Hello and welcome to episode 20 of my series of Tiny Talks about Dementia.
Today I will be talking about unmet needs.
The term unmet needs was first introduced in dementia care by Jiska Cohen Mansfield.
She developed the Unmet Needs model,
Which states,
And I'm quoting here,
That problem behaviors of people with dementia result from unmet needs,
Stemming from a decreased ability to communicate those needs and to provide for oneself.
Let me walk you through that definition step by step.
First of all,
The term problem behaviors reflects also BPSD and neuropsychiatric symptoms.
I prefer to refer to all of these as misunderstood behavior.
So the theory postulates that behaviors that we observe in someone with dementia and that do not make sense at face value have an underlying cause.
Wandering may be related to a need for activity or connection.
Shouting may be related to fear related to disorientation in place,
So not knowing where one is.
Just for a moment imagine how you would feel when one day or every day you wake up in an unfamiliar environment.
You may recognize some of your personal belongings,
But they are out of context.
This is not your bed and this is not your room.
And when you open the door you enter a space that is not your house and is filled with people that you have not seen before.
The second part of the definition is equally important and challenges us to think outside our normal take on things.
It is important to acknowledge that people with dementia can not only not provide for themselves,
They may also have lost the ability to communicate about what they need.
This may be literally not being able to speak anymore,
But can also be more subtle.
Maybe somebody seems able to respond to questions well,
But to phrase that they are in pain or miss a loved one may just come out as moaning or shouting a name.
These are cries for help.
Cohen Mansfield conducted a study in the USA with 89 people with dementia from 6 different nursing homes.
Each participant was assessed by two professionals to identify their top 3 of unmet needs.
The results?
1.
Boredom and sensory deprivation.
2.
Loneliness and a need for social interaction.
3.
A need for meaningful activity.
These were found to be the most scored needs.
The study highlights the importance of developing programs that address those unmet needs,
Especially social and activity needs of nursing home residents.
