Daycare for elderly people in Sweden: a national survey

Older people's experiences of visiting social day centres: The importance of doing and being for health and well-being

BACKGROUND

Social day centres can support active and healthy ageing amongst older people. However, little is known regarding the importance of social day centres.

AIMS/OBJECTIVES

The aim of this study was to explore how older people visiting social day centres perceive the day centres' social influence on their health and well-being.

MATERIAL AND METHODS

Twenty older persons attending social day centres on a regular basis were interviewed regarding activities at the day centre and their importance for active and healthy ageing. The data were analysed using qualitative content analysis.

RESULTS

The social day centres were described as arenas to provide a structure (and something to do) in the visitor's everyday life. By attending a day centre, the participants created a social context with other visitors. Staff acted as facilitators for visitors, helping them to interact with other visitors and to experience the feeling of being needed by others.

CONCLUSIONS

The findings suggest that social day centres are important arenas for creating a sense of context and belongingness amongst older people.

SIGNIFICANCE

This study provides knowledge on how doing and being contribute to healthy and active ageing.

Access to Community Living Infrastructure and Its Impact on the Establishment of Community-Based Day Care Centres for Seniors in Rural China

Community-based day care centres play an important role in service delivery for Chinese seniors. Little research has examined how community living infrastructure has influenced the establishment of these day care centres in rural communities. The purposes of this study were: (1) explore regional differences in community living infrastructure; and (2) to examine the impact of such infrastructure on the establishment of day care centres for Chinese seniors in rural communities. The data were derived from “The Fourth Sample Survey on the Living Conditions of Elderly People in Urban and Rural China (2015)”. The establishment of at least one day care centre was the outcome of interest, which was dichotomized at the community level into the establishment of at least one day care centre or the absence of any day care centres. Logistic regression analysis was employed to examine the impact of various community living infrastructural characteristics on the establishment of day care centres. The results showed that of the 4522 rural communities surveyed in 2015, only 10.1% had established at least one day care centre. Community living infrastructural characteristics that were significantly associated with the establishment of day care centres were the availability of cement/asphalt roads, natural gas, tap drinking water, sewage systems, and centralized garbage disposal. Our findings suggest that the significant association between community-level characteristics, especially community living infrastructure, and the establishment of rural day care centre for seniors may inform policy decision making.

Day care for persons with dementia

Day care, as a type of care in between residential care and home help, has been available for several years, and is often referred to as an adequate alternative form of care for people with dementia. The goals of Swedish day care are to create a meaningful day for participants, offer family caregivers respite, and provide care for persons with dementia. The aim of this Swedish study was to describe day care clients with dementia problems over a 12-month period, and to discuss what distinguished those who discontinued day care from those who stayed with it. Of the clients, 76 percent were diagnosed by a doctor as having dementia between level one and four out of a total of six levels, according to the Berger rating scale of severity of senility. The results showed that one third of the people with dementia discontinued within four months. Another third dropped out within 12 months. People with behavioral problems and those who needed assistance with dressing and toileting discontinued earliest. All caregivers found some benefit of day care for their relatives and for themselves, with the exception of some caregivers of those who ended within four months. Most of the clients who lived alone at the start of day care, and ended within 12 months, went to a nursing home. Two differing conclusions may be drawn from the findings: (1) that offering day care services to persons with dementia who also show signs of behavioral problems is questionable; or (2) that the planning of day care in Sweden should be adjusted to also meet the needs of persons with behavioral problems, such as depression. In its current form, day care in Sweden seems only partially to fulfil its goals.

