<p>Facilitation of activities for people with dementia in day care: a qualitative study exploring the experiences of staff</p>

Abstract

Background: Day care service (day care) is recommended as an activity service for home-dwelling people with dementia in Norway. However, there is limited knowledge about strategies to promote engagement and participation in activities at day care. The aim of this study was to gain understanding of the staff’s experiences on how to enhance engagement and participation in activities for attendees. Methods: The study has a qualitative design, using group interviews with staff and field observations at day care designed for people with dementia. Thematic content analysis was used to analyze interviews, and the findings from the observations were used to illuminate the findings in the interviews. Three group interviews including a total of 10 staff participants were conducted. Additionally, 35 attendees were observed during 2 days of field observations at each day care. Results: The main theme that emerged from the analysis was the staff’s primary objective to make meaningful days for the attendees. To achieve this, the importance of having individual knowledge about the attendees to enhance relationships, creating a balanced group composition, personal competence and skills of the staff, and the importance of using activities in different ways, was highlighted. Most findings from the field observations coincide with those in the interviews. However, the observations revealed that the staff seemed to have insufficient knowledge of offering individual tailored and structured meaningful activities to the attendees. There is a potential of including the attendees even more in the ongoing activities. Conclusion: Staff play an important role in promoting and facilitating activities to increase engagement and participation in activities. There is a potential for greater structured use of activities and cognitive stimulation. To avoid occupational injustice and the risk of decreased health and well-being among home-dwelling people with dementia, more differentiated and individual tailored services are needed.

Comparing the care environment at farm‐based and regular day care for people with dementia in Norway—An observational study

“…However, the level of engagement at both types of day care found in our study supports Strandenæs et al. (2019) finding that regular day care attendees had a generally high level of engagement. The two types of day care, therefore, seem to provide attendees with activities that create engagement in line with the overall aim of such services.…”

“…Even though day care services are organised differently than long‐term residential care, they are often situated in the same institutional environment. Strandenæs, Lund, and Rokstad (2019) study of day care services found that even though staff talked about the importance of getting to know the attendees to provide tailored activities and meaningful days, no examples of this was found in observations of attendees. Staff also expressed that there was too much focus on attendees’ limitations indicating that there is a potential to offer more differentiated and tailored day care services (Strandenæs et al., 2019).…”

“…Strandenæs, Lund, and Rokstad (2019) study of day care services found that even though staff talked about the importance of getting to know the attendees to provide tailored activities and meaningful days, no examples of this was found in observations of attendees. Staff also expressed that there was too much focus on attendees’ limitations indicating that there is a potential to offer more differentiated and tailored day care services (Strandenæs et al., 2019). This would be more in line with person‐centred care, taking into account the person's own subjective experiences (Kitwood, 1997; Kitwood & Bredin, 1992).…”

Self‐reported quality of life in people with dementia attending a day‐care programme in Norway: A 24‐month quasi‐experimental study

“…Consequently, some day care alternate attendees of different ages and functional levels to different activities or days for more homogenous groups. When there is a progression in dementia or behavioural problems occur, day care is often no longer considered a suitable service (Strandenaes et al., 2019). Day care is traditionally and most commonly established in an institution like a nursing home or in centres offering services for older adults (Gjøra et al., 2015; Taranrød & Strandli, 2012).…”

Effects of non-facilitated meaningful activities for people with dementia in long-term care facilities: A systematic review

“…18,21 However, most activity interventions for people living with dementia were facilitated by nursing or care staff, researchers, or others (e.g., volunteers, musicians, clowns). While the presence of a facilitator can promote uptake of, and engagement in, meaningful activities by people living with dementia in LTC, 22 questions have been raised about the effectiveness of the activity interventions being confounded by the social contact with or person-toperson attention received from the facilitator, making it unclear and difficult to determine which element (i.e., the activity or the facilitator) has contributed most to the intervention effect. 18 This means that it is difficult to delineate the 'real' effect of the activity interventions being introduced to people living with dementia, as any positive effect found may either be mediated and/or inflated by their interaction with the facilitator.…”