The DOI matches its Crossref record; 29 of the 32 references it cites were found in a registry or an index; 1 of the 18 sources its claims cite were checked for support.
Which unmet needs contribute to behavior problems in persons with advanced dementia?
Open accessAbstract
The Unmet Needs Model states 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. The purpose of this study is to describe the unmet needs of persons with dementia exhibiting behavior problems. Eighty-nine residents from 6 Maryland nursing homes with dementia were assessed by research assistants and nursing assistants for their unmet needs using multiple assessment tools. Three unmet needs per resident were identified on average, with informants rating boredom/sensory deprivation, loneliness/need for social interaction, and need for meaningful activity as the most prevalent needs. Discomfort was associated with higher levels of verbally agitated behaviors (e.g., complaining). Based on results and independent ratings of pain, the authors estimate notable under detection of discomfort and pain by both types of informants. The study demonstrates methodologies for uncovering unmet needs among persons with dementia and highlights the importance of developing programs that address those unmet needs, especially social and activity needs of nursing home residents. The detection of pain, and possibly that of discomfort, may require a different methodology.
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Claims the paper makes
19 Own result · 14 Own interpretation · 8 No full text of the sources · 4 Own method · 2 Not checked yet · 2 No basis given · 1 Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Discomfort was associated with higher levels of verbally agitated behaviors (e.g., complaining).”
- Also stated in: § 3.4 Unmet needs in relation to the type of agitation manifested · plain
“Discomfort was related to better cognitive function (MMSE, z=2.56, p=.01), greater pain (PAINE, z=2.07, p=.039), higher levels of negative affect at baseline (z=1.96, p=.05), higher levels of manifesting verbally agitated behaviors of constant requests for attention (z=1.93. p=.027, one-tailed), complaining (z=2.92, p=.004), and screaming (z=2.28, p=.02).”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § 3.4 Unmet needs in relation to the type of agitation manifested · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Three unmet needs per resident were identified on average, with informants rating boredom/sensory deprivation, loneliness/need for social interaction, and need for meaningful activity as the most prevalent needs.”
- Also stated in: § 4. Discussion · plain
“This is the first paper to delineate the unmet needs of agitated NH residents with dementia, revealing an average of 3 unmet needs per resident.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § 4. Discussion · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“RAs reported an average of 2.9 unmet needs per participant (range 0–7, s.d.=1.3) and NAs reported an average of 2.6 unmet needs per participant (range 0–6, s.d.=1.4).”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 3. Results > 3.1 The perceptions of unmet needs contributing to behavior problems, and the level of confidence in the determination of unmet needs
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Moreover, each study participant was rated as having at least one unmet need.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 3. Results > 3.4 Unmet needs in relation to the type of agitation manifested
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The following unmet needs were found for over half of the residents: loneliness/need for social contact, boredom, need for meaningful activity, pain, and discomfort. Moreover, each study participant was rated as having at least one unmet need.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 3. Results > 3.4 Unmet needs in relation to the type of agitation manifested
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The RA, unlike overextended nursing staff, was able to give undivided attention to a resident's response to social and activity opportunities.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“RAs reported an average of 2.9 unmet needs per participant (range 0–7, s.d.=1.3) and NAs reported an average of 2.6 unmet needs per participant (range 0–6, s.d.=1.4).”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 3. Results > 3.1 The perceptions of unmet needs contributing to behavior problems, and the level of confidence in the determination of unmet needs
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Discomfort was noted as an unmet need for about one third of the sample and included many types of needs including the need to use the bathroom (most commonly) and uncomfortable seating positions (Table 1).”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 3. Results > 3.1 The perceptions of unmet needs contributing to behavior problems, and the level of confidence in the determination of unmet needs
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants who were rated as having an unmet need which is related to boredom and sensory deprivation displayed somewhat higher levels of physical nonaggressive behaviors (mean ranks of 47.1 for those rated as having the need and 39.9 for those rated as not having it, z=1.20, p=.11, one-tailed). However, this difference did not reach statistical significance.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 3. Results > 3.4 Unmet needs in relation to the type of agitation manifested
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The most common needs were loneliness/need for social contact and boredom/sensory deprivation, noted for about two thirds of the sample by RAs and for approximately half by NAs, followed by the need for a meaningful activity, which was noted for around half the sample by both sources.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 3. Results > 3.1 The perceptions of unmet needs contributing to behavior problems, and the level of confidence in the determination of unmet needs
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Based on results and independent ratings of pain, the authors estimate notable under detection of discomfort and pain by both types of informants.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > Abstract
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 14
- It may state two separate claims as one. 21
Every source the paper cites for this claim was checked and supports it.
In the paper
“Inter-rater reliabilities regarding agitated behaviors previously averaged 0.93 (Cohen-Mansfield et al., 1989) and currently averaged 96% with Intra-Class Correlation (ICC) of 0.90.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 2. Methods > 2.3 Measurements
What the sources say
- Supportedcites Cohen-Mansfield et al., 1989 source
The citation supports the historical reliability figure, not the citing study’s current 96% or ICC of 0.90. The source paper’s Methods section states that interobserver agreement for each agitated behavior averaged 0.93. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Three unmet needs per resident were identified on average, with informants rating boredom/sensory deprivation, loneliness/need for social interaction, and need for meaningful activity as the most prevalent needs.”
