Adult Day Care Centers Research Articles

Resistência aeróbia e força de membros inferiores de idosos praticantes e não-praticantes de ginástica recreativa em um centro de convivência

OBJETIVO: Analisar a resistência aeróbia e força de membros inferiores de idosos praticantes e não-praticantes de um programa de ginástica recreativa em um centro de convivência. MÉTODOS: Fizeram parte do estudo 54 voluntários - 26 não-praticantes (71,2 ± 6 anos e 26 ± 4,7 kg/m²) e 28 praticantes de ginástica recreativa (68,6 ± 7,7 anos e 27,5 ± 4,5 kg/m²). Todos foram submetidos ao teste de sentar-levantar da cadeira em 30 segundos (avaliação da força de membros inferiores) e teste de caminhada de seis minutos (avaliação da resistência aeróbia). RESULTADOS: O grupo participante do programa de ginástica obteve melhor média tanto no teste de sentar-levantar da cadeira em 30 segundos (16,1 ± 2,8 vs. 12,1 ± 2,7 execuções - p < 0,001), quanto no teste de caminhada de seis minutos (439,2 ± 46,1 vs. 373,1 ± 58,5 metros - p < 0,001). CONCLUSÃO: De acordo com os resultados obtidos, é possível concluir que os idosos participantes do programa de ginástica recreativa do centro de convivência analisado apresentaram melhores indicadores de resistência aeróbia e força de membros inferiores, sugerindo melhor nível de capacidade funcional em relação aos não-participantes.

Reliability of 4-m and 6-m walking speed tests in elderly people with cognitive impairment

The purpose of this study was to evaluate the interrater and test–retest reliability of 4-m and 6-m walking speed tests in elderly people with cognitive impairment. 50 subjects aged 65 and over with cognitive impairment were selected from an adult day-care centre and a nursing home. To examine interrater reliability, 21 people were evaluated independently by two researchers who administered the 4-m and 6-m walking tests in each evaluation. For test–retest reliability, two observers administered the tests to the same 29 subjects, with a time interval of one week. Intraclass correlation coefficients (ICCs) were calculated to examine interrater and test–retest reliability. The ICCs for interrater reliability reached values of 0.96 and 0.88 for the 4-m and 6-m walking tests, respectively. In the test–retest study, the time interval was 7.4 ± 1.17 days. The ICCs were 0.91 for the 4-m test and 0.86 for the 6-m test. The results support the use of walking tests in elderly people with cognitive impairment.

Prevalence of fractures in women with intellectual disabilities: a chart review

Numerous studies have demonstrated high rates of osteoporosis and fractures in women with intellectual disabilities (IDs). All of the studies use either institutionalized women or women in the community recruited at adult day-care centres or specialty clinics. We examined the prevalence of fractures in women with IDs who attend a primary care clinic, and assessed osteoporosis-prevention/intervention activities. This was a chart review study. Charts were identified of women with an ICD-9 diagnosis code for ID, Down syndrome or developmental disabilities. All charts reviewed were patients of one of 13 family medicine clinics affiliated with Department of Family Medicine, the University of Wisconsin. A total of 93 charts were reviewed. More than 32% (30/93) of the charts contained a history of an adult-onset fracture. Increasing age, being postmenopausal and taking anticonvulsant medications were significantly associated with having a fracture. The average age of first fracture was 41.7 years. Of the women with a fracture, 35.5% were placed on a medication to maintain bone density, 67.7% received a recommendation for a calcium supplement, and 38.7% obtained a bone density test. The prevalence of fractures in women with IDs attending a family medicine clinic was very high, and fractures occurred at young ages. Primary care providers need to consider women with IDs at a high risk for fractures and begin preventive counselling in young women.

Las Comadres and adult day care centers: The perceived impact of socialization on mental wellness

Using a semi-structured interview format, this study examined the narratives of 24 Mexican-American, elderly impoverished women in order to gain their perception of the effects of adult day care centers (ADCs) on their mental and physical wellness. Some of the emergent themes and categories included 1) popular activities, crafts, dances, prayers and services, 2) depression, isolation and boredom 3) family stress, children living far away, history of verbal and physical abuse, 4) reliance on other comadres, and 5) perceived positive affect of ADCs and socialization on health, easing of depression, and relying on other comadres. Pearlin's Stress Process Model [Pearlin, L. I. 1999. “The Stress Process Revisited: Reflections on Concepts and their Interrelationships”. Pp. 395–415 in Handbook of the Sociology of Mental Health, edited by C. S. Aneshensel and J. C. Phelan. New York: Kluwer Academic/Plenum Publishers.] provides explanations for the buffering effects of socialization and activities that ADCs provide. Data suggests that ADC activities buffer stress related to growing old and play an important role in alleviating depression.

