scholarly journals ADULT DAY SERVICES IN A RURAL REGION: CHALLENGES AND OPPORTUNITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S154-S155
Author(s):  
Sandra S Butler ◽  
Jennifer Crittenden ◽  
Dyan Walsh ◽  
Lenard Kaye
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Service Providers ◽  
Positive Impact ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Adult Day Services ◽  
Challenges And Opportunities ◽  
Day Services ◽  
Intergenerational Programming

Abstract Adult day services (ADS) programs provide stimulation and socialization for older adults with cognitive and physical disabilities, and much needed respite for family caregivers. Like many services for older adults, ADS programs are far less available in rural regions of the country than in more urban settings. This paper reports on a needs assessment for an ADS program in a small city, which serves as a health and human services hub for a large rural area; a particular focus of the study was to assess the feasibility and interest in intergenerational programming. Family caregivers were surveyed (n = 84) about their use and knowledge of and interest in ADS. Less than one in five respondents were using or had ever used ADS. Cost (20%) and ignorance of such programs (20%) were primary reasons for not using ADS; reduction of stress was the most frequently cited reason for using ADS (73%). Ten in-person interviews were conducted with ADS program directors and service providers who refer clients to ADS. Funding issues emerged as the key challenge given lack of private insurance coverage and poor reimbursement levels from public insurance programs. Challenges around transportation, stigma, and marketing of services also surfaced in the interviews. Nonetheless, all ten informants spoke of the positive impact of ADS for both consumers and their caregivers, and generally endorsed intergenerational activities, though with caveats. Implications will be discussed, including the need for greater financial support for this valuable aspect of our long-term supports and services system.

scholarly journals Adult Day Services and COVID: A Crisis in Ohio

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 111-111
Author(s):  
Holly Dabelko-Schoeny ◽  
Susan Wallace ◽  
Salli Bolin
Keyword(s):  
Nursing Homes ◽  
Assisted Living ◽  
Service Providers ◽  
Coalition Building ◽  
Executive Order ◽  
Policy Makers ◽  
Levels Of Care ◽  
Adult Day Services ◽  
Challenges And Opportunities ◽  
Day Services

Abstract An Ohio Executive Order forced adult day service providers across the state to close from March 24, 2020 until September 21, 2020 due to COVID, resulting in significant hardship for providers and families. In fact, 65% of programs reported laying off or reducing staff and 83% of directors reported participants had to move to higher and more expensive levels of care such as nursing homes and assisted living. Programs reported that 74% of caregivers had to choose between working and taking care of their family members. Ninety-one percent of ADS program directors in Ohio reported their caregivers were experiencing an increase in stress and anxiety. This paper explores the experiences of Ohio adult day providers during the COVID epidemic, and identifies the challenges and opportunities to coalition building to educate policy makers about day services and the crucial care centers provide.

Engaging persons with dementia in advance care planning: Challenges and opportunities

Dementia ◽  
2020 ◽  
pp. 147130122097305
Author(s):  
Tamara Sussman ◽  
Rebecca Pimienta ◽  
April Hayward
Keyword(s):  
Focus Groups ◽  
Family Caregivers ◽  
Advance Care Planning ◽  
Service Providers ◽  
Care Planning ◽  
Reflective Process ◽  
Challenges And Opportunities ◽  
Future Care ◽  
Advance Care ◽  
Positive Engagement

This study reports findings from a series of focus groups with persons with dementia and family caregivers intended to explore: (1) perceptions of and experiences with advance care planning (ACP); (2) concerns related to future care including, but not limited to, end-of-life care; and (3) practices that may support positive engagement with ACP. A total of 18 participants including 10 persons with dementia and eight family caregivers participated in five focus groups held in two urban cities in Canada. All focus group deliberations were audio recorded, transcribed verbatim, and analyzed in five stages using a semantic thematic approach. All participants expressed some form of engagement in ACP, but understandings were limited and divergence was expressed regarding the timing of more expansive conversations about future care. Although some persons with dementia were ready to engage in future care discussions, most preferred focusing on the present and suggested their families did not require direction. This placed families in the complex dilemma of protecting their loved ones while compromising their own needs for dialogue. Although individually focused models of ACP engagement hold promise for those persons with dementia ready to engage in future planning, our findings suggest that early engagement of families in the reflective process may go a long way in supporting ACP activation. Our findings further suggest that persons with dementia who do not have close family/friends may require extensive ACP encouragement and support from service providers.

scholarly journals Use of Adult Day Services: Improving the Lives of Family Caregivers

2020 ◽  
Vol 21 (8) ◽  
pp. 20
Author(s):  
Theresa A. Kessler ◽  
Lynette Rayman
Keyword(s):  
Family Caregivers ◽  
Adult Day Services ◽  
Day Services

scholarly journals Temporal Patterns of Daily Behavioral and Psychological Symptoms of Dementia Throughout the Day

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 53-54
Author(s):  
Caitlin Connelly ◽  
Kyungmin Kim ◽  
Yin Liu ◽  
Steven Zarit
Keyword(s):  
Family Caregivers ◽  
Stress Responses ◽  
Stress Reactivity ◽  
Psychological Symptoms ◽  
Temporal Patterns ◽  
Adaptive Intervention ◽  
Adult Day Services ◽  
Lower Reactivity ◽  
Day Services ◽  
Behavioral And Psychological Symptoms

