The process of adult day service use

Abstract

The objective of this study was to examine why and how families and older adults utilize adult day services. The current study included three months of participant observation in one rural and one suburban adult day service program in an upper-Midwestern region of the United States as well as semi-structured interviews with 14 family members of clients and 12 staff members from these programs. Several key constructs emerged that organized the multiple sources of qualitative data including programmatic philosophy, positioning, and environment of ADS; clients’ and family members’ reasons for use; the process of ADS use by families and clients; and pathways to family/client psychosocial and client functional outcomes. A number of inter-related themes emerged within each construct. The constructs identified and their potential associations among each other were used to expand upon and refine prior conceptualizations of ADS to frame future clinical and research efforts.

Correlates of Service Delivery and Social Environment in Adult Day Service Programs

“…There were extensive activity of daily living needs and chronic health care conditions present among ADS clients, emphasizing as in recent national surveys that the type of individuals ADS programs are serving have increasingly complex healthcare needs. The results here also seem to imply that a considerable proportion of ADS clients reside in less-intensive residential care settings and thus rely on the activities and services in ADS for the stimulation and socialization they may not receive in such environments (Gaugler, in press). …”

Family caregivers’ perceptions of an Irish palliative day-care unit: A qualitative descriptive study

“…Palliative day-care provides caregivers' with support mainly in the form of direct contact with a specialist palliative care team [53] and respite helping them to cope by gaining confidence in their role [10,15,51,55]. In addition this study highlights caregivers' expressed that they valued being able to access advice and help when required and that respite was seen as a key support to allow them do everyday activities.…”

“…This home like environment was important to participants' as it created a link between person-centred care and the physical environment and acknowledge in other research [50,51]. Thoughtful environmental design is a therapeutic resource promoting well-being and functioning among patients' [52] and improves well-being and quality of life of caregivers' [10,[53][54][55]. Findings from this study highlight the effects of caregiving in that participants' describe the responsibility entailed within the role of caregiver and portrayed that the responsibility of this role was challenging.…”

“…Through providing support to patients' in a holistic manner family caregivers' are included and report; satisfaction with the service received [71], responsive communication and a partnership approach [72] and a sense of freedom, relaxation and lowering of stress [73,74]. However, while palliative day-care has an important role [75] there often remains a difficulty in balancing patient preferences and needs [10].…”

“…Palliative day-care programmes offer outof-home supervised activities and socialisation for patients and offer families relief from day-to-day care responsibilities, to enhance the functional independence and quality of life of clients who attend, and enable clients to remain in a home/community setting for as long as possible [10]. Patients who access palliative or hospice day centres in the main have either a malignant or non-malignant/neurological condition.…”