Table 3.
Needs Identified in the Literature Including Their Operational Definition and Associated Studies.
| Need | Number of Studies | Overall Quality of Studiesa | Definition | |
|---|---|---|---|---|
| Quantitative | Qualitative | |||
| Management of behavioral problems 5,9,11,30,32,40,42–44, 46,50,53,55,57,58,62–66,68,70,72,73,76–78,80–83 | Total: 31 Quantitative: 27 Qualitative: 3 Mixed design: 1 | 34 | 8 | Need to receive support from staff in decreasing behavioral symptoms (general) and be provided with appropriate care measures (eg, redirection) when exhibiting disruptive behaviors |
| Need for daily individualized activities/care 5,6,11,22–24, 29,33,36,38,41,43,48,49,50,52,57,59,60,61,64–66,74,79,81 | Total: 26 Quantitative: 20 Qualitative: 6 | 30 | 8 | Need to engage in meaningful daily activities (inside or outside the facility) tailored to the resident’s interests and abilities. Activities are not limited to the individual per se; activities may be offered in a group setting. Includes the need to receive individualized care (eg, medication prescribed to meet individual symptom) |
| Social needs 5,6,11,23,30,32,34,41,45,48,49,50,51,54,56,57,59, 60–62,64,71,72,75 | Total: 24 Quantitative: 17 Qualitative: 5 Mixed design: 2 | 29 | 8 | Need for social interactions that allow the resident to connect with others on an interpersonal level; meaningful interactions and communication opportunities with staff, family members, and residents |
| Emotional needs/personhood 6,21,23,26,30,32–35, 41,42,49,50,59,60–63,70,72,73,75,79 | Total: 23 Quantitative: 15 Qualitative: 7 Mixed design: 1 | 28 | 7 | Need to retain a good emotional balance (increase positive feelings such as pleasure and decrease negative feelings such as sadness). Development of a sense of personal identity (expression of self). Feelings such as reassurance, affection, acceptance, and appreciation are of great emotional importance |
| ADLs 5,11,20,21,23,27,38,30,32,37,50,53,54,57,63,64,69,71 | Total: 18 Quantitative: 14 Qualitative: 4 | 24 | 4 | Receiving assistance with activities of daily living (ADLs). These include activities we normally perform for ourselves (eg, hair care, eating/drinking, getting in and out of bed, and toileting) |
| Need for independence/choice 6,21,24,25,32,49,50,59,60,61,72,83 | Total: 12 Quantitative: 6 Qualitative: 6 | 29 | 7 | Need to preserve a sense of agency by means of opportunities for decision-making and personal control (ie, right to refuse medications and choice of activities). In the inability to make own decisions, residents’ next of kin should be sought for decisions related to their care |
| Cognitive needs 5,6,11,32,38,50,52,54,57,71,72 , | Total: 11 Quantitative: 10 Qualitative: 1 | 29 | 9 | Need for assistance with the interpretation of messages and surroundings |
| Need to be safe/secure 5,11,25,32,39,49,50,57,59,60,72 | Total: 11 Quantitative: 8 Qualitative: 3 | 26 | 8 | Need to feel safe and be protected from self-injury as well as harm from other residents. An example of a safety feature on a dementia unit would be exit control measures (Zeisel et al 39 ) |
| General overall physical health 5,11,31,59,47,49,50,57,44,28 | Total: 10 Quantitative: 8 Qualitative: 2 | 22 | 8 | Need to retain good physical health by means of clinical care, exercise, and proper nutrition |
| Need to be in a homelike comforting environment 5,11,25,32,39,49,50,57,59,72 | Total: 10 Quantitative: 8 Qualitative: 2 | 26 | 7 | Need to reside in a “homelike” environment which may include but is not limited to having a quiet space and personalized spaces. Such an environment induces a sense of familiarity |
| Need to receive proper pain management 21,34,44,59,60,61,70,75,82,83 | Total: 10 Quantitative: 5 Qualitative: 4 Mixed design: 1 | 39 | 7 | Need to diminish the discomfort caused by physical pain |
| Sensory needs 5,11,24,32,39,49,50,57,67 | Total: 9 Quantitative: 9 | 23 | – | Need for optimal sensory stimulation from the environment (eg, proper lighting—visual stimulation). Relates to the residents 5 senses |
| Need for daily structured care 79,27,50,32,33,34 | Total: 6 Quantitative: 5 Mixed design: 1 | 29 | 7 | Need for continuous, routine, predictable care based on the resident’s needs |
| Functional needs—IADLs 5,11,54,63,80 | Total: 5 Quantitative: 5 | 20 | – | Receiving assistance in performing IADLs which include tasks that we often do to ensure our independent living (eg, taking medication, managing money, talking on the phone, and shopping) |
| Need for knowledgeable staff 5,9,21,50,64 | Total: 5 Quantitative: 4 Qualitative: 1 | 26 | 2 | Need for well trained and educated (dementia specific) staff as well as staff who have gained extensive experience in caring for people with dementia at various levels |
| Sexual needs 5,11,57,59,60 | Total: 5 Quantitative: 3 Qualitative: 2 | 28 | 9 | Need for intimate relationships |
| Need for privacy 25,32,50,59,72 | Total: 5 Quantitative: 3 Qualitative: 2 | 31 | 7 | Need for a secluded personal environment, if privacy is desired |
| Money—financial issues 5,11,59 | Total: 3 Quantitative: 2 Qualitative: 1 | 18 | 9 | Need to have a good financial situation for purchase of desired items and bill payments |
| Spiritual needs 21,59 | Total: 2 Qualitative: 2 | – | 6 | Need for spiritual support and opportunities to exercise one’s religion |
Abbreviation: IADLs, instrumental activities of daily living.
a The overall quality of the studies supporting each need is based on the sum of the level of evidence score (10-50) and the quality rating (1-10) of each study. Possible scores range from 11 to 60.