- Also stated in: § 3.1 The perceptions of unmet needs contributing to behavior problems, and the level of confidence in the determination of unmet needs · plain
“The most common needs were loneliness/need for social contact and boredom/sensory deprivation, noted for about two thirds of the sample by RAs and for approximately half by NAs, followed by the need for a meaningful activity, which was noted for around half the sample by both sources.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § 3.1 The perceptions of unmet needs contributing to behavior problems, and the level of confidence in the determination of unmet needs · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Cross tabulating ratings for both of these unmet needs shows that RAs identified only one or the other of these needs, rather than both, 39% of the time; the corresponding rate for NAs was 66% indicating that informants found these two needs to be different.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 4. Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants who were rated by RAs as having a loneliness need had significantly higher ratings of verbal agitation (Mann-Whitney test, z=1.70, p=.045, one-tailed – used based on the hypothesis) than those not designated as having this need, but there was no difference between the groups in physical agitation.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 3. Results > 3.4 Unmet needs in relation to the type of agitation manifested
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The most common needs were loneliness/need for social contact and boredom/sensory deprivation, noted for about two thirds of the sample by RAs and for approximately half by NAs, followed by the need for a meaningful activity, which was noted for around half the sample by both sources.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 3. Results > 3.1 The perceptions of unmet needs contributing to behavior problems, and the level of confidence in the determination of unmet needs
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Residents rated as having anxiety/need for relaxation by the RA had significantly higher ratings of verbal agitation (z=2.04, p=.041), and negative affect (z=2. 60, p=.009).”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 3. Results > 3.3 Unmet needs in relation to residents’ background information
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The agreement rate between RAs and NAs averaged 86% for all types of needs, and kappas averaged .25.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 3. Results > 3.2 A comparison of RAs and NAs determination of unmet needs
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Similarly, there was considerable overlap between the categories of pain and discomfort, yet the ratings were different.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 4. Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the average rating of confidence was identical for both RAs and NAs (mean=3.78).”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 3. Results > 3.1 The perceptions of unmet needs contributing to behavior problems, and the level of confidence in the determination of unmet needs
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In regard to the hypotheses relating to the 4th research question pertaining to the relationship between unmet needs and type of agitation, the relationships between loneliness and verbal agitation and between pain and verbal agitation were supported by the findings.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 4. Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“RA’s designation of the unmet need of pain was associated with significantly better cognitive function as tapped by the MMSE (z=2.16, p=.03), significantly higher levels of negative affect at baseline (z=2.21, p=.027), and higher scores on the PAINE (z=1.76. p=.039, one-tailed; one-tailed tests used to examine one sided hypotheses).”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 3. Results > 3.3 Unmet needs in relation to residents’ background information
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“That pilot tackled problems of categorizing unmet needs in order to develop categories and suggested, for example, combining the categories of boredom and need for sensory stimulation, since differentiation between these proved difficult.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 4. Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Significant relationships between discomfort and specific types of verbal agitation were found, but not with the category as a whole.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 4. Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“According to the Unmet Needs Model, problem behaviors result from an imbalance in the interaction between lifelong habits and personality, current physical and mental states, and less than optimal environmental conditions (Figure 1).”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 1. Introduction
What the sources say
- Not checked — no full text of the sourcecites Cohen-Mansfield and Werner, 1995 source
- Not matchedcites Cohen-Mansfield, 2000b
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“The Unmet Needs Model (Cohen-Mansfield and Werner, 1995; Cohen-Mansfield, 2000b) postulates that the dementia process results in a decreased ability to meet one’s needs because of an increasing difficulty in communicating these needs, and a decreased ability to provide for oneself (Hancock et al., 2006).”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 1. Introduction
What the sources say
- Not checked — no full text of the sourcecites Hancock et al., 2006 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The Unmet Needs Model states 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.”
- Also stated in: § 1. Introduction · plain
“The Unmet Needs Model (Cohen-Mansfield and Werner, 1995; Cohen-Mansfield, 2000b) postulates that the dementia process results in a decreased ability to meet one’s needs because of an increasing difficulty in communicating these needs, and a decreased ability to provide for oneself (Hancock et al., 2006).”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > Abstract
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Also stated in: § 1. Introduction · plain
In the paper
“Persons with dementia often exhibit inappropriate behaviors, which increases their suffering as well as the burden of caregivers (Cohen-Mansfield, 2001).”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 1. Introduction
What the sources say
- Not checked — no full text of the sourcecites Cohen-Mansfield, 2001 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Consequently, agitated behaviors, such as pacing may act to alleviate boredom or repetitious vocalizations may be used to communicate the need.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 1. Introduction
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“This finding corroborates previous findings in persons with dementia of a need for being useful/giving meaning to life, enjoyment of activities, and social contact, which have been rated as psychological domains judged to be important to the quality of life of persons with dementia (see Schölzel-Dorenbos et al., 2010).”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 4. Discussion
What the sources say
- Not checked — no full text of the sourcecites Schölzel-Dorenbos et al., 2010 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The determination of unmet needs is a basis for developing intervention and prevention programs to meet those needs, thereby leading to improvement in the quality of life of NH residents with dementia.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 4. Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
- Rests on an assumption: Unmet needs are an internal construct that cannot be assessed by self-report.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We believe this result stems from the different perspectives of these informants. Whereas the RAs focused on social and activity needs and their fulfillment, the NAs were more concerned with physical needs and often had more information of this type (e.g., constipation as an unmet need) to draw from when completing the TUNA.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 4. Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Based on our examination of the results, this indicates high agreement when most of the residents do not exhibit the need, but much lower agreement when determining which residents actually experience a specific unmet need.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 3. Results > 3.2 A comparison of RAs and NAs determination of unmet needs
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Activities interpreted as meaningful by residents relate to their past values, beliefs, interests and routines, and psychological needs and are experienced as enjoyable (Schölzel-Dorenbos et al., 2010).”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 4. Discussion
What the sources say
- Not checked — no full text of the sourcecites Schölzel-Dorenbos et al., 2010 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is likely to affect nursing assistants’ ability to provide a thorough evaluation of unmet needs via the TUNA and should therefore be taken into account in future research.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 4. Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The study was approved by the Institutional Review Board of the Charles E. Smith Life Communities and participants or closest relatives signed an informed consent.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 2. Methods
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The specific nature of the identified discomfort needs make these particularly amenable to improvement efforts.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 4. Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“This has been shown to pose a barrier to quality of care (Trinkoff et al., 2013; Lerner et al., 2014).”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 4. Discussion
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This study can therefore be seen as a template for developing such programs.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 4. Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
- Rests on an assumption: This is the first paper to delineate the unmet needs of agitated nursing home residents with dementia.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Inter- rater agreement evaluations averaged 88% per emotional mode, with a range of 70%–99%, and an average ICC of 0.91.”