Changes in everyday life after discharge from day care rehabilitation

Community-based day care that provides rehabilitation (DCR) targets elderly people with physical disabilities. The goal of these programmes is mainly to improve physical ability in order to enable participants to remain in their ordinary homes. Knowledge of the outcomes of DCR is limited as well as knowledge of what it is that makes a difference for the individual. The aim of this study was to describe what changes in everyday life elderly persons experienced after discharge from a community-based day care rehabilitation centre and to give possible explanations for these changes. Fifteen elderly people were interviewed after that they had been discharged from DCR. A narrative approach was used for analysing the interview data. Four case stories constitute the findings, each of them with unique descriptions of changes in everyday life as well as possible explanations for these changes. The first case story described resumption of daily activities that made the days more eventful and meaningful. The second described how everyday life became an arena for exercising, which create confidence for the future. The third described how an increased sense of certainty and security in the movements led to an increased appetite for life. Finally, the fourth case story described both the stay at the DCR centre and the promise of a new period there as uplifting that made the days easier. Concerning possible explanations for these changes, the findings indicate that it was a combination of several events that together contributed to the changes. Examples were physical training, counselling about how to live in an active and healthy lifestyle, and socialisation with other patients in formal as well as in informal sessions.

Elderly persons' expectations of day-care rehabilitation

The aim of this study was to explore elderly persons' conceptions of what they expected to gain from attending day-care rehabilitation centres (DCR). A purposeful sampling procedure was employed. Interviews with 22 prospective elderly day-care patients were carried out and analysed according to a phenomenographic approach. The analysis yielded eight categories. Two categories, Social contact and Exercise, described what the elderly persons expected to encounter. The remaining categories, A change from the monotony of everyday life, An opportunity to be yourself, A balm for the body, A safety net, A mastery of everyday activities, and An energizing spark, described the meanings of the encounters. Two categories were attributed to the elderly persons' physical presence at the centre and the gains were expected to end when the programme ended. In three categories the expected improvements were projected into the future and were expected to last. The findings imply that follow-up home visits and suggestions for alternative social activities in order to provide stimulation and social equality would be a valuable complement to the DCR programme. Rehabilitation personnel need to consider the ambivalent view on assistive devices as well as the elderly person's need for continuity when setting goals and planning individual programmes.

Does day care also provide care for the caregiver?

People caring for relatives with dementia may need respite to be able to cope and maintain some quality of life. With the aim to investigate whether day care is an effective form of respite for caregivers of dementia sufferers, 115 new day care clients were invited and 90 caregivers agreed to participate. Of these, 51 fulfilled the inclusion criteria and were asked to assess feelings of worry, depression, overload and role captivity before using day care and again 4 months later. The study group comprised both co-residing (CR) and non-co-residing (NCR) caregivers and care recipients. Those NCR caregivers whose elderly relative dropped out of day care had significantly higher values for worry, overload and role captivity, and a higher level of depression than the caregivers in the NCR group whose care recipient continued day care. Although this study is of an explorative character, some conclusions may be drawn from it. Dementia sufferers seem to need an informal caregiver to help them when they are not at day care. Day care is probably a form of support most suitable for caregivers, who are looking after relatives in the early stages of the illness and are not yet too exhausted.

Elderly participants of social and rehabilitative day centres

As it develops, an ageing society has increased need of services that can promote the health and well-being of the elderly. Community-based day programmes are one kind of service intended to support elderly people with restricted function in their daily lives. There are several different forms of day programmes for the elderly in Sweden, but guidelines are vague about their aim and implementation and little is known about the persons using them. The aim of this study was to identify characteristics of the elderly people living in their own home who participated in social day centres in comparison with participants who attended a rehabilitative day centre. The focus was on perceived functioning and competence in daily life. Twelve social day centre participants and 12 rehabilitative day centre participants answered two questionnaires, the sickness impact profile (SIP) and occupational self-assessment (OSA). The results show that the majority of participants from both centres were elderly persons living alone who experienced severely restricted physical function. This demonstrates that the day centres serve the needs of a specific group of elderly people, namely, those with highly restricted functioning living on their own. A significant difference between the groups was that those who attended the social day centre perceived better psychosocial function than the group attending the rehabilitative centre. The fact that the social centre group had better psychosocial function than the other group, but yet had severely restricted physical function indicates that it is preferably the psychosocial well-being of elderly persons with restricted functioning that is possible to influence. This result implies that these centres serve as an important meeting place for elderly persons who would otherwise be isolated in their homes because of their physical restrictions. To fulfil this challenge, the day centres might need to accommodate a wider range of persons with restricted functioning.