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Day care for persons with dementia: the impact of the physical environment on staff stress and quality of care
- Author:
- LYMAN Karen A.
- Journal article citation:
- Gerontologist, 29(3), August 1989, pp.557-56O.
- Publisher:
- Oxford University Press
Considers the impact of the physical environment in a day care centre and discusses implications for facility design and other service characteristics.
Kin relationship of caregivers and people with dementia: stress and response to intervention
- Authors:
- KIM Kyungmin, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 27(1), January 2012, pp.59-66.
- Publisher:
- Wiley
Care for older people with dementia is usually provided by family members. The type of kin relationship between the caregiver and the older person may have an impact on the caregiver’s expectations and motivation, on the support and resources available to them, and on their levels of stress and well-being. The aim of this study was to examine the effects of kin relationship on the response to use of adult day services (ADS) on feelings of overload, depressive symptoms, and positive affect for family caregivers of people with dementia. The sample comprised 341 participants drawn from 2 similar studies of ADS. Both studies compared family caregivers enrolling their care receiver in an ADS programme to a control group not using ADS. The 2 most common kin groups, wives and daughters (including daughters-in-law), were used for analysis. The findings showed that kin relationship affected the response to intervention in a different way for each outcome measure. For depressive symptoms, both wives and daughters using ADS had lower scores over time compared to controls. Both wives and daughters using ADS had lower feelings of overload over time, but daughters had a greater decline and wives' scores on this measure dropped only to the level found among controls.
Day care for older dementia patients: favorable effects on behavioral and psychological symptoms and caregiver stress
- Authors:
- MOSSELLO Enrico, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(10), October 2008, pp.1066-1072.
- Publisher:
- Wiley
This Italian study assesses the effects of Day Care (DC) on older subjects with dementia and their caregivers. Thirty patients with dementia, consecutively admitted to a DC, were compared with 30 patients, matched for age and cognitive function, who received usual home care (HC). Primary caregivers were compared as well. At baseline and after 2 months, patients were assessed for cognitive and functional status, behavioural and psychological symptoms [Neuropsychiatric Inventory (NPI)] and psychotropic drugs use, and caregivers were evaluated for care burden [Caregiver Burden Inventory (CBI)] and depressive symptoms. After adjusting for potential confounders, NPI score significantly decreased in DC group, with a reduction of psychotropic drugs prescription, whereas it increased in HC. No significant between-group difference was observed for cognitive and functional change. CBI significantly decreased in DC, but not HC, caregivers, with no significant between-group difference in depressive symptoms change.
Influence of emotional distress among supporters on the outcome of psychogeriatric day care
- Author:
- GILLEARD C.J.
- Journal article citation:
- British Journal of Psychiatry, 150, February 1987, pp.219-223.
- Publisher:
- Cambridge University Press
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Effect of Meeting Centres Support Programme on feelings of competence of family carers and delay of institutionalization of people with dementia
- Authors:
- DROES R.-M., et al
- Journal article citation:
- Aging and Mental Health, 8(3), May 2004, pp.201-211.
- Publisher:
- Taylor and Francis
The study tested the hypotheses that integrated support, in which patients and carers are both supported by one professional staff member, will be more effective in reducing the feelings of (over)burden of carers and in positively influencing some potential determinants of experienced burden than non-integrated support, such as psychogeriatric day-care. A quasi-experimental pre-test/post-test control group design was applied with matched groups and measurements at baseline and after seven months. Fifty-five of the eighty dyads (31% dropped out) of persons with mild-to-moderate dementia and their carers who presented for four community meeting centres and three day-care centres in nursing homes over an 18 month period, were included in the study. The carers in the Meeting Centres Support (MCS) Programme participated in an integrated family support program together with the persons with dementia, while the carers in the control group only received respite through psychogeriatric day-care. Standardized questionnaires were applied to measure some indicators of burden experienced by the carers (feelings of stress, life dissatisfaction, psychological and psychosomatic complaints), as well as some potential determinants of experienced burden (feeling of competence, coping strategies, experienced support and loneliness). Furthermore, as an indicator of feelings of (over)burden of the carer, the time between start of participation in one of the programs and institutionalization in a nursing home was calculated. After seven months the carers in the MCS group (n = 36), compared to the carers in regular psychogeriatric day-care (n = 19), showed a moderate positive effect on the feeling of competence (effect size 0.45). No effect was found on feelings of stress, dissatisfaction or psychological and psychosomatic complaints. However, as compared to the control group in regular day-care, the persons with dementia in the MCS Program participated for a longer period of time before they were placed in a nursing home. The MCS Program proved more effective than psychogeriatric day-care in influencing the feeling of competence of the carers, and seems to lead to an increased delay of nursing home placement of the person with dementia, as compared to regular day-care. Because of the small sample and limited power of the study, and the possible influence of the selection of carers on the study outcome, further research into the value of meeting centres for carers of people with dementia is recommended.
