Comparison of Adult Day Services in Atlantic Canada, Maine, and Vermont

Abstract

Comparisons of aging services in Canada and the United States reