am Med Assoc. 1963; 185: 914-919.
25.
Lawton MP, Brody EM: Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist. 1969; 9: 179-186.
26.
Manton KG, Stallard E, Corder LS: The dynamics of dimensions of age-related disability 1982 to 1994 in the U. S. elderly population. J Gerontol A Biol Sci Med Sci. 1998; 53A: B59-B70.
27.
Given CW, Given B, Stommel M, et al.: The Caregiver Reaction Assessment (CRA) for caregivers to persons with chronic physical and mental impairments. Res Nurs Health. 1992; 15: 271-283.
28.
Jöreskog KG, Sörbom D: LISREL 8: Structural equation modeling with the SIMPLIS command language. Chicago: Scientific Software International, 1993.
29.
Cohen J: A power primer. Psychol Bull. 1992; 112: 155-159.
30.
Schumacker R, Lomax RG: A beginner's guide to structural equation modeling. Mahwah, NJ: Lawrence Erlbaum Associates, 1996.
31.
Bergman-Evans BF: Alzheimer's and related disorders: Loneliness, depression, and social support of spousal caregivers. J Gerontol Nurs. 1994; 20: 6-16.
32.
Sandberg J, Lundh UU, Nolan MR: Placing a spouse in a care home: The importance of keeping. J Clin Nurs. 2001; 10: 406-416.
33.
Bodner JC, Kiecolt-Glaser JK: Caregiver depression after bereavement: Chronic stress isn’t over when it's over. Psychol Aging. 1994; 9: 372-380.
34.
Robinson WS, Tada Y, MacCallum RC, et al.: Long-term caregiving: What happens when it ends?J Abnorm Psychol. 2001; 110: 573-584.
35.
Thompson LW, Gallagher-Thompson DE, Haley WE: Future directions in dementia caregiving intervention research and practice. In Coon DW, Gallagher-Thompson DE, Thompson LW (eds.): Innovative interventions to reduce dementia caregiver distress: A clinical guide. New York: Springer, 2003
36.
Gaugler JE, Zarit SH: The effectiveness of adult day services for disabled older people. J Aging Soc Policy. 2001; 12: 23-47.
37.
Schulz R, O’Brien A, Czaja S, et al.: Dementia caregiver intervention research: In search of clinical significance. Gerontologist. 2002; 42: 589-602.