Family Caregivers of Impoverished Mexican American Elderly Women: The Perceived Impact of Adult Day Care Centers

Using an interview format, this exploratory study examined the narratives of 15 Mexican American primary caretakers and the perceived effects of adult day care centers (ADCs) on the lives of their elderly impoverished parents. Emergent themes and categories included (a) caretaking and gender differences, (b) resistance to nursing homes, (c) negative perceptions of White caregivers, (d) perceived positive effect of ADCs on the elderly parent's physical and emotional (depression) states and the elderly parent-caregiver relationship, and (d) the negative effects of stress associated with caregiving. The data also provide insight into complicated dynamics regarding the differential treatment of daughters and sons in Mexican American families. Pearlin's stress process model provides explanations for the buffering effects of ADCs reported by caregivers.

Refractive errors and visual impairment in 900 adults with intellectual disabilities in the Netherlands.

To collect data on refractive errors and visual impairment in adults with an intellectual disability (ID) in the Netherlands. A randomized sample of 2100 participants was drawn from a base population of 9000 adults with intellectual disabilities in the Netherlands. This article reports on the first 900 participants. All participants underwent a protocol-based on-site ophthalmological assessment carried out by skilled investigators. Co-operation was classified according to the number of tests that could be carried out reliably and was good or excellent in 80% of subjects, average in 13% and poor in 7%. Refraction could be reliably assessed in 505/900 (56%) subjects. There was an increased risk of visual impairment in all subgroups compared to the general Dutch population. Visual acuity (VA) was related to the level of ID, but refractive errors were not. New spectacles were prescribed in 106 cases (12%). Of 374 people in whom both monocular VA and the refractive error of the right eye could be reliably assessed, 153 (41%) had a pretest prescription, 16 (10%) of which we found to be inadequate. Of the 221 participants without a pretest prescription, 41 (19%) benefited from correction. Only 38/84 (45%) subjects aged 50 years or older, who could benefit from correction for near vision, had near spectacles. New correction increased the mean distant VA significantly from 0.44 to 0.65 (p < 0.0005). With some adaptations, visual screening is feasible in a majority of adults with ID. Visual impairment and refractive errors are much more prevalent in adults with ID than in the normal population. Accurate spectacle correction resulted in significant improvement in distant VA.

Montessori Improved Cognitive Domains in Adults with Alzheimer's Disease

Montessori materials were used in two adult day-care centers to slow cognitive decline in adults with Alzheimer's disease. Using a within-subject design, participants in one adult day care received three months of the Montessori materials, then standard intervention later. Participants were administered a battery of cognitive measures at baseline, three months, and six months. Favorable scores for the Montessori condition were significant with the subscales of the Ordinal Scale of Psychological Development-Modified (total, object permanence, means-ends), Dementia Rating Scale (total, attention, concept, memory), Parachek Geriatric Behavior Rating Scale (social behavior), and the Wechsler Memory Scale (digit forward). Montessori materials appeared instrumental in positively influencing basic cognitive abilities of attention, object permanence, and social behavior.

National survey of hospital-based pharmacokinetic services.

The status of pharmacokinetic services in the nation's hospitals was studied. A questionnaire was mailed in February 1995 to all 252 respondents to ASHP's 1994 national survey of hospital-based pharmaceutical services who indicated the provision of pharmacokinetic services in their institution. Ninety-eight completed questionnaires were returned (40.2% response rate). The pharmacokinetic services provided required an average of 19.1 person-hours per week, tended to be provided by staff pharmacists, were managed by the pharmacy department, tended to be most focused on aminoglycosides and vancomycin, required an average of 60 notes in patient charts per month, and relied on both computers and calculators for deriving values. There was little contact with patients during the consultation process. Drug concentration measurements tended to be scheduled by service providers, but confidence in the accuracy of the timing of dose administration and blood sampling was limited. Respondents believed that the services tended to be supported by other hospital personnel and that they were successful. There was very little expectation that the workload for providing pharmacokinetic services would increase in the near future. A national survey of hospital-based pharmacokinetic services showed that it took 19 hours per week on average to provide the services, that the focus was on aminoglycosides and vancomycin, and that the services were perceived to be supported by other departments.

