Development of a multidimensional home health care needs scale: Implications for dementia care
Sara Knox, Janet Horn, Julie Bynum, Kit N. SimpsonAbstract
INTRODUCTION
Home health clinicians require practical tools to assess complex care needs, particularly for people living with dementia. Existing measures are time‐consuming and not well aligned with clinical workflows.
METHODS
We utilized 2019 national Medicare data, including the Outcome and Assessment Information Set (OASIS), to develop and validate a multidimensional care needs scale through exploratory factor analysis and standardized scores. Results were confirmed in the validation cohort.
RESULTS
Six domains were identified: self‐care and mobility (dominant), cognitive and behavioral supervision, complex ambulation, memory and decision‐making, hospitalization risk, and challenging behaviors. The Care Needs Scale showed strong gradients in impairment across the cohort, with people living with dementia disproportionately represented in moderate and high care‐need categories.
CONCLUSION
This scale leverages routinely collected data to characterize care needs across home health populations, with particular relevance to people living with dementia. Its design supports integration into existing documentation systems and facilitates individualized care planning, research, and policy evaluation in home health settings.