§ Which unmet needs contribute to behavior problems in persons with advanced dementia? > 2. Methods > 2.3 Measurements
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper relies on this without support.
Direct observations are more objective and accurate than other forms of assessment.
“Direct observations were chosen because these are more objective and more accurate than other forms of assessment.”
The paper relies on this without support.
Unmet needs are an internal construct that cannot be assessed by self-report.
“Unmet needs represent an internal construct that cannot be assessed by self-report, yet is crucial for proper treatment.”
The paper relies on this without support.
The RA, unlike overextended nursing staff, was able to give undivided attention to a resident's response to social and activity opportunities.
“For social and activity needs, we chose to use only the RA’s evaluation since the RA, unlike the overextended nursing staff, was able to give undivided attention to a resident’s response to social/activity opportunities”
The paper relies on this without support.
This is the first paper to delineate the unmet needs of agitated nursing home residents with dementia.
“This is the first paper to delineate the unmet needs of agitated NH residents with dementia”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“DAD may be influenced by, or may facilitate, challenging behavior in the care recipient (Cohen-Mansfield et al., Citation2015; Feast et al., Citation2016).”
From How do care-related beliefs contribute to depression and anxiety in family caregivers of people with dementia? Testing a cognitive vulnerability-stress model. (2025) · cites this paper as Cohen-Mansfield et al., 2015
Experimental — accuracy not yet measuredIn the citing paper
“Since pain and discomfort may cause difficulties in communication and self-management, and contribute to BPSD, these factors should be carefully searched and treated (111, 112).”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [112]
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- Consistentz = 2.16reported p = .03 · recomputed p = .031
“(z=2.16, p = .03”
- Consistentz = 2.21reported p = .027 · recomputed p = .027
“(z=2.21, p = .027”
- Consistentz = 2.04reported p = .041 · recomputed p = .041
“(z=2.04, p = .041”
- Consistentz = 1.7reported p = .045 · recomputed p = .089
“z=1.70, p = .045”
The paper states a one-tailed test
- Consistentz = 2.56reported p = .01 · recomputed p = .010
“z=2.56, p = .01”
- Consistentz = 2.07reported p = .039 · recomputed p = .038
“z=2.07, p = .039”
- Consistentz = 1.96reported p = .05 · recomputed p = .050
“(z=1.96, p = .05”
- Consistentz = 2.92reported p = .004 · recomputed p = .004
“(z=2.92, p = .004”
- Consistentz = 2.28reported p = .02 · recomputed p = .023
“(z=2.28, p = .02”
- Consistentz = 1.2reported p = .11 · recomputed p = .230
“z=1.20, p = .11”
The paper states a one-tailed test
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Self-check results appear here once an independent check has confirmed them.
Citations
Cites
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · Journal of Psychiatric Research · doi:10.1016/0022-3956(75)90026-6 · Cited by 88,282 · cited 7×
“…direct care of the resident judged him/her to have a life expectancy of less than 3 months due to obvious causes; (b) The resident had an accompanying diagnosis of bipolar disorder or schizophrenia; and (c) A score of 25 or higher on the Mini-Mental State Examination (MMSE; Folstein et al., 1975).”
BackgroundMethodInfluentialHirono, N., Mori, E., Ikejiri, Y., Imamura, T., Shimomura, T., Hashimoto, M., Yamashita, H., & Ikeda, M. (1997) · PubMed · Cited by 21,012
Kok, J. S., Berg, I. J., & Scherder, E. J. A. (2013) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000353441 · Cited by 20,589
Older Adults' Reasons for Using Technology while Aging in Place
Peek, S. T. M., Luijkx, K. G., Rijnaard, M. D., Nieboer, M. E., van der Voort, C. S., Aarts, S., van Hoof, J., Vrijhoef, H. J., & Wouters, E. (2015) · Gerontology · doi:10.1159/000430949 · Cited by 19,852
Sensitivity and False Alarm Rate of a Fall Sensor in Long-Term Fall Detection in the Elderly
Kangas, M., Korpelainen, R., Vikman, I., Nyberg, L., & Jämsä, T. J. (2014) · Gerontology · doi:10.1159/000362720 · Cited by 19,007
Cohen-Mansfield, J. (2001) · The American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200111000-00005 · Cited by 593
Self-citationObserved Affect in Nursing Home Residents with Alzheimer's Disease
Lawton, M. P., Van Haitsma, K., & Klapper, J. (1996) · The Journals of Gerontology Series B: Psychological Sciences and Social Sciences · doi:10.1093/geronb/51b.1.p3 · Cited by 401 · cited 1×
“Affect—Evaluation of positive and negative affect was based on direct observation and assessed via Lawton’s Modified Behavior Stream (LMBS; Lawton et al., 1996).”
MethodThe needs of older people with dementia in residential care
Hancock, G. A., Woods, B., Challis, D., & Orrell, M. (2006) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1421 · Cited by 269 · cited 2×
“The Unmet Needs Model (Cohen-Mansfield and Werner, 1995; Cohen-Mansfield, 2000b) postulates that the dementia process results in a decreased ability to meet one’s needs because of an increasing difficulty in communicating these needs, and a decreased ability to provide for oneself (Hancock et al., 2006).”
BackgroundEngagement in persons with dementia: the concept and its measurement
Cohen-Mansfield, J., Dakheel-Ali, M., & Marx, M. (2009) · The American journal of geriatric psychiatry · doi:10.1097/jgp.0b013e31818f3a52 · Cited by 252 · cited 1×
“For instance, while one would expect that boredom would be rather close to the need for meaningful activities, as has been found in other studies (Cohen-Mansfield, 2001; Cohen-Mansfield et al., 2009; Kolanowski et al., 2011), data from this study suggest otherwise.”
