[Care burden in nursing homes: uni- or multidimensional?]

The objective of this study was to determine the concurrent validity of a new rating scale for dependence of elderly people in residential homes (EBISZ). Care dependence was assessed by 5 items of ADL (dressing, bathing, using toilet, eating, getting around inside) and 5 items on special care (e.g., because of pressure scores), annoying behaviour, wandering, and language and memory impairment. Subjects were 212 elderly residents (mean age 84 years, sd = 6.3). The Pearson correlation between the new rating scale and a 12-item ADL-scale was 0.88. A multiple regression analysis with ADL, cognitive impairments, mood and behaviour problems, and social activities as independent variables, revealed that 2 variables (ADL and cognition) explained 83% of the variance in EBISZ. The new rating scale was relatively insensitive to problems of mood and social behaviour. The EBISZ missed more than 50% of the residents who needed special care because of depression or lack of social contacts. Dependence is a multidimensional concept. Its assessment should include ADL, mood, and social behaviour measures.