The impact of adult day programs on family caregivers of elderly relatives

Author(s): Warren, S., Kerr, J.R., Smith, D., and Schalm, C.

Published In: J Community Health Nurs; 20(4): 209-21

Study Aim/Purpose: This study, part of a broader evaluation of 14 adult day programs in Alberta, Canada, sought to measure the impact of the programs on the caregivers of elderly relatives and the degree of caregiver satisfaction with the program. 

Summary of Methods: A time series research design was used with caregivers of adult day program participants interviewed in their own homes at four time points: just prior to client admission, 2 weeks, 2 months, and 6 months after admission. The following outcomes were assessed through a primarily quantitative survey instrument: 1) caregiving burden (measured by the Caregiver Burden Inventory), 2) quality of life (measured by the Self-Anchoring Striving Scale), 3) perceived health (measured by asking for a subjective report of current health on a continuum from 1 (excellent) to 6 (poor), and 4) opinion on institutionalization (measured using a single question with Likert scale response options). Their satisfaction with the day program was measured at the 3 time points after client admission (measured using the Day Program Satisfaction Scale, developed by the researchers). A total of 61 caregivers completed the first measurement, 110 completed the second, 91 completed the third and 80 completed the final measurement. 

Summary of Results: “Caregiver status on burden, quality of life, and perceived health status remained stable over time. In addition, caregivers’ opinions on institutionalization remained negative and satisfaction with the programs high. Caregivers reported that client socializing and improved health were what they liked best about the program, followed by respite for themselves. Time conflicts/limits and transportation were identified as problems.” 

Study Limitations (as cited by authors): The authors note the lack of a control group in the study as limiting its generalizability, though they suggest that the baseline measure taken before admission serves as a form of control. They also suggest that “it is possible that some of the tools used to measure family caregiver outcomes were not sensitive enough to detect improvements over time.” They also note that the low moderate burden scores, moderate quality of life scores and good health scores of caregivers at baseline may not have allowed for room for improvements sufficient to detect significantly. 

Authors’ Discussion/Conclusions: With regard to future research, the authors suggest studies of the impact of adult day programs on client-caregiver relationships, opportunities to interact with other caregivers, and relationships with health professionals.