2023 IPA International Congress Book of Abstracts - S10: Needs assessment, the basic tool for psychogeriatric care – ADDENDUM: Exploring the needs of people with dementia: Implications of epidemiological, health service and primary care research in Portugal.

Although much used, the concept of ‘need’ is not entirely consistent in the healthcare literature. Regardless, exploring older age people needs at populational and individual levels is crucial for service planning, implementation and evaluation.

We build on different studies’ results, including secondary analyses, to illustrate major unmet needs in people living with dementia in the community.

A Portuguese epidemiological study using 10/66 DRG methods produced community prevalence estimates of dementia and late-life depression (n=1405)(1). Comprehensive assessments yielded additional results on levels of disability and dependency, informal care arrangements, and carer strain (among those participants identified as needing care).

In the Portuguese subsample of the EU-JPND Actifcare (ACcess to TImely Formal Care) cohort study (n=66) we found a relevant number of unmet needs, at baseline(2) and over twelve months. Participants were people with mild to moderate dementia, living in the community, and their unmet needs were mainly psychosocial in nature.

Considering primary care, we re-analysed recordings from the 2xPCD-BAYER/NOVA Ageing 2018 study consultations (involving triads of GPs, people with dementia and their primary carers). Using qualitative methods, we searched for evidence of clinical explorations of biopsychosocial needs and/or their spontaneous expression by patients or carers in 16 consultations.

In Portugal as in other countries, research unraveled the importance of needs assessments in people with dementia and their families. A relevant proportion of them displays unmet needs which should be addressed by healthcare and social services. A discussion ensues, namely on how to conduct needs assessments in clinical practice or at least in cost-effective ways. At this purpose, we critically consider the feasibility of a Camberwell Assessment of Need five-item short-form assessments for older people in primary care (SPICE)(3).

References

1. Gonçalves-Pereira et al. The prevalence of dementia in a Portuguese community sample: a 10/66 DRG study. BMC Geriatr. 2017;17(1):261.

2. Gonçalves-Pereira et al. Needs for care and service use in dementia: Baseline assessment of Portuguese participants in the Actifcare study. Acta Med Port. 2019;32(5).

3. Illiffe et al. The development of a short instrument to identify common unmet needs in older people in general practice. Br J Gen Pract. 2004;54(509):914–8.