Unmet care needs in the oldest old with social loss experiences: results of a representative survey
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RESEARCH ARTICLE
Open Access
Unmet care needs in the oldest old with social loss experiences: results of a representative survey Janine Stein1†, Margrit Löbner1†, Alexander Pabst1, Hans-Helmut König2 and Steffi G. Riedel-Heller1*
Abstract Background: Loss experiences such as the loss of a spouse, a close relative or significant others become more likely in old age and may be strongly related to specific unmet health care needs. These unmet needs may often remain undetected and undertreated followed by a negative impact on well-being and social role functioning. The present study aims at exploring the relationship between loss experiences and specific unmet care needs in old age. Methods: As part of the study „Need assessment in the oldest old: application, psychometric examination and establishment of the German version of the Camberwell Assessment of Need for the Elderly (CANE)”, the adapted German version of the CANE was used in a population-representative telephone survey in a sample of 988 individuals aged 75+ years. Loss experiences within the last 12 months were assessed within the structured telephone survey. Descriptive and interferential statistical analyses were run in order to examine the association between loss experiences and occurring unmet care needs. Results: Overall, 29.7% of the oldest old reported at least one social loss with other relatives losses being the most frequent (12.5%), followed by non-family losses (10.7%). A significant relationship between loss experiences and a higher number of unmet care needs was observed, especially for close family losses. Other risk factors for unmet care needs were age, marital status, depression, social support and morbidity. Conclusions: This study provides, for the first time in Germany, data on the association between loss experiences and unmet needs. These findings may substantially contribute to the development of loss-specific interventions, effective treatment and health care planning for the bereaved elderly. Keywords: Loss experiences, Bereavement, Need assessment, Old age, Health services research
Background Bereavement and loss experiences, such as the loss of the spouse, close relatives, friends or significant others are common phenomena in the elderly [1]. Such loss experiences are not only more likely with age, but also require psychological re-adjustment from relatives and survivors, and can be associated with substantial health * Correspondence: [email protected] † Janine Stein and Margrit Löbner are shared first authorship. 1 Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany Full list of author information is available at the end of the article
and psychosocial impairments [2–5]. Such effects of loss experiences and bereavement on health and other outcomes range from negative changes in routine health behaviors including physical activity, nutrition, sleep quality, alcohol consumption, tobacco use, and body weight status [6], reduced
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