Comparative Study of Outcomes for Older People with Long Term Conditions Attending Day Care Services Delivered by Paid Staff or by Volunteers

Background Day care services can support older people living with multiple long term conditions (LTCs), to age in place, but little research on outcomes of Day Care attendance. Aims The aims of this comparative study were to determine outcomes for older people with LTCs attending day care services run entirely by paid staff or predominantly volunteers Methods Newly referred older people with LTCs to nine day care services in North West of England and North Wales were invited to participate in this longitudinal study with data being collected at baseline attendance and at 6 and 12 weeks. Demographic information was collected and the EQ-5D-3L and De Jong Loneliness 6 item questionnaire were completed at each time point.RESULTS 94 older people (64% female),age range 65 - 99 years (mean 82 years) were recruited. The mean number of LTCs was 4.3 (range 2-9) and 52% people lived alone. More than a third (36%) lived in one of the 20% most deprived local authorities in England and Wales. The outcomes in this exploratory study over 12 weeks appeared to be similar for paid, blended (paid staff and volunteers) and for volunteer led service, with those attending volunteer led services were significantly more likely to report fewer health problems in follow-up (OR=3.45, 95% CI 1.01-12.8, P=0.04). CONCLUSIONS This study suggests that Day Care Services for older people with long term conditions provide benefits in terms of self-rated physical and emotional well-being. Older people attending paid staff services were more likely to have greater number of LTCs associated with a higher symptom burden. However, at baseline there was no difference in self-reported health by service type. This study suggests that Day Care Services provided by volunteers can provide comparable outcomes. Following the Covid-19 pandemic, it is increasingly urgent to support older people with long term conditions who have lost physical and cognitive function during lockdown and to maintain and improve their function. Our study suggests that volunteers may be able to complement the care provided by paid staff freeing up resources and enabling increasing numbers of people to be supported.