ResultSelf-citationKolanowski, A., Litaker, M., Buettner, L., Moeller, J., & Costa, Jr. (2011) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2011.03449.x · Cited by 199 · cited 2×
“For instance, while one would expect that boredom would be rather close to the need for meaningful activities, as has been found in other studies (Cohen-Mansfield, 2001; Cohen-Mansfield et al., 2009; Kolanowski et al., 2011), data from this study suggest otherwise.”
BackgroundResult
Cited by
Sorted by citations
Items 101–200 of 281
Exploring the Relationship Between Premorbid Personality and Dementia-Related Behaviors
Zielin, S., & McCabe, M. P. (2015) · Journal of Gerontological Nursing · doi:10.3928/00989134-20151008-77 · Cited by 11
Wang, J., Ying, M., Temkin‐Greener, H., et al. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16949 · Cited by 10
“Particularly among older adults with ADRD, loneliness (lack of social interaction) and boredom (lack of activities) are among the most common unmet needs.(39) Moreover, social isolation predicts hospitalization.”
BackgroundSass, C., Griffiths, A. W., Shoesmith, E., Charura, D., & Nicholson, P. (2021) · Counselling and Psychotherapy Research · doi:10.1002/capr.12421 · Cited by 12
Davis, E. R., Aggar, C., & Bissett, M. (2023) · Journal of Clinical Nursing · doi:10.1111/jocn.16891 · Cited by 11
Tan, E. Y. L., de Vugt, M. E., Deckers, K., Schols, J. M. G. A., & Verhey, F. R. J. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-046869 · Cited by 10
Lapane, K. L., Lim, E., Mack, D. S., Hargraves, J. L., Cosenza, C. A., & Dube, C. E. (2023) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2023.05.018 · Cited by 10
Jones, L., Cullum, N. A., Watson, R., Thompson, J., & Keady, J. D. (2024) · Ageing and Society · doi:10.1017/s0144686x24000096 · Cited by 9
Aberdeen, S. M., & Byrne, G. (2016) · Dementia · doi:10.1177/1471301216641785 · Cited by 10
Challenging Behavior in Nursing Home Residents with Dementia
Smalbrugge, M., Zwijsen, S. A., Koopmans, R. C. T. M., & Gerritsen, D. L. (2017) · Springer eBooks · doi:10.1007/978-3-319-49832-4_5 · Cited by 9
Ogama, N., Sakurai, T., Saji, N., Nakai, T., Niida, S., Toba, K., Umegaki, H., & Kuzuya, M. (2018) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000486826 · Cited by 9
Rose, K. M., Lach, J., Perkhounkova, Y., Gong, J., Dandu, S. R., Dickerson, R. F., Emi, I. A., Fan, D., Specht, J. P., & Stankovic, J. A. (2018) · Journal of Gerontological Nursing · doi:10.3928/00989134-20180626-03 · Cited by 9
Dhuny, S., Foley, T., & Jennings, A. (2020) · Irish Journal of Medical Science (1971 -) · doi:10.1007/s11845-020-02356-7 · Cited by 9
Pinazo‐Clapés, C., Hernandis, S. P., & Sales, A. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17238845 · Cited by 10
“Other options or methodologies are the ones that view BPSD as an expression of unmet needs [21], bringing to light the underlying physico-pathological, psychological, and environmental factors.”
BackgroundShah, F. I., Lew, G., Chawdhry, Z., Reich, K. M., Crowder, K., Lorenzetti, D., McGillivray, M., & Goodarzi, Z. (2025) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2025.04.019 · Cited by 8
Ashrafizadeh, H., Gheibizadeh, M., Rassouli, M., Hajibabaee, F., & Rostami, S. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.707913 · Cited by 10
“Unmet needs could lead to a lower quality of life, higher levels of depression, worsening of neuropsychiatric symptoms, and increased disruptive behaviors (Hancock et al., 2006; Cohen-Mansfield et al., 2015).”
BackgroundSevere dementia: relational social engagement (RSE) during family visits
Walmsley, B. D., & McCormack, L. (2016) · Aging & Mental Health · doi:10.1080/13607863.2016.1220923 · Cited by 8
“However, family visits may have the potential to ameliorate social isolation and loneliness that otherwise become a nexus of behavioural and psychological symptoms of dementia (Bird et al., 2007; Cohen-Mansfield et al., 2015).”
Leaman, M. C., & Azios, J. H. (2021) · American Journal of Speech-Language Pathology · doi:10.1044/2020_ajslp-20-00176 · Cited by 8
Parkman, S., Mastel‐Smith, B., McGuire, A., & Duke, G. (2021) · Journal of Gerontological Nursing · doi:10.3928/00989134-20210113-01 · Cited by 8
Resilience and prosocial behaviour in Spanish care professionals of dependent persons
Vilar, M. M., Tortosa, A. C., Sales, A., & Corradi, G. B. (2022) · Health & Social Care in the Community · doi:10.1111/hsc.14110 · Cited by 8
Cohen‐Mansfield, J., & Jensen, B. A. (2018) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317518788158 · Cited by 8
Self-citationShier, V., Edelen, M. O., McMullen, T., Dunbar, M. S., Bruckenthal, P., Ahluwalia, S. C., Chen, E. K., Dalton, S. E., Paddock, S. M., Rodriguez, A., et al. (2022) · Journal of the American Geriatrics Society · doi:10.1111/jgs.17647 · Cited by 8
“Assessment of patients who are unable to communicate, can improve staff's ability to meet the patients' unmet needs, which may include pain or physical discomfort, mental discomfort, needs for social interaction, or inadequate stimulation, all of which may contribute to behavioral problems.(26) Given the importance of…”
BackgroundThe Impact of Enhanced Group Activity Kits (EGAKs) on Well-being of Persons With Dementia
Cohen‐Mansfield, J. (2024) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2024.105329 · Cited by 7
Self-citationThe role of maladaptive personality in behavioural and psychological symptoms in dementia
Dero, K., van Alphen, S. P. J., Hoogenhout, E. M., & Rossi, G. M. P. (2023) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5971 · Cited by 7
“Current non‐pharmacological care strategies, such as person‐ centered care and the Unmet Needs model, are focusing on the individual course of the disease, the patient's specific needs and the care strategies.(31,32) We believe these types of strategies can benefit from our results as implementing personality assessme…”
BackgroundResultHung, L., Ka, C. M. H., Huang, C. Y., Wong, J., Wong, K. L. Y., Chew, K. H., Chao, Y. C., Hussein, A., Yuen, K., Ren, L. H., et al. (2025) · Frontiers in Virtual Reality · doi:10.3389/frvir.2025.1552370 · Cited by 9
“Unmet needs may trigger responsive behaviors by these individuals (Cohen-Mans fi eld et al., 2015).”
