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Measuring dementia carers' unmet need for services - an exploratory mixed method study

DOI: 10.1186/1472-6963-10-122

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This mixed method exploratory study compared measures of carer burden with community services received and unmet needs, for 20 community-dwelling carer/care-recipient pairs.A simple one-item measure of carers' felt need for more services was significantly related to carer stress as measured on the GHQ-30. Qualitative data showed that there are many potential stressors for carers, other than those related to the care-giving role. We found a statistically significant rank correlation (p = 0.01) between carer's use of in-home respite and the care-recipient's cognitive and functional status which is likely to have been related to increased requirement for carer vigilance, effort and the isolation of spouse carers. Otherwise, there were no statistically significant relationships between carer burden or stress and level of service provision.When carers are stressed or depressed, they can recognise that they would like more help from services, even if measures of carer burden and care recipient status do not clearly indicate unmet service needs. A question designed to elicit carer' felt need may be a better indicator of service need, and a red flag for recognising growing stress in carers of people with dementia. Assessment of service needs should recognise the fallibility of carer burden measures, given that carer stress may not only come from caring for someone with dementia, but can be significantly compounded by other life situations.Assessment and monitoring of caregiver (carer) burden are increasingly seen as essential factors in ensuring that carers receive community support [1], but the outcomes of this approach are uncertain. While meeting carer service needs has been the subject of increased policy and research interest, Bradshaw's [2] taxonomy of need has not been utilised in this context. Intervention studies often show non significant findings, and researchers increasingly question the usefulness of existing measures of carer burden [3,4]. It follows then that


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