Hostname: page-component-cc8bf7c57-n7qbj Total loading time: 0 Render date: 2024-12-11T22:59:27.209Z Has data issue: false hasContentIssue false
  • English
  • Français

People with dementia living alone: what are their needs and what kind of support are they receiving?

Published online by Cambridge University Press:  10 March 2010

Claudia Miranda-Castillo ,
Bob Woods  and
Martin Orrell
Claudia Miranda-Castillo
Affiliation:
Department of Mental Health Sciences, University College London and Facultad de Medicina, Escuela de Psicología, Universidad de Valparaíso, Valparaíso, Chile
Bob Woods
Affiliation:
Dementia Services Development Centre, Bangor University, Bangor, U.K.
Martin Orrell*
Affiliation:
Department of Mental Health Sciences, University College London, London, U.K.
*
Correspondence should be addressed to: Professor Martin Orrell, UCL Department of Mental Health Sciences, 67–73 Riding House Street, London W1W 7EJ, U.K. Phone: +44 (0)20 7679 9418; Fax: +44 (0)20 7679 9426. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: In the U.K. about 141,460 people with dementia (PWD) live alone. They are at risk of social isolation and inadequate social and medical supervision. The aims of this study were to identify the needs of PWD living alone and to compare the needs of PWD living alone versus those living with others. It was predicted that PWD living alone would have significantly more unmet needs than those living with others.

Methods: 152 PWD were interviewed about their cognitive status and quality of life (QoL); and 128 informal carers were interviewed about the PWD's QoL, social networks, behavioral and psychological symptoms (BPSD), functional status, and services used. For 24 PWD no carer was available. Carers were also interviewed about their own symptoms of depression, anxiety, burden, and satisfaction. Researchers rated PWD's needs. One-third of the PWD (50) were living alone.

Results: PWD living alone had significantly more unmet needs (M = 3.9, s.d. 3.1) than those living with others (M = 2.0, s.d. 2.0) (U = 1578, p < 0.01) particularly in the areas of looking after home (χ2 = 17.23, p < 0.001), food (χ2 = 13.91, p < 0.002), self-care (χ2 = 10.23, p < 0.002) and accidental self-harm (χ2 = 16.51, p < 0.001). The most frequent unmet needs were daytime activities (27, 54.0%), company (26, 52.0%), psychological distress (22, 44.0%), eyesight/hearing (16, 32.0%), and accidental self-harm (16, 32.0%).

Conclusion: PWD living alone are a vulnerable group who are at increased risk for unmet social, environmental, psychological and medical needs. This study illustrates the need to identify these individuals and to make provisions among social service agencies to monitor their well-being regularly and provide a higher level of support when needs are identified.

Keywords

communityneeds assessmentsocial networksservices
Type
Research Article
Information
International Psychogeriatrics , Volume 22 , Issue 4 , June 2010 , pp. 607 - 617
Copyright
Copyright © International Psychogeriatric Association 2010