Older Adults’ Responses to a Meaningful Activity Using Indoor-Based Nature Experiences: Bird Tales
Lee, K., Cassidy, J., Tang, W., & Kusek, V. (2020) · Clinical Gerontologist · doi:10.1080/07317115.2020.1808869 · Cited by 7
“Moreover, meaningful activities are associated with a reduction in negative behaviors among residents with dementia (Cohen-Mansfield et al., 2015).”
BackgroundApplication of virtual reality for dementia management
Yang, Y., Situmeang, R., Ong, P. A., & Liščić, R. M. (2022) · Brain Science Advances · doi:10.26599/bsa.2022.9050019 · Cited by 7
“Staff barriers and having pain are usually associated with worse outcomes [25] because pain and uncomfortable situation may limit the application and the efficacy for NP-I, and will contribute to BPSD [26, 27].”
BackgroundLee, S. J., Park, M. S., & Chang, S. O. (2023) · International Journal of Nursing Knowledge · doi:10.1111/2047-3095.12420 · Cited by 7
“This finding is supported by a previous study (Cohen-Mansfield et al., 2015) that emphasized social and activity needs, whereas a NANDA-I nursing diagnoses study related to the frequently utilized general care for 57 NH patients found that the most frequent nursing diagnoses were risk of falls,…”
Inacio, M. C. S., Jorissen, R. N., Gaget, V., et al. (2022) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2022.05.004 · Cited by 7
Woolford, M., Bruce, L. J., Rigoni, D., Gulline, H., Horsman, P., MacRae, A., Berkovic, D. E., Morawaka, N., Alberti, S., Skouteris, H., et al. (2024) · Age and Ageing · doi:10.1093/ageing/afae217 · Cited by 9
Ashrafizadeh, H., Gheibizadeh, M., Rassouli, M., Hajibabaee, F., & Rostami, S. (2023) · Florence Nightingale Journal of Nursing · doi:10.5152/fnjn.2023.23032 · Cited by 6
Concept Development of Identification of Discomfort for Nursing Home Patients With Advanced Dementia
Lee, S. J., Park, M. S., Choi, Y., & Chang, S. O. (2020) · International Journal of Nursing Knowledge · doi:10.1111/2047-3095.12277 · Cited by 6
Schaub, C., Morin, D., & von Gunten, A. (2016) · Recherche en soins infirmiers · doi:10.3917/rsi.125.0068 · Cited by 6
“Cependant, malgré ces idées développées depuis de nombreuses années, il apparaît que ces besoins non satisfaits restent sous détectés par les soignants, surtout ceux en rapport avec l’inconfort et la douleur (11).”
BackgroundInfluentialUnderstanding quality of life and well-being for people living with advanced dementia
Hughes, S. E., Woods, B. T., Algar-Skaife, K., & Ch, J. (2019) · Nursing Older People · doi:10.7748/nop.2019.e1129 · Cited by 6
Communication behavior of cognitively impaired older inpatients
Schnabel, E.-L., Wahl, H., Penger, S., & Haberstroh, J. (2019) · Zeitschrift für Gerontologie und Geriatrie · doi:10.1007/s00391-019-01623-2 · Cited by 6
Dys, S., Tunalilar, O., & Carder, P. (2021) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2020.12.030 · Cited by 6
Design for Dementia Care: Making A Difference
Jakob, A., Manchester, H., & Treadaway, C. (2017) · Nordic design research conference · doi:10.21606/nordes.2017.036 · Cited by 6
“Dementia - an umbrella term describing several disorders, such as Alzheimer’s disease, vascular dementia and dementia with Lewy bodies - is a process of cognitive decline that impacts a person’s ability to take part in everyday activities such as personal care and leisure, to cope with and adjust to their environment,…”
InfluentialWrede, N., Töpfer, N. F., Risch, A. K., & Wilz, G. (2025) · Aging & Mental Health · doi:10.1080/13607863.2024.2386079 · Cited by 6
“Thus, their reactions might enhance discomfort in the person with dementia, which, in turn, may increase the likelihood of further challenging behavior (Cohen-Mansfield et al., 2015).”
Hockley, A., Moll, D., Littlejohns, J., Collett, Z., & Henshall, C. L. (2025) · Age and Ageing · doi:10.1093/ageing/afaf150 · Cited by 5
Nguyen, A. N., Nguyen, B. T., Nguyen, B. T., Nguyễn, B. T. T., Nguyen, N. T. A., Dang, N. T., Nguyen, A. T., Nguyen, A. T., Pham, T., Mantyh, W. G., et al. (2023) · Psychogeriatrics · doi:10.1111/psyg.13068 · Cited by 6
“28 – 30 PLWD with single or divorced/ separated marital status demonstrated a higher number of needs than those who were married or widowed.”
BackgroundAu-Yeung, W.-T. M., Miller, L. M., Wu, C., Beattie, Z., Nunnerley, M., Hanna, R., Gothard, S., Wild, K. V., & Kaye, J. A. (2024) · Interactive Journal of Medical Research · doi:10.2196/56452 · Cited by 9
“Such findings are consistent with the existing models that explain the causes of BPSD, including the unmet needs model [69] and the progressively lowered stress threshold model [70].”
