Enhancing Quality of Life of Families Who Use Adult Day Services: Short- and Long-Term Effects of the Adult Day Services Plus Program

Gitlin, Laura N.; Reever, Karen E.; Dennis, Marie P.; Mathieu, Esther; Hauck, Walter W.

doi:10.1093/geront/46.5.630

Cited by 104 publications

(115 citation statements)

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“…The different response of wives indicates that ADS programs may need to take a different approach with them to delay placement. One such approach has been described by Gitlin, Reever, Dennis, Mathieu, and Hauck (2006) , who compared an enhanced ADS program that included counseling for the primary caregiver and other supportive services in addition to traditional ADS. The results indicated that spouse caregivers in the enhanced program had greater relief of stress and were more likely to use ADS for a longer period of time than caregivers in the control program.…”

Section: Discussionmentioning

confidence: 99%

Wives and Daughters: The Differential Role of Day Care Use in the Nursing Home Placement of Cognitively Impaired Family Members

2009

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Purpose: To expand knowledge concerning the signifi cance of kin relationships in caregiving, this study assessed predictors of the timing of institutionalization for persons with dementia. The focus was on whether use of adult day care by wives and daughters holds the same implications for placement. Design and Methods: Guided by a caregiving stress process model, primary objective and subjective stressors, secondary stressors, caregiver wellbeing, and use of day care services were included as predictors. Cox proportional hazards models were tested using a sample of 371 community-dwelling caregivers, including 141 wives and 230 daughters and daughters-in-law. Results: The main effect of kinship was found to be signifi cant before interactions were introduced. Adult day care use at Time 1, role captivity, role overload, and social impact were subsequently found to interact with kinship. Analyses indicated that wives who used adult day care placed their husbands to a nursing home earlier than their counterparts. Among daughters, however, those who used adult day care were more likely to postpone the placement. The infl uence of role overload was also stronger in wives than in daughters in predicting the timing of placement. A similar pattern was observed in the interaction between social impact and kinship. Implications: The results demonstrate that factors infl uencing nursing home placement may vary according to the caregiver's familial relationship to the relative. Different approaches may be needed when targeting wife vs. daughter caregivers, especially when designing adult day care programs. Key Words: Predictors of nursing home placement , Spouse caregivers , Cognitively impaired elders , DementiaOne of the major challenges faced by family caregivers of elders with disability is the decision to institutionalize. Although placement is diffi cult for most caregivers, the meaning of institutionalization is likely to be different, depending on the kin relationship between caregiver and care receiver. The two most common groups of caregivers, wives and daughters, have very different relationships and obligations, and may differ as well in the resources they have available for providing care and in other demands on their time. Although one of the goals of respite programs such as adult day care services (ADSs) is to delay institutional placement, little is known about how kin relationship might affect its timing. At the program level and from a broader policy perspective, understanding how factors such as kin relationship might affect the placement decision may lead to development of better targeted services that could delay, where appropriate, the use of more expensive institutional care. The present study examines whether kin relationship affects the timing of nursing home placement for caregivers who enroll a relative into an ADS program compared with caregivers not using ADS.Studies of predictors of nursing home placement have generally found that persons with dementia who have more functional limitations, mo...

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Section: Discussionmentioning

confidence: 99%

Wives and Daughters: The Differential Role of Day Care Use in the Nursing Home Placement of Cognitively Impaired Family Members

2009

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“…Nevertheless, it is noteworthy that a US study on a day care plus programme that provided care management and support to family caregivers in addition to day respite for elders resulted in reduced caregiver depression and fewer nursing placements. 171 It is hoped that more of such studies will be conducted to provide a stronger evidentiary base on the usefulness of caregiver respite and support services.…”

Section: Gppmentioning

confidence: 99%

Systematic review of recent dementia practice guidelines

2014

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Level Type of Evidence + +High quality meta-analyses, systematic reviews of randomised controlled trials (RCTs), or RCTs with a very low risk of bias. +Well conducted meta-analyses, systematic reviews of RCTs, or RCTs with a low risk of bias. -Meta-analyses, systematic reviews of RCTs, or RCTs with a high risk of bias + +High quality systematic reviews of case control or cohort studies. High quality case control or cohort studies with a very low risk of confounding or bias and a high probability that the relationship is causal 2 + Well conducted case control or cohort studies with a low risk of confounding or bias and a moderate probability that the relationship is causal -Case control or cohort studies with a high risk of confounding or bias and a significant risk that the relationship is not causal 3Non-analytic studies, e.g. case reports, case series 4 Expert opinion Levels of evidence and grades of recommendation Statement of IntentThese guidelines are not intended to serve as a standard of medical care. Standards of medical care are determined on the basis of all clinical data available for an individual case and are subject to change as scientific knowledge advances and patterns of care evolve.The contents of this publication are guidelines to clinical practice, based on the best available evidence at the time of development. Adherence to these guidelines may not ensure a successful outcome in every case. These guidelines should neither be construed as including all proper methods of care, nor exclude other acceptable methods of care. Each physician is ultimately responsible for the management of his/her unique patient, in the light of the clinical data presented by the patient and the diagnostic and treatment options available. ForewordDementia represents a major public health concern in Singapore and worldwide. Being the most prevalent neurodegenerative disease, dementia is expected to affect 55,000 patients in Singapore by the year 2020. The commonest cause of dementia is Alzheimer's disease with vascular dementia being the next most important cause. Right from the stage of mild dementia up to the stages of severe dementia, this condition poses a significant health and socio-economic burden to patients, caregivers and the nation as a whole. Early diagnosis will allow appropriate use of pharmacological and non-pharmacological management. Along with disease stabilization, efforts to address caregiver burden, patient safety and medico legal concerns should form the principles of management. Clear practise guidelines will allow holistic and optimal care in dementia.I am pleased to present the revised clinical practise guidelines for dementia. In this regard the workgroup has performed a thorough review of the existing literature to recommend both pharmacological and nonpharmacological aspects of management for patients ranging from mild cognitive impairment to severe dementia. This revised guidelines also highlights issues related to the management of mild cognitive impairment, young onset dementia and e...

