Introduction
Broadway Adult Day Care Center is an organization that provides services of all-inclusive care management specifically designed for the requirements of senior individuals, people with disabilities, and those with cognitive and physical impairments. As a staff caregiver at Broadway’s Adult Day Care Center, I am responsible for meeting clients’ needs through personalized assistance and attention, enabling them to enjoy life and maintain their independence. Even though we put all our efforts into support development, the dementia clients that live in our care still have many issues that cannot be addressed with one single intervention. Dementia, a complicated brain condition that features a significant impairment in mental functioning, giving rise to difficulties in daily activities, is a significant challenge both to the clients and to the caregivers. Common symptoms like memory loss, confusion, and communication difficulties can significantly affect an individual’s quality of life and independence. Meanwhile, the chronic nature of dementia requires re-adjustment and novel methods for addressing changing requirements daily. Specialized dementia support is a critical part of the amenities that best match the uncommon issues of dementia clients at the Broadway Adult Day Care Center. While these interventions, such as cognitive stimulation activities, social engagement programs, and personalized care planning, have been implemented, the need for improving and overhauling the existing approach persists. This also means finding creative approaches for the improvement of memory, better quality of life, and reducing caregiver burden for caregivers of Alzheimer’s dementia patients. Given this ongoing challenge, the research question guiding our inquiry is: How do adult daycare centers help dementia clients?
Article Summary
Williams et al.’s 2016 article, “Stress in Persons with Dementia: Benefits of a Memory Center Day Program.”
The purpose of this study was to investigate the impact of a Day Care Program for Adults (ADC) on psychological states such as stress and arousal in individuals with mild or moderate dementia. The unit was made up of Caucasian Americans aged 55 years and above who were members of the ADC program under the supervision of the Louis and Ann Greene Memory & Wellness Center. The experiment sample size was 26 people. We had an intervention that included the participants in the ADC program and assessment at enrollment and one month and three months after enrollment.
The intervention was enrollment at the Louis and Ann Greene Memory and Wellness Center of the ADC program. It had activities tailored for cognitive enhancement, social interaction, and physical exercise. Participants attended a session for a certain period, from morning to afternoon or whole day. The course implementation lasted three months, with the data collected at enrollment, one month, and the end of three months after enrollment.
The methodology was a descriptive longitudinal design measuring the following: stress, anxiety, mood, emotions, and physiological arousal at the three data collection points. This investigation combined quantitative and qualitative components that incorporated self-report measures like the Index of Clinical Stress (ICS) and the Perceived Stress Scale (PSS) in addition to observer rating of severity of anxiety using the Rating for Anxiety in Dementia (RAID). Physiological arousal was measured through blood pressure by determining the systolic and diastolic blood pressure, as well as salivary cortisol levels. The Folstein Mini-Mental State Examination (MMSE) is the tool used to measure the severity of dementia.
The outcomes showed a significant decline in cortisol levels in morning saliva after one and three months of the commencement (p = .047), which was used to indicate decreased physiological arousal. In contrast, however, reading through books did not produce significant variations in blood pressure. Differences in measured scores of the stress of the participants have been highly significant, as evidenced by a decrease in the scores on the Perceived Stress Scale (p = .03) and the Index of Clinical Stress (p = .01) from the period of the participants’ enrollment to three months. The ratings of anxiety from the observer side did not have a difference related to time. Overall, the results imply that the deceased person might be no different in behavior than those in the control group.
The study’s limitations include the relatively small sample size consisting of 26 respondents and the presence of potential confounding variables like drug use and comorbidities that were not considered while conducting the analysis. Additionally, the study did not examine the specific features of the ADC program that may have contributed to stress reduction, nor did it account for potential cultural variations when generating a response to the intervention. First of all, the measure of cortisol levels will be missed during the day if the variation is only in the morning. Moreover, the evening cortisol levels would be influenced by several unspecified factors after the participants had left the ADC program. Future studies should address larger sample sizes, consider other covariates, investigate the role of the family in stress reduction, and analyze the association between stress and behavioral outcomes in individuals with ADC. The investigation can be interpreted as successful in line with the fact that the overall de-stressing results in patients with mild to moderate dementia are confirmed, which, though, requires more research in the future to better understand the mechanisms that underlie these effects.
Takai et al.’s 2013 article, “Family caregiver strategies to encourage older relatives with dementia to use social services.”
