Chapter 7 180 Do different patient or population characteristics give rise to different needs and to different amounts of meeting these needs? Is there a difference in the ratings of patients and their (professional) caretakers? First, the benefits of this gathered information can be helpful for the primary healthcare process, as well as for policymakers. On an individual level, it shows where the needs are, so the treatment can be customized for the individual patients’ recovery, not only in the clinical domain but also in the functional and social domains. Second, for specific patient groups, it highlights where the treatments are effective in countering the needs and where the lacunae are so that policy can be adjusted. There is even greater urgency to understand the needs of older patients due to ageing, especially because there is uncertainty if there is an increase in met needs, as age seems not to be correlated to unmet needs, and if this is due to a shift in needs or merely a rise in the same needs (Lloyd, King and Moore, 2010; Meesters et al., 2013). Finally, a comparison between different diagnostic groups can highlight if there are differences in needs, especially unmet needs. Not only can we try to determine why these differences exist, but a more effective policy can also be adopted. Based on our results and the available literature, we hypothesise the following: 1. Overall, older (psychiatric) patients have the same items of needs and unmet needs as their younger counterparts. Except for diagnose specific items such asmemory for dementia and patients’ demographic characteristic-specific needs such as incontinence for age. 2. It is the amount of these needs that differs between populations and is influenced by the degree of disability or recovery. 3. We speculate that if their disability is more comprehensible, these needs will be better met, and the discrepancy between the rating of the patients and their caregivers will be less. However, we hypothesise that this will be the case for items that belong to the core treatment of medical psychiatry (i.e. clinical recovery), and less the case for items that can be attributed to functional as well as social recovery. Future studies should examine whether these hypotheses are correct. A major contribution would be to study the needs of middle-aged patients with bipolar disorder so that these can be better compared with our results. Assessments with CANE/CANSAS or CAN can provide valuable information at these three decision levels. This is done by knowing and comparing the needs and unmet needs of the individual patient, within a group (intragroup), and between different groups (intergroup).
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