ResultCohen‐Mansfield, J., & Cohen, R. (2024) · Gerontology and Geriatric Medicine · doi:10.1177/23337214241274883 · Cited by 5
“Such group activities may improve the well-being of this population (Cohen-Mansfield, 2018; Cohen-Mansfield, Marx, Thein, et al., 2011), address the social needs of participants (Cohen-Mansfield et al., 2015), and can also decrease challenging behaviors (Cohen-Mansfield et al., 2010).”
BackgroundSelf-citationDigital Technologies in Dementia Care
Coelho, T. (2021) · Advances in psychology, mental health, and behavioral studies (APMHBS) book series · doi:10.4018/978-1-7998-8634-1.ch006 · Cited by 5
Bullock, L., Bedson, J., Chen, Y., Chew-Graham, C. A., & Campbell, P. (2021) · Pain · doi:10.1097/j.pain.0000000000002257 · Cited by 5
Flessa, S. J., Harrison, J. D., Turnigan, R., Rathfon, M. A., Chandler, M., Newton-Small, J., & Rogers, S. (2024) · JMIR Aging · doi:10.2196/59306 · Cited by 4
“…include information deemed most readily applicable to acute care, including evidence-based commonly unmet needs for patients with dementia or at risk of delirium (eg, boredom, discomfort, and loneliness) [36,37], as well as what matters to align with the Age-Friendly Health Systems framework [38].”
BackgroundMalioukis, A., Snead, R. S., Marczika, J., Ambalavanan, R., Towett, G., & Mbogori-Kairichi, M. (2026) · Frontiers in Neurology · doi:10.3389/fneur.2026.1683517 · Cited by 4
“According to Cohen-Mansfield et al. (15), needs may include physical discomfort, mental unease, the desire for social interaction, discomfort in the environment, or insufficient stimulation.”
A protocol for responding to aggression risk in residential aged care facilities
Roberton, T., & Daffern, M. (2022) · Australian journal of advanced nursing · doi:10.37464/2020.394.631 · Cited by 3
Dasgupta, M., Beker, L., Schlegel, K., Hillier, L. M., Joworski, L., Crunican, K., & Coulter, C. (2021) · Canadian Geriatrics Journal · doi:10.5770/cgj.24.469 · Cited by 4
“(28,29) Patients displaying these responsive behaviours may have needs for relief of discomfort, social isolation, boredom, or desire for meaningful activity,(30) which may be difficult for patients to communicate and manage.”
BackgroundRead, S., Hu, B., Dixon, J., Brimblecombe, N., Wittenberg, R., Brayne, C., & Banerjee, S. (2022) · Aging & Mental Health · doi:10.1080/13607863.2021.2017846 · Cited by 4
“Their dementia may go undiagnosed, and, in cases where dementia is diagnosed, needs may not be met if they do not relate to problems assumed to be associated with dementia such as poor orientation and memory (Bieber et al., 2019; Boustani et al., 2003; Cohen-Mansfield et al., 2015).”
Erkes, J., & Bayard, S. (2023) · Gériatrie et Psychologie Neuropsychiatrie du Viellissement · doi:10.1684/pnv.2023.1079 · Cited by 4
Behaviors of Persons with Dementia: A Review and New Perspective for Future Research
Minyo, M. J., & Judge, K. S. (2020) · OBM Geriatrics · doi:10.21926/obm.geriatr.2001104 · Cited by 5
Family caregiver perceptions of end of life in persons with and without dementia
Cohen‐Mansfield, J., & Brill, S. (2020) · Geriatric Nursing · doi:10.1016/j.gerinurse.2020.03.008 · Cited by 4
Self-citationAmjad, I., Niazi, I. K., Toor, H. G., Nedergaard, R. B., Shafique, M. S., Holt, K. R., Haavik, H., & Ahmed, T. (2020) · Brain Sciences · doi:10.3390/brainsci10100663 · Cited by 3
“AD patient’s often have deprivation of sensory-enriching experiences which may affect their health and wellbeing [13,14] and motor abilities, like slowness of movement, altered rhythm, impaired fine motor skills, coordination abnormalities and gait difficulties [58–60].”
BackgroundResistance to care in people with dementia: challenges, responsibilities and unmet need
Pritchard, J., & Dening, K. H. (2022) · Nursing and Residential Care · doi:10.12968/nrec.2021.0009 · Cited by 4
Neurodegenerative Disorders/Dementia
Manni, B., Bergamini, L., & Turci, M. (2023) · Springer eBooks · doi:10.1007/978-3-031-27968-3_22 · Cited by 4
Hirt, J., Adlbrecht, L., Maurer, C., & Beer, T. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-075664 · Cited by 4
Zhu, Y., Song, T., Zhang, Z., Deng, C., Yin, M., Li, W., Chang, H., Yu, P., & Song, L. (2024) · Psychiatry International · doi:10.3390/psychiatryint5040046 · Cited by 4
Diehl, K., Kratzer, A., & Graessel, E. (2020) · BMC Geriatrics · doi:10.1186/s12877-020-01807-1 · Cited by 4
Charras, K. (2021) · Architectural Science Review · doi:10.1080/00038628.2021.1927667 · Cited by 5
Sefcik, J. S., Ersek, M. T., & Cacchione, P. Z. (2020) · International Journal of Older People Nursing · doi:10.1111/opn.12322 · Cited by 4
Jönsson, L., Wibom, M., Londos, E., & Nägga, K. (2025) · Alzheimer s & Dementia Translational Research & Clinical Interventions · doi:10.1002/trc2.70057 · Cited by 3
Ayeno, H. D., Kassie, G. M., Atee, M., & Nguyen, T. A. (2025) · Campbell Systematic Reviews · doi:10.1002/cl2.70029 · Cited by 5
Qiao, J., Qiao, Y., Tan, J., Chen, N., Peng, N., Mao, Z., Zhao, Y., Chen, C., & Yao, Y. (2025) · Health and Quality of Life Outcomes · doi:10.1186/s12955-025-02375-x · Cited by 4
“Studying perceived unmet needs thus ensures interventions address the psychosocial dimensions of care, fostering person-centered models that validate lived experiences over standardized metrics [19].”