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

Beecham, J. and Knapp, M. (1992). Costing psychiatric interventions. In Thornicroft, G. (ed.), Measuring Mental Health Needs. 2nd edn.London: Gaskell.Google Scholar
Bjelland, I., Dahl, A. A., Haug, T. T. and Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale: an updated literature review. Journal of Psychosomatic Research, 52, 69–77.Google Scholar
Burns, A., Lawlor, B. and Craig, S. (2004). Assessment Scales in Old Age Psychiatry, 2nd edn.London: Martin Dunitz, Taylor and Francis Group.Google Scholar
Cummings, J. (1997). The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology, 48, S10–S16.CrossRefGoogle ScholarPubMed
Cummings, J., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.Google Scholar
Ebly, E. M., Hogan, D. B. and Rockwood, K. (1999). Living alone with dementia. Dementia and Geriatric Cognitive Disorders, 10, 541–548.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. (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
Fratiglioni, L. (1998) Epidemiology of Alzheimer's disease. In Wimo, A., Jonsson, B., Karlsson, G., and Windblad, B. (eds.), Health Economics of Dementia (pp. 13–31) Chichester: John Wiley & Sons Ltd.Google Scholar
Gordon, D., Carter, H. and Scott, S. (1997). Profiling the care needs of the population with dementia: a survey in central Scotland. International Journal of Geriatric Psychiatry, 12, 753–759.Google Scholar
Grant, G. and Wenger, G. (1993). Dynamics of support networks: Differences and similarities between vulnerable groups. Special Issue: Psychological aspects of ageing: well-being and vulnerability. Irish Journal of Psychology, 14, 79–98.Google Scholar
Knapp, M., Comas-Herrera, A., Somani, A. and Banerjee, S. (2007a). Dementia: International Comparisons. London: Personal Social Services Research Unit, London School of Economics and Political Science.Google Scholar
Knapp, M. et al. (2007b). Dementia UK. The Full Report. London: Alzheimer's Society.Google Scholar
Larsson, K., Thorslund, M. and Forsell, Y. (2004). Dementia and depressive symptoms as predictors of home help utilization among the oldest old: population-based study in an urban area of Sweden. Journal of Aging and Health, 16, 641–668.CrossRefGoogle Scholar
Lawton, M. and Brody, E. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.CrossRefGoogle ScholarPubMed
Livingston, G., Manela, M. and Katona, C. (1997). Cost of community care in older people. British Journal of Psychiatry, 171, 56–59.Google Scholar
Logsdon, R. G., Gibbons, L. E., Mc Curry, S. M. and Teri, L. (1999). Quality of life in Alzheimer's disease: patient and caregiver reports. Journal of Mental Health and Aging, 5, 21–32.Google Scholar
Meaney, A. M., Croke, M. and Kirby, M. (2005). Needs assessment in dementia. International Journal of Geriatric Psychiatry, 20, 322–329.Google Scholar
Moriarty, J. and Webb, S. (2000). Part of their Lives. Community Care for Older People with Dementia. Bristol: The Policy Press.Google Scholar
Nelson, T., Livingston, G., Knapp, M., Manela, M., Kitchen, G. and Katona, C. (2002). Slicing the health service cake: the Islington study. Age and Ageing, 31, 445–450.Google Scholar
Nelson, T., Fernandez, J. L., Livingston, G., Knapp, M. and Katona, C. (2004). Does diagnosis determine delivery? The Islington study of older people's needs and health costs. Psychological Medicine, 34, 147–155.Google Scholar
Orrell, M. W. and Hancock, G. A. (2004). CANE: Camberwell Assessment of Need for the Elderly. London: Gaskell.Google Scholar
Prescop, K. L., Dodge, H. H., Morycz, R. K., Schulz, R. M. and Ganguli, M. (1999). Elders with dementia living in the community with and without caregivers: an epidemiological study. International Psychogeriatrics, 11, 235–250.CrossRefGoogle ScholarPubMed
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
Schneider, J. et al. (2002). Formal and informal care for people with dementia: factors associated with service receipt. Aging and Mental Health, 6, 255–265.Google Scholar
Sibley, A. et al. (2002). The effect of the living situation on the severity of dementia at diagnosis. Dementia and Geriatric Cognitive Disorders, 13, 40–45.Google Scholar
SPSS (2006). SPSS for Windows, Version 15.0 and AMOS Version 7.0. Chicago: SPSS Inc.Google Scholar
Thorgrimsen, L. et al. (2003). Whose quality of life is it anyway? The validity and reliability of the Quality of Life-Alzheimer's Disease (QOL-AD) Scale. Alzheimer's Disease and Associated Disorders, 17, 201–208.CrossRefGoogle ScholarPubMed
Tierney, M., Snow, G., Charles, J., Moineddin, R. and Kiss, A. (2007). Neuropsychological predictors of self-neglect in cognitively impaired older people who live alone. American Journal of Geriatric Psychiatry, 15, 140–148.Google Scholar
Tuokko, H., MacCourt, P. and Heath, Y. (1999). Home alone with dementia. Aging and Mental Health, 3, 21–27.Google Scholar
Webber, P. A., Fox, P. and Brunette, D. (1994). Living alone with Alzheimer's disease: effects on health and social service utilization patterns. The Gerontologist, 34, 8–14.CrossRefGoogle ScholarPubMed
Wenger, G. C. (1994). Support networks and dementia. International Journal of Geriatric Psychiatry, 9, 181–194.Google Scholar
Whitlatch, C. J., Zarit, S. H. and von Eye, A. (1991). Efficacy of interventions with caregivers: a reanalysis. The Gerontologist, 31, 9–18.CrossRefGoogle ScholarPubMed
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. The Gerontologist, 20, 649–655.Google Scholar
Zigmond, A. S. and Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.Google Scholar