Agitation among elderly persons at adult day-care centers: the experiences of relatives and staff members.

Two hundred participants (mean age = 80 years) from five senior day-care centers were included in a study of agitation. Staff members at the centers and participants' relatives rated the frequency with which participants displayed agitated behaviors, via an expanded version of the Cohen-Mansfield Agitation Inventory. The most frequent behaviors noted were general restlessness, repetitious sentences, verbal interruptions, and pacing. A three-factor solution for staff members' ratings included (a) physically nonaggressive behaviors, including general restlessness and pacing; (b) verbally agitated behaviors, including complaining and constant requests for attention; and (c) aggressive verbal behaviors, including cursing and temper outbursts. A three-factor solution for relatives' ratings included (a) physically nonaggressive behaviors, including general restlessness and pacing; (b) verbally agitated behaviors, including constant requests for attention and related interruptions; and (c) aggressive behaviors, including cursing, grabbing, kicking, and pushing. The syndromes of both models showed similarity to the factors found in a nursing home population, although differences were also apparent.

A medicare adult day care model: proposed criteria and available supply.

The study on which this article is based addressed the issue of the proportion of adult day care centers (ADCs) existing in 1986 that would qualify for Medicare funding under the 1989 U.S. Senate Medicare Adult Day Care Amendments. It also estimated the impact of the criteria on two policy-relevant subgroups of ADCs-that is, Alzheimer's vs. non-Alzheimer's and rural vs. urban-using data from a 1986 national census survey of ADCs. The five proposed Medicare criteria and the percentage of ADCs meeting them were: services to be provided directly, 14.6%; multi-disciplinary team, 20%; services to be provided directly or indirectly, 16%; program activities, 42%; and other, 53%. Only 3% met all five criteria while 13% met four out of five. Alzheimer's centers met the criteria more often than non-Alzheimer's centers, while urban centers qualified more often than rural centers. Based on the findings, implications for Medicare funding policy are discussed.

ROM Dance Program Effects on Frail Elderly Women in an Adult Day-Care Center

ROM Dance Program Effects on Frail Elderly Women in an Adult Day-Care Center

ROM Dance Program Effects on Frail Elderly Women in an Adult Day-Care Center

The purpose of this study was to determine if the Range of Motion (ROM) Dance Program, created by Harlowe and Yu (1984), when used as part of an occupational therapy treatment program, has an effect on chronically ill elderly patients' ROM, self-esteem, and participation in activities of daily living (ADL). Seventeen frail, elderly female individuals participated in this four-week study as either an experimental or control group member. Participants' age ranged from 64 to 85 and all had various impairments or conditions associated with aging. This research study compared the participant's pre-program scores to their post-program scores on ROM, self esteem, and ADL's participation. Analysis of the pre-program and initial post-program mean score variances failed to reveal any significant differences between experimental and control groups, in the ADL, self-esteem, or ROM variables. In addition, evaluation of one-month follow-up mean score variances also were not significantly different. These results appear...

The meaning of activity: day care for persons with Alzheimer disease.

The purpose of this study was to gain understanding of the meaning of the daily routines and activities at a day-care center for persons with Alzheimer disease, as experienced by the staff. With the use of the qualitative research techniques of participant observation and ethnographic interviewing, data were collected for 4 weeks at a small adult day-care center for persons with mid- to late-stage Alzheimer disease or related disorders. Analysis of the data revealed that the foremost guiding principle for all activities during the day was prevention, that is, to prevent participant behavior that would be harmful to self or to others. Secondary to this overarching guideline, other characteristics of a "good day" versus a "rough day" were also identified. The findings are discussed as they relate to activity program planning and to sources of staff satisfaction in the care of persons with Alzheimer disease.

Attitudes of Decision Makers Toward Adult Day Care

There is a growing body of literature on adult day care, but there appear to be no studies of those who make decisions about older adults'participation. This article begins to fill this gap. The results suggest several directions for entrepreneurs and local planners. Adult day-care centers need to advertise extensively to children of older adults, their special friends, and older adults themselves. Large centers in central locations would probably not be as successful as small programs, perhaps in churches catering to a local homogeneous clientele. Centers arranged for the convenience of the decision makers, providing care during nonworking hours and transportation, would probably flourish. The data consist of 1985-1986 telephone interviews with 247 current and potential decision makers who lived in Greensboro, N.C.