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

Abstract

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 ...

Les activités de groupe des centres de jour pour personnes âgées correspondent-elles aux besoins des différents profils de participants ?

“…On peut se demander si cette clientèle a réellement besoin de fréquenter un CJ ou si elle pourrait fréquenter des (Gaugler, Kane, Kane et, Newcomer, 2005 ;Gaugler et Zarit, 2001 ;Gottlieb et Johnson, 2000 ;Zarit et al, 1999 (Lindeman et al, 1991 ;Nissenboim et Vroman, 1998 ). (Savard et al, 2007 ).…”

“…Les femmes, pour leur part, se regroupent dans trois groupes distincts, ce qui laisse suggérer qu’elles ont une plus grande variété de raisons de fréquenter un CJ. Cela est cohérent avec les résultats d’une première étude qui indiquaient que les hommes participent davantage au CJ lorsqu’ils ont fait un AVC et lorsqu’ils sont moins autonomes (Savard et al, 2007).…”

“…Les caractéristiques des cinq CJ qui offrent des services sur le territoire des deux CLSC de l'étude ont été décrites plus en détail dans un article précédent (Savard, Leduc, Lebel, Béland, et Bergman, 2007 ) et sont résumées ci-après.…”

“…Les variables sociodémographiques retenues sont l’âge, le sexe, l’état civil, l’éducation, le pays de naissance, la langue d’usage et la cohabitation avec une personne de soutien. Elles ont été choisies parce que des études antérieures ont démontré des différences dans l’utilisation des CJ en fonction de ces variables (Baumgarten et al, 2002 ; Henry et Capitman, 1995 ; Savard et al, 2007 ; Zarit, Stephens, Townsend, Greene, et Leitsch, 1999).…”

Determinants of Adult Day Center Attendance Among Older Adults With Functional Limitations

“…In our previous study of 723 individuals aged 65 years and older, the probability of ADC use was higher among those who were younger; did not have a university degree; received help for daily life activities from home care services more than once a week; or were in an area where ADC fees were lower. For men only, history of stroke and greater functional impairment were associated with ADC use (Savard, Leduc, Lebel, Béland, & Bergman, 2007).…”