Community-Based Service Providers’ Experiences With Activities for Persons With Dementia
Holden, R. J., Cavalcanti, L., Vemireddy, S., Bateman, D. R., Sheetz, N. J., Fowler, N. R., Parmar, T., & Karanam, Y. (2020) · The International Journal of Aging and Human Development · doi:10.1177/0091415020974620 · Cited by 3
Beer, T., Hirt, J., Adlbrecht, L., Lindwedel, U., Dammert, M., Maurer, C., Kliegel, M., König, P., & Bleses, H. M. (2024) · JMIR Research Protocols · doi:10.2196/58190 · Cited by 3
“In their findings, Cohen-Mansfield et al [34] showed three main unmet needs of persons with dementia exhibiting challenging behaviors: (1) boredom or sensory deprivation, (2) loneliness XSL • FO RenderX or a lack of social interaction, and (3) the need for meaningful activities.”
Davis, E. R., Aggar, C., & Bissett, M. (2025) · Applied Nursing Research · doi:10.1016/j.apnr.2025.151953 · Cited by 3
Lynch, D. H., Houston, E. R., Andrews, A. L., Mournighan, K. J., Butler, W. F., Batsis, J. A., Niznik, J. D., Leeman, J., & Hanson, L. C. (2025) · Journal of the American Geriatrics Society · doi:10.1111/jgs.19479 · Cited by 3
“These behaviors in persons with dementia or delirium often indicate distress from unmet needs (e.g., pain, hunger, fear, urinary retention, constipation, or infection), or related to personal care or medical procedures [9].”
Kumar, G. S., Thomas, P. T., Arun, M., Mohandas, R. P., Arshad, F., & Alladi, S. (2025) · Indian Journal of Palliative Care · doi:10.25259/ijpc_362_2024 · Cited by 5
“[16] [17-19] The present study aims to gain insight into the caregiver’s perception of the unmet needs during advanced dementia care.”
Beer, T., Hirt, J., & Bleses, H. M. (2020) · Springer eBooks · doi:10.1007/978-3-658-28643-9_33 · Cited by 3
Holistic and individualized interventions for behavioral and psychological symptoms of dementia
Tsukii, N. (2022) · Annals of Alzheimer s and Dementia Care · doi:10.17352/aadc.000023 · Cited by 3
Martínez-Contreras, C. A., & Moreno‐Fergusson, M. E. (2023) · Revista Española de Geriatría y Gerontología · doi:10.1016/j.regg.2023.101410 · Cited by 3
Soziale Teilhabe in Pflegeheimen mit Covid-19-Schutzmaßnahmen in der zweiten Pandemiewelle?
Gangnus, A., Hering, C., Kohl, R., et al. (2022) · Pflege · doi:10.1024/1012-5302/a000898 · Cited by 3
Iatrogenesis in the Context of Residential Dementia Care: A Concept Analysis
Morris, P., McCloskey, R. M., & Bulman, D. (2022) · Innovation in Aging · doi:10.1093/geroni/igac028 · Cited by 3
“These programs are rooted in the person-centered care approach, which emphasizes the continued humanity of people with dementia and argues that all behavior (no matter how challenging) has meaning (Cohen-Mansfield et al., 2015).”
BackgroundBehavioral changes in migrants with dementia
Bosma, C., & Smits, C. H. M. (2022) · Zeitschrift für Gerontologie und Geriatrie · doi:10.1007/s00391-022-02057-z · Cited by 3
Anticonvulsant use in persons living with dementia: When is it justified?
Carnahan, R. M., & Saliba, D. (2022) · Journal of the American Geriatrics Society · doi:10.1111/jgs.18117 · Cited by 3
“These are not mutually exclusive challenges as pain can contribute to BPSD and is underrecognized in dementia.(9,10) Nondrug interventions are important strategies for managing both BPSD and pain but are not sufficient in all cases.”
BackgroundBourgeois, C., Brigaud, E., Louis, E., Azzoune, L., Gambonnet, M., Vitou, V., Jeandel, C., Erkes, J., & Bayard, S. (2024) · Dementia · doi:10.1177/14713012241270805 · Cited by 2
Trees, S., James, I. A., Stapleton, S., & Rippon, D. (2024) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12568 · Cited by 2
“…approaches in dementia care. communication, dementia, healthcare professional, interaction unable to communicate and achieve particular aspects of these person-centred needs when residing in dementia care settings, this can then manifest into overt distress (Cohen-Mansfield et al., 2015).”
Leisure: Promoting Holistic Health
Peel, N., & Stoddart, S. R. (2025) · Springer eBooks · doi:10.1007/978-981-92-1288-0_117 · Cited by 1
Morris, P., McCloskey, R. M., Durkee-Lloyd, J., & O’Regan, K. M. (2025) · Healthcare · doi:10.3390/healthcare13131562 · Cited by 2
“Changing the caregivers’ approach is a popular topic of consideration in the nursing literature [10].”
Davidoff, H., van Kraaij, A., Lutin, E., den Bulcke, L. V., Vandenbulcke, M., Helleputte, N. V., Vos, M. D., Hoof, C. A. V., & Bossche, M. J. A. V. D. (2025) · JMIR Formative Research · doi:10.2196/60274 · Cited by 3
“This is in line with the Cohen-Mansfield “Unmet Needs” model [12], where different unmet needs (possibly triggered by environmental parameters) are said to be related to different behaviors, like the expression of agitation of different types.”
InfluentialOliveira, D., Declercq, I., & Gerritsen, D. L. (2025) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.70168 · Cited by 2
Cohen‐Mansfield, J., & Cohen, R. (2026) · BMC Geriatrics · doi:10.1186/s12877-026-07027-3 · Cited by 2
“…underlying theoretical background of the EGAKs is informed by multiple frameworks and experiences, including the unmet needs of persons with dementia [26] especially loneliness and boredom, Montessori-based activities programming [27] and the Comprehensive Process Model of Group Engagement [7, 20].”
