Burgdorf Julia G, Wolff Jennifer L, Barrón Yolanda, Amjad Halima
Center for Home Care Policy & Research at VNS Health, New York, NY, USA.
Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
J Appl Gerontol. 2025 May 23:7334648251332232. doi: 10.1177/07334648251332232.
One-third of home health care (HHC) patients have dementia. Despite the critical role of caregivers for this population, little is known regarding prevalence or risk factors for unmet caregiving needs during HHC. We examined 426,608 older (65+) HHC patients with dementia in 2018. Unmet caregiving needs were determined from HHC clinician reports indicating that (1) no caregiver was present (lack of availability) or (2) the caregiver needed training (lack of capacity). Most (83%) HHC patients with dementia experienced an unmet need for caregiving. Medicaid enrollment and depression were associated with lack of caregiver availability; greater clinical severity and being post-acute were associated with lack of caregiver capacity. Patients with high (compared to low) cognitive symptom severity had higher odds of unmet needs due to lack of caregiver capacity (aOR:1.80; 95% CI: 1.70-1.90). Findings illustrate the gap between dementia caregiving needs and capacity, highlighting the importance of supportive resources such as training.
三分之一的家庭医疗保健（HHC）患者患有痴呆症。尽管护理人员对这一群体起着至关重要的作用，但对于HHC期间未满足的护理需求的患病率或风险因素却知之甚少。我们在2018年对426,608名患有痴呆症的老年（65岁及以上）HHC患者进行了调查。未满足的护理需求是根据HHC临床医生的报告确定的，报告表明：（1）没有护理人员在场（缺乏可获得性）或（2）护理人员需要培训（缺乏能力）。大多数（83%）患有痴呆症的HHC患者存在未满足的护理需求。医疗补助登记和抑郁症与护理人员缺乏可获得性有关；更高的临床严重程度和处于急性后期与护理人员缺乏能力有关。认知症状严重程度高（与低相比）的患者由于护理人员缺乏能力而未满足需求几率更高（调整后比值比：1.80；95%置信区间：1.70 - 1.90）。研究结果说明了痴呆症护理需求与能力之间的差距，凸显了培训等支持性资源的重要性。
