[Are psychiatric illnesses adequately considered in distribution of nursing care levels according to the nursing care insurance law? Evaluation using a new scale for evaluating need for nursing care by senior citizens].

The object of our study is the evaluation of care needs of senior citizens and the adjustment of certain stage of care according to the German Health Care Act ("Pflegeversicherungsgesetz"). For assessment of care needs we developed a new rating scale (BPS). Factor analysis of the rating scale showed 5 dimensions: (1) "Psychoorganic Syndrome" (Dementia), (2) "Physical Care Needs", (3) "Lack of Social Skills", (4) "Aggressiveness" and (5) "Depression". The sample size is N = 1739, mean age 82.5 years. A statistically significant partial correlation of the extent of care needs as indicated by the stage of care described by BPS dimensions was found only for dimension (2) "Physical Care Needs" (r = 0.50). Cluster analysis resulted in distribution of the whole sample into 6 discriminable groups, according to their syndrome specificity (BPS profiles). Additionally clusters are different regarding the severity of need for care. It is obvious, analyzing the adjustment of stages of care within clusters, that psychiatric relevant disturbances contribute substantially to this adjustment. Nevertheless this finding is valid only for aged people, who receive regular care by ambulant or home services, and can not be transferred to senior citizens cared by their families.