Abstract Behavioral and psychological symptoms of dementia (BPSD) are taxing for both the person with dementia (PWD) and their family caregivers. Yet, little is known about how BPSD fluctuates throughout the day (i.e., morning, daytime, evening, and night; e.g., sundowning) and how caregivers perceive BPSD at different times of the day. Using 8-day daily diary data from 173 family caregivers whose relatives were using Adult Day Services (ADS), this study investigated temporal patterns of BPSD and caregivers’ stress responses to BPSD throughout the day. Overall, the number of BPSD was highest in the evening, and caregivers’ stress reactivity to BPSD increased throughout the phases of the day (i.e., most stressful at night). However, caregivers showed lower reactivity to BPSD in the mornings and at night on days when the PWD used ADS. Our findings about fluctuations of (caregiver reactions to) BPSD throughout the day suggest target windows for just-in-time adaptive intervention.

scholarly journals Daily Cortisol Total Output Mediated Sleep and Affect Among Dementia Family Caregivers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 180-180
Author(s):  
Daniel Fleming ◽  
Elizabeth Fauth ◽  
Yin Liu
Keyword(s):  
Family Caregivers ◽  
Quality Care ◽  
High Stress ◽  
Area Under The Curve ◽  
Total Output ◽  
Night Time ◽  
Wake Time ◽  
Adult Day Services ◽  
Time In Bed ◽  
Day Services

Abstract Cortisol is a primary stress hormone associated with sleep. We examined daily cortisol as the potential mechanism linking prior night’s sleep and daily mood among 173 dementia family caregivers (M (SD) age = 61.97 (10.66)) who used adult day services (ADS) at least two days a week. Caregivers self-reported sleep characteristics (bed and wake time, sleep quality, care receiver’s night-time problems) and affect (anxiety, depressive symptoms) across eight consecutive ADS/non-ADS days. Salivary cortisol was collected five times each day. Multilevel mediation analysis suggested that daily cortisol total output (assessed as “area under the curve”) mediated prior nights’ total time in bed and daily anxiety, but only on high-stress (non-ADS) days. Mediation was non-significant on low-stress (ADS) days, and at the between-person level. ADS use is respite from a chronically stressful role. Reducing exposure to stress via respite may protect against harmful processes related to sleep, cortisol reactivity, and daily anxiety.

scholarly journals Caring for a Family Member Living With Dementia When Adult Day Services Close

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 111-111
Author(s):  
Katherine Marx ◽  
Lauren Parker ◽  
Joseph Gaugler ◽  
Holly Dabelko-Schoeny ◽  
Laura Gitlin
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Family Member ◽  
Family Caregivers ◽  
Community Services ◽  
Time Range ◽  
Adult Day Services ◽  
Day Services ◽  
At Home

Abstract Adult Day Service (ADS) centers play an important role in community services that help families keep a person living with dementia (PLWD) at home. We interviewed 33 family caregivers about their experience during the COVID-19 Pandemic and the shutdown of the ADS centers where the PLWD attends. All 33 (100%) reported that the ADS center was shut for a period of time (range: 2 weeks – remain closed). Caregivers reported a decline in their physical health (33%,n=11) and mental health (52%,n=17) and an increase in feelings of loneliness (48%,n=16). For the PLWD, the caregivers noted, a decline in physical (48%,n=16) and mental (55%,n=18) health and an increase in behaviors (39%,n=13). The shutdown of most ADS centers across the country due to the COVID-19 pandemic has had implications not only for the ADS sites but for the families that entrust them with the care for a family member.

scholarly journals Challenges with Pain Treatment for Rural Older Adults: Family Caregivers' Views

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 893-894
Author(s):  
Hyunjin Noh ◽  
Cho Rong Won ◽  
Zainab Suntai
Keyword(s):  
Older Adults ◽  
Health Insurance ◽  
Family Caregivers ◽  
Rural Areas ◽  
Pain Treatment ◽  
Financial Burden ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Thinking Skills ◽  
Rural Older Adults

Abstract Family caregivers face various challenges in assisting older adults experiencing pain and difficult symptoms. Living in rural areas poses additional obstacles to their caregiving. The purpose of this study was to explore family caregivers’ lived experiences in caring for older adults with pain and discomfort in rural communities. A qualitative research design was adopted to capture the common essence of participants’ experiences through a phenomenological method. Purposeful sampling was used, and the participant criteria was: age 18+, have good thinking skills, resident of Alabama, provide unpaid assistance to a family/relative who has chronic/serious health conditions and experienced pain/discomfort in the last 3 months. Ten participants were recruited from rural counties of Alabama. Individual semi-structured interviews were conducted via phone and were recorded and transcribed verbatim. Inductive, thematic analysis of the data revealed themes in five categories: 1) impact of pain (physical and psychological/emotional toll), 2) coping strategies (faith/contentment with life/logistical adaptation), 3) impact of Covid-19 (physical health/social interaction/mental health/added caregiving), 4) challenges in pain treatment (transportation (time/distance/driver/cost) and non-transportation related problems (healthcare provider issues/health insurance/financial burden)), and 5) suggestions (transportation-related (more transportation options/tailored services) and non-transportation-related support (home-based services/better health insurance coverage)). Findings of this study highlight rural family caregivers’ unique experiences in assisting older adults’ access to pain treatment, particularly during the Covid-19 pandemic. Policy- and program-level intervention is called for to increase individualized transportation options, improve health insurance coverage, and expand financial support for rural older adults experiencing pain and their caregivers.

Sign in / Sign up

Export Citation Format

Share Document