Self-citationReframing nurses’ time to enhance interpersonal interactions in dementia care
Krohne, J. (2022) · Nursing Older People · doi:10.7748/nop.2022.e1402 · Cited by 2
Spiritual needs of people with suicidal ideation: a qualitative study
Amiri, S., Mohtashami, J., Memaryan, N., & Vasli, P. (2023) · Current Psychology · doi:10.1007/s12144-023-04424-4 · Cited by 2
de Melo, R. C., Schutz, V., Wachholz, P. A., et al. (2023) · Journal of Gerontological Nursing · doi:10.3928/00989134-20230414-05 · Cited by 2
Assessing and managing pain in older people with dementia
Dening, K. H. (2023) · Nursing Standard · doi:10.7748/ns.2023.e12165 · Cited by 2
Correlations between the architectural plans of dementia units and residents’ well-being
Rom, Y., Morag, I., Palgi, Y., & Isaacson, M. (2025) · Scientific Reports · doi:10.1038/s41598-025-14586-9 · Cited by 2
Менделевич, Е. Г. (2018) · Neurology neuropsychiatry Psychosomatics · doi:10.14412/2074-2711-2018-3-129-134 · Cited by 2
Trouble neurocognitif majeur et méthodes optimisant l’apprentissage
Viscogliosi, C., Dame, N., Mino‐Roy, J., Rahimaly, S., Breton, V., Déry, J., Chassé, B., Couturier, Y., Giroux, D., Renaud, C., et al. (2022) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s0714980822000216 · Cited by 2
De afweging tussen een open of gesloten afdeling voor bewoners met dementie: een kwalitatieve studie
Horsten-Schoonen, S. A. G. A., & Bolt, S. (2023) · Tijdschrift voor Gerontologie en Geriatrie · doi:10.36613/tgg.1875-6832/2023.02.02 · Cited by 2
Doyle, M., Louw, J., & Corry, M. (2023) · Journal of Gerontological Nursing · doi:10.3928/00989134-20230915-02 · Cited by 2
Pineau, E. (2016) · UWSpace (University of Waterloo) · Cited by 2
Hammar, L. M., Wickberg, S. M., Skogsbäck, M., et al. (2022) · Music & Science · doi:10.1177/20592043221120386 · Cited by 1
“Cohen-Mansfield et al. (2015) also suggest that responsive behaviors are associated with loneliness, boredom, discomfort, and a need for meaningful activities.”
BackgroundAssessment and Management of Dementia-Related Agitation
Wang, L. Y. (2023) · Current Geriatrics Reports · doi:10.1007/s13670-023-00388-2 · Cited by 1
Prevalence and Correlates of Antipsychotic Medication Use in Oregon Assisted Living
Dys, S., Tunalilar, O., & Carder, P. (2024) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2024.105073 · Cited by 1
Wang, Y., Li, Y., Zhang, W., Guo, X., & Chen, T. (2023) · ICME International Conference on Complex Medical Engineering (CME) · doi:10.1109/cme60059.2023.10565610 · Cited by 1
“Clinical findings have shown that PSCI patients are less satisfied with social interaction and recreational activities [53].”
BackgroundKraake, S., Pabst, A., Bickel, H., Pentzek, M., Fuchs, Â., Wiese, B., Oey, A., König, H., Brettschneider, C., Scherer, M., et al. (2024) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000541118 · Cited by 1
“Affected patients may be more likely to exhibit problematic behaviors, such as agitation or repeated vocalizations as a means of communicating needs [8].”
Obesity management with blood flow restriction training: a scoping review
Gujral, T., Rai, R. H., & Malik, S. (2024) · Bulletin of Faculty of Physical Therapy · doi:10.1186/s43161-024-00242-2 · Cited by 1
“3 Effect of exercise of obesity [37, 38] Apart from dietary managements, yoga is also among top trends in obese population according to latest regional [46] and global researches [47].”
BackgroundActivities of persons with dementia at home and after nursing home admission: A survey study
Groenendaal, M., Smaling, H. J. A., Achterberg, W. P., & Caljouw, M. A. A. (2024) · Geriatric Nursing · doi:10.1016/j.gerinurse.2024.10.056 · Cited by 1
Mercieca, A., Scott, I., Thompson, C. W., & Wilkinson, H. A. (2025) · Frontiers in Dementia · doi:10.3389/frdem.2025.1502911 · Cited by 1
Dementia Care Training Interventions for Residential Aged Care Workers: An Umbrella Review
Bruce, L. J., Woolford, M., Gulline, H., Berkovic, D. E., & Ayton, D. (2025) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2025.105627 · Cited by 1
Metadata
- Authors
- Cohen-Mansfield, J., Dakheel-Ali, M., Marx, M. S., Thein, K., & Regier, N. G.
- ORCID
- Regier, Natalie G.
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2015-07
- Volume
- 228
- Issue
- 1
- Pages
- 59-64
- ISSN
- 0165-1781 (ISSN-L)
- PMC
- PMC4451402
- OpenAlex
- W1988292497
- Semantic Scholar
- cc1a9c2635510a9c9875de4eaa550a367b18d87a
- Cited by
- 287
- References
- 32
- Citations by year
- 2026: 27 · 2025: 26 · 2024: 31 · 2023: 28 · 2022: 33 · 2021: 36 · 2020: 36 · 2019: 14 · 2018: 23 · 2017: 14 · 2016: 16 · 2015: 3
- FWCI
- 15.14
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (2 R01 AG010172- 10A2)
- Minerva-Stiftung Foundation (31583295000, 80539)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Geriatric Care and Nursing Homes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- dementia, unmet needs, behavioral problems, nursing home residents, boredom, sensory deprivation, loneliness, social interaction, meaningful activities, verbal agitation, pain detection, discomfort, informant ratings
- MeSH terms
- Problem Behavior, Aged, Aged, 80 and over, Dementia, Female, Health Services Needs and Demand, Homes for the Aged, Humans, Male, Maryland, Nursing Homes, Pain, Psychomotor Agitation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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Cited sources are checked with a language model’s help (gpt-6-sol).
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