Adult day service use and reductions in caregiving hours: effects on stress and psychological well-being for dementia caregivers
- Authors:
- GAUGLER Joseph E., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(1), January 2003, pp.55-62.
- Publisher:
- Wiley
The objective of this study was to determine whether adult day service use interacts with decreases in primary caregiving hours (i.e. the time caregivers spent on activities of daily living/instrumental activities of daily living, memory problems, and behavior problems for patients) to alleviate caregiver stress and negative mental health over time. The findings suggest that adult day services are potentially effective in restructuring caregiving time and providing respite to family members.
Day care: do carers gain?
- Author:
- WALDER Sue
- Journal article citation:
- Journal of Dementia Care, 3(5), September 1995, pp.28-29.
- Publisher:
- Hawker
One of the aims of day care for people with dementia is to relieve stress and enhance the well-being of carers. Reports on a study which aimed to show how far this was being achieved.
Anticipating an easier day: effects of adult day services on daily cortisol and stress
- Authors:
- KLEIN Laura Cousino, et al
- Journal article citation:
- Gerontologist, 56(2), 2016, pp.303-312.
- Publisher:
- Oxford University Press
Purpose of the Study: Family caregivers experience high levels of stress that place them at risk for poor health outcomes. The authors explore whether an intervention which lowers caregivers’ daily exposure to stressors, adult day services (ADS), leads to improved regulation of the stress hormone, cortisol, which has implications for health and well-being. Design and Methods: Participants (N = 158) were family caregivers of individuals with dementia (IWD) who were using ADS. Eligibility included: the IWD had a dementia diagnosis, IWD used ADS at least twice a week, and IWD and caregiver lived in the same household. A within-subject treatment design was used to compare caregivers’ diurnal cortisol responses on days they received the intervention (ADS use by the IWD) and days they did not. Participants completed daily interviews over eight consecutive days and provided five saliva samples on each of those days. Primary outcomes were salivary cortisol awakening response (CAR) and cortisol area under the curve with respect to ground (AUC-G). Results: Caregivers with a “burned-out” or flattened CAR, and associated low AUC-G on non-ADS days displayed a more normative CAR and AUC-G response on ADS days. Restored cortisol regulation was also observed on ADS days among caregivers with the highest CAR and AUC-G levels on non-ADS days. Implications: Results indicate that ADS use improves caregivers’ cortisol regulation, which could enhance long-term health outcomes. Effects may be due to caregivers’ anticipation of an easier day when the IWD attends ADS. (Edited publisher abstract)
How effective are interventions with caregivers?: an updated meta-analysis
- Authors:
- SORENSON Silvia, PINQUART Martin, DUBERSTEIN Paul
- Journal article citation:
- Gerontologist, 42(3), June 2002, pp.356-372.
- Publisher:
- Oxford University Press
The purpose of this study is to determine the effectiveness of interventions for family caregivers of older adults. Caregiver interventions are effective, but some interventions have primarily domain-specific effects rather than global effects. The differences between intervention types and moderators suggest ways of optimizing interventions
A comparison of elderly day care and day hospital attenders in Leicestershire: client profile carer stress and unmet need
- Authors:
- FURNESS L., et al
- Journal article citation:
- Aging and Mental Health, 4(4), November 2000, pp.324-329.
- Publisher:
- Taylor and Francis
Traditionally, day care for elderly persons has been provided by health or social services; however, recently facilities have been developed by voluntary organizations. This study was conducted to examine the characteristics of elderly clients with mental health problems attending these various settings, and to identify any areas of unmet need. There were both similarities and important differences between clients attending day hospitals, social services and Age Concern day centres. Day centres had a higher proportion of cognitively impaired clients than day hospitals. Although there were similar rates of depression across all settings, the severity of depression was greater in those attending Age Concern day centres. Patients at day hospitals suffering from dementia were more likely to be psychotic or behaviourally disturbed. The reasons for these differences are discussed in detail. Carers and clients were generally satisfied with services, though professionals were less satisfied. There is a need for joint planning and commissioning of day care to provide maximum flexibility and co-ordination of services.