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Medical and Social Adult Day Service Programs

A Comparison of Characteristics, Dementia Clients, and their Family Caregivers

University of Michigan, sleitsch{at}umich.edu

Steven H. Zarit

The Pennsylvania State University

Aloen Townsend

Mandel Alzheimer’s Disease Caregiving Institute, Case Western Reserve University

Rickey Greene

Administration on Aging

This investigation evaluates the differences between medical and social adult day service models (ADS) on three levels: the program level, the client level, and the care-giver level. Two hundred sixty-one older adults with dementia and their family care-givers participated in the investigation, representing 36 ADS programs in New Jersey. The few model differences found in program characteristics were primarily in the area of services offered, with medical programs offering more physician care, personal care, and care planning services. Family caregivers rated social programs to be more home-like, to have less institutional elements, and to have increased quality of interaction between staff and clients. Throughout a three-month period, there were no significant differences in levels of caregivers’ stress or well-being or care recipients’ impairment between the models. Caregivers using medical ADS models experienced greater financial strain over the cost of ADS. This study failed to confirm claims of differential advantages by proponents of each model and instead found evidence to suggest that the demands of caring for someone with dementia result in a convergence of approaches on the dimensions investigated.

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