Barriers to Utilizing Adult Day Centers and Associated Factors on Alzheimer's Patients Literature Review

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Alzheimer's

Adult Daycare for Patients with Alzheimer's Disease

Barriers to Daycare Utilization:

Fortinsky, Richard H., Kulldorff, Martin, Kleppinger, Alison, and Kenyon-Pesce, Lisa. (2009). Dementia care consultation for family caregivers: Collaborative model linking an Alzheimer's association chapter with primary care physicians. Aging & Mental Health, 13(2), 162-170.

The study by Fortinsky et al. (2009) discusses some of the obstacles standing between family caregivers and the admission of their patients to daycare nursing communities. The purpose of the research is to evaluate strategies that might improve the willingness of family caregivers to work with these community services. In a consultation with 84 family caregivers, the study aims to determine what strategies might raise confidence in the capabilities of such services. Additionally, the study seeks to evaluate the responses of primary caregivers to the outcomes produced by this type of intervention. A third objective of the study would be to determine how successfully caregivers and voluntary community service providers are able to collaborate in the given intervention environment. According to the study, "the dementia care consultation intervention showed favorable effects on nursing home admission and on caregiver outcomes among intervention group caregivers more satisfied with the intervention, but there are important barriers to sustaining this collaboration between primary care physicians and a voluntary sector organization such as an Alzheimer's association chapter." (p. 162)

This contributes a clear understanding, in the present research, of the paths to overcoming barriers in use of such daycare services.

Hamilton, Edith M., Braun, Jean W., Kerber, Paul, Thurlow, Christine, and Schwieterman, Irma. (1996). Factors associated with family caregivers' choice not to use services. American Journal of Alzheimer's Disease and Other Dementias, 11(4), 29-38.

The study by Hamilton et al. (1996) addresses what might be considered a control group in a research discussion concerning patients with dementia and daycare services. Here, an evaluation is given on the reasons offered by primary caregivers for choosing not to utilize such services. In a discussion on the implications of the burden placed on primary caregivers in facilitating the needs of aging family members with dementia or Alzheimer's, this forms an important part of our understanding. Specifically, the study surveys 70 respondents among primary caregivers who have been referred to but declined to employee such assistive services.

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It finds that among the major reasons that individual caregivers have declined to employ such services, the major focus is on a negative impression of the competence represented in such treatment contexts. According to the study, "Personal competence, measured as perception of caregiving mastery, emerged as a significant factor in service nonuse. Caregiver gender and daily hours of caregiving, an environmental press factor combined with perception of mastery to most often correctly classify respondents' high and low adaptation." (p. 29) The resolution of this study is an important one within the context of the present research as well. Here, researchers resolve that it is necessary to focus on improving quality, training and competence among adult daycare service caregivers.

Benefits of Daycare Utilization:

Mossello, Enrico, Caleri, Veronica, Razzi, Elena, Di Ban, Mauro, Cantini, Claudia, tonon, Elisabetta et al. (2008). Day care for older dementia patients: Favorable effects on behavioral and psychological symptoms and caregiver stress. International Journal of Geriatric Psychiatry, 23(10), 1066-1072.

The study by Messello et al. (2008) offers a high level assessment of the benefits of daycare utilization for adults with dementia. The study focuses specifically on a comparative assessment of subjects with dementia admitted for daycare (DC) and those prescribed homecare (HC). The study was engaged across a 2-month period during which 30 patients in each of the prescribed groups was observed for a range of characteristics. The included characteristics would be cognitive and functional status, behavioral and psychological symptoms and psychotropic drug use. The specific priority for our research is the finding concerning behavioral and psychological symptoms. However, also of value to the present study is the reference made in the research to the burden placed on the primary caregiver. This is because a discussion of the benefits of daycare must include, in addition to a discussion on its benefits to the patient, its benefits to the caregiver. According to the findings for the study in question, "A 2-month period of DC assistance is effective in reducing behavioral and psychological symptoms of dementia patients and in alleviating caregivers' burden." (p. 1066) This is a promising finding,….....

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