Géraud Dautzenberg

General introduction

Camberwell Assessment of Need for the Elderly ‘CANE ’: For finding the ‘unmet needs’ and ‘needs’ we used the CANE (Camberwell Assessment of Need for the Elderly) which has been validated already (Reynolds et al. , 2000). The CANE is a semi-structured interview based on the Camberwell Assessment of Need (CAN) (Phelan et al. , 1995), which is adapted for the elderly. It was developed to ‘measure the needs of people in the general adult population with severe mental illness. It is based on a model of need as a subjective concept, accepting that there may be differing but equally valid ideas about the existence of a need’. Therefore, the needs are not solemnly scored from the professionals’ perspective, but also from the experience of the patient and (especially important for patients with cognitive impairment such as dementia) from the caretakers’ perspective. This results in three different scores from three different points of view that can be compared. Where ‘Identifying a need means identifying a problem plus an appropriate intervention which will help or alleviate the need’ or ‘a need was thought to be present when a patient’s level of functioning falls below or was threatened to fall below, some minimum specified level and if a potentially effective remedy existed’. It consists of 24 questions covering 24 areas divided into 4 domains (environmental, physical, psychological, and social needs). Each of the 24 areas or ‘items’ is scored on a 3-point scale. This item or need can either be: no problem, that is, ‘no need’ (0 points); no/moderate problem because of continuing intervention, that is, ‘met need’ (1 point); and current serious problem, irrespective of any on-going intervention, that is, ‘unmet need’ (2 points). The duration of administration to the patient, next of kin, or clinician are 30, 20, and 10 minutes respectively. 1.5.2 What do we mean (definitions)? The abovementioned personal clinical experience reveals multiple uncertainties. These uncertainties led to questions. We aim to reduce uncertainty of some (by no means all) of these questions by our study. However, before addressing these uncertainties, definitions must be introduced to avoid further confusion. ‘Need’ : In the paragraph above, the word ‘need’ was introduced. In general, a ‘need’ can be translated to, amongst others, require (something) because it is essential or very important rather than just desirable ( Google.com , 2021) or the things that a person must have in order to have a satisfactory life ( Cambridge dictionary ). ‘Need’ in the context of well-being probably

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