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“…Par la stimulation des capacités résiduelles de la personne âgée, elle peut aussi faciliter certaines tâches d'assistance quotidienne accomplies par la personne de soutien. De plus, certains centres de jour offrent des groupes d'éducation et de soutien pour les familles ou encore permettent la participation des personnes de soutien à certaines fêtes ou activités spéciales incluses à leur programmation, de façon à diminuer leur isolement (Curran, 1996;Gitlin, Reever, Dennis, Mathieu et Hauck, 2006 • incapacités fonctionnelles d'origine motrice;…”

Section: Les Centres De Jourunclassified

L'utilisation des services de centre de jour par les personnes âgées qui présentent des incapacités

et al. 2007

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Objectives: The purpose of this study was to document the use of ADCs by seniors with functional limitations. There were three main objectives: 1) To identify the characteristics of ADC users versus non-users and to identify the determinants of use.2) To explore how well ADC program activities matched the different needs of participants with various health and functional characteristics profile.3) To examine the factors related to regularity of ADC attendance.Methods: This study was based on a secondary analysis of data collected from 723 seniors participating in the Services intégrés pour personnes âgées (SIPA) demonstration project implemented in two CLSCs in Montreal. ADC use data were obtained for a six month period, from the five ADCs serving the same catchment area. To better understand the ADC program characteristics, individual interviews and focus groups were carried out with ADC coordinators. Data were analysed with descriptive statistics, cluster analysis, and logistic and multiple regression analysis. Results:The results are presented in three articles, one for each main objective. Article 1:The proportion of ADC users was 18.8 % (CI 0.95: 16.0 -21.7%). The following factors increased the probability of ADC use: being younger (OR: 1.12; CI 0.95: 1.06 -1.19); not having a university degree (OR: 1.92; CI 0.95: 1.04 -3.57); receiving help from the CLSC for daily living activities more than once a week (OR: 1.73 and 2.48 for help two to five times per week and six to seven times per week respectively; CI 0.95: 1.06 -2.80 and 1.22 -5.06); being in the catchment population of an ADC with a lower daily fee (OR: 1.054; CI 0.95: vii 1.001 -1.108 for each 1$ fee increase); and for men only, having had a stroke or presenting with more functional incapacities (interaction between gender and presence of a stroke: OR: 0.298; CI 0.95: 0.108 -0.825; interaction between gender and functional capacity as measured by OARS: OR: 1.096; CI 0.95: 1.019 -1.178). In addition, the probability of ADC use was higher among individuals who live with the person identified as their caregiver.However, this association was found only among persons born in Canada (interaction between whether they lived with caregiver and country of birth: OR: 0.417; CI 0.95: 0.185 -0.938). Article 2: Four different participant profile groups were identified using cluster analysis: 1) frail seniors of advanced age who had a large number of health problems;2) individuals who were younger and more independent than the average participants who appeared early users of ADC; 3) individuals with functional impairment related to cognitive problems; and 4) those with movement disorders which affected their independence.Classification of program activities by a panel of experts distinguished eight categories of activities: physical exercise; groups for those with common diagnoses or functional problems; functional activities; cognitive stimulation; music or reminiscence activities; sports and physical games; social skills and interaction; disease prevention and ...

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Enhancing Quality of Life of Families Who Use Adult Day Services: Short- and Long-Term Effects of the Adult Day Services Plus Program

Abstract: ADS Plus is cost efficient and is easy to implement within adult day centers. It affords important clinical and public health benefits, including enhanced caregiver well-being, greater adult day service use, and fewer nursing home placements.

Cited by 104 publications

References 18 publications

Wives and Daughters: The Differential Role of Day Care Use in the Nursing Home Placement of Cognitively Impaired Family Members

Wives and Daughters: The Differential Role of Day Care Use in the Nursing Home Placement of Cognitively Impaired Family Members

Systematic review of recent dementia practice guidelines

L'utilisation des services de centre de jour par les personnes âgées qui présentent des incapacités

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