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Relationship Between Perceived Needs and Assessed Needs for Services in Community-Dwelling Older Persons

Correspondence: Address correspondence to Jiska Cohen-Mansfield, PhD, Research Institute on Aging of the CES Life Communities, 6121 Montrose Road, Rockville, MD 20852. E-mail: cohen-mansfield{at}

Purpose: We examine the relationship between the perceived needs and assessed needs of community-dwelling seniors. Design and Methods: Trained research assistants administered the Naturally Occurring Retirement Community Baseline Survey to 268 community-dwelling older adults in suburban Maryland. Perceived and assessed needs were measured in the domains of health and function (memory, health, functional needs, mobility, and financial management), mental health (depression and loneliness), sensory functioning (vision), and health behaviors (nutrition and exercise). Results: In the areas of functional needs, mobility, financial management, loneliness, and vision, persons who scored as more needy were already utilizing significantly more services. Of persons not receiving services, participants in need of memory, physical health, functional, loneliness, and nutrition services were more likely to indicate they would use those services. Although there were significant relationships between assessed needs and perceived needs, there was also a high level of discrepancy, such that a substantial proportion of those participants screened as not needing services requested those services, and a sizable proportion of those who screened as needing services did not request them. The results also show a high prevalence of needs among older adults and yet low service use by those with needs for these services. Implications: Both assessed and perceived needs should be examined in future need assessment surveys. Further investigations into the nature of discrepancies will likely result in improvement in the methodologies of screening assessed and perceived needs. Services targeted to older adults must be made more available to those dwelling in the community.

Key Words: Aging in place • Community services • NORC • Screening • Unmet needs