Unmet Home Care Needs Correlate with Increased Mortality
A study recently published in the Journal of the American Geriatrics Society found strong correlations between unmet home care needs among dementia patients and increased mortality (Gaugler J, Kane RL, Kane RA, et el. Unmet care needs and key outcomes in dementia. Journal of the American Geriatrics Society;53 (12) : 2098-2105.). Gaugler, et el tracked 5831 dementia patients over 18 months. They interviewed caregivers about needs for assistance with specific activities of daily living (ADL's) and whether those needs were being met. Researchers asked about eating, bathing, toileting, etc. They followed participants for 18 months.
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People who need more assistance with just one ADL are 12% more likely to be placed in a nursing home.
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People who need more assistance with two ADLs are 77% more likely to be placed in a nursing home.
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People who need more assistance with two or more ADLs have a 37% higher mortality rate.
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Unmet ADL needs were a better predictor of mortality and nursing home placement that direct tests of mental and functional abilities.
Various reports over the past two decades have connected unmet ADL needs among older adults with medication non-adherence, injuries, falls, dehydration and hunger. Considering the strong connection between unmet home care needs and loss of independence and increased mortality, it may be appropriate for care planners to make specific questions about home care part of normal discharge/planning activities. Some sample questions about:
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Patients feel safe getting out of the shower
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Cook less because it is too difficult
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Trouble remembering medications
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Taxing to buy groceries
Ask Assisting Hands about an in-home home aide program. All home aides are trained by a Physical Therapist, and receive advanced training in hospice care, housekeeping and personal care.
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