This article investigates the tactics applied by the participating Japanese family caregivers to make their elderly relatives with dementia accept the help offered by community support, including adult daycare and respite services. The study participants were caregivers (primary family) of elderly people with dementia living in the community in Japan. The size of the sample being analyzed consisted of 16 caregivers, broken down to 9 women and 7 men. Out of the eight of us, there were 4 who were taking care of a parent, 4 for a spouse, and another 4 for a husband or wife, respectively. The ages of the older adults ranged from 57 to 103 years. On average, they provided care for 5.3 years. The research has failed to address the economic status and especially the division between those residing in urban and rural areas.
The study focused on the different methods family caregivers use to help their eldest relatives with dementia to use adult day care and respite. The study carried out between 2005 and 2007 used a qualitative design and grounded theory. A qualitative approach was employed to know the experiences, processes, and methods that family caregivers used in facilitating service utilization among care recipients.
Data collection was done using a semi-structured interview with the participants. The interviews were guided by a format that provided room for the participants to express themselves and discuss their experience of accessing home-based services like daycare and temporary stays. Through the application of probing questions when required for further understanding, the researcher managed to get to the bottom of the issue with every participant, the duration of which, on average, was 1-2 hours. Transcribed interviews were studied qualitatively through constant comparative analysis to develop themes that exemplified what caregivers did or used to be effective.
The research findings revealed six major patterns of caregiver strategies: support the individual choice of an older adult, motivate the willingness to search for a less harmful service, customize the service to the older adult, leverage emotional persuasive tools, seduce the older adult to use the service, and coerce the older adult to use the service. These strategies were put into practice by the young caregiver facing different situations, such as the need to get some rest, confidence in providing the best care, the willingness to do this despite the circumstances, and the anticipated reaction of the older adult to these assistance methods.
The study is subject to some limitations, such as the risk of sampling bias, since the research was conducted in only one prefecture in Japan, which may not be a good representative of the country’s full cultural variety. Besides, the volunteers were also contacted by Caregivers Services, which might have overlooked Family caregivers who are not connected to any provider. On the other hand, qualitative methods offered some in-depth understanding of caregivers’ experiences and coping mechanisms, but the study lacked any quantitative data or statistical analysis to prove the findings. This consequently greatly limits the extent to which the results can be referenced to be relevant to the Japanese family caregivers of older relatives who are affected by dementia only. The study concludes that caregivers’ strategy has revealed significant impacts on service use. Eventually, the understanding of the issue will be extended to include the findings of those limitations.
Conclusion
While the research findings presented by Williams et al. and Takai et al. have practical applications in dementia care, daycare centers can still use these findings to successfully support dementia clients and their caregivers. While the studies focus on different dimensions—Williams et al. on reducing stress in dementia patients through day programs and Takai et al. on family caregivers’ strategies to increase service uptake—they are both important to the clients of our Broadway Adult Day Care Center. The findings from the Williams et al. study reveal the impact of artificial day programs for dementia clients, including cognitive stimulation, social interaction, and physical exercise, among other elements. This study not only demonstrates its applicability to our clientele but also because dementia patients have their own unique needs that should be addressed with similar interventions and methods in our center. The research findings of Takai et al. reveal the coping strategies shared by family caregivers to boost access to adult day care and respite services by their elderlies with dementia. The strategies of supporting individual choice, customizing services, and involving emotional appeal provide valuable lessons that can be applied to caregiving to serve clients better.
To meet our client’s specific needs, we will implement several changes in our approach at Broadway Adult Day Care Center LLC as we follow these findings. Firstly, we will implement more structured activities that boost cognition, socialization, and physical fitness just like the interventions highlighted in Williams et al.’s study. Also, we will work as a team to get in touch with family caregivers, understand their needs and preferences, and tailor our services by adopting strategies that were put forward in the study done by Takai et al. This change plan has been designed to assist in creating a more caring and interactive setting for dementia clients, hence the overall quality of life and health is enhanced.
References
Takai, Y., Yamamoto-Mitani, N., Okamoto, Y., Fukahori, H., Ko, A., & Tanaka, M. (2013). Family caregiver strategies to encourage older relatives with dementia to use social services. Journal of Advanced Nursing, 69(12), 2675–2685. https://doi.org/10.1111/jan.12155
Williams, C., Tappen, R., Wiese, L., Newman, D., Corbett, M., Pinos, S., … & Murray, B. (2016). Stress in persons with dementia: Benefits of a memory center day program. Archives of psychiatric nursing, 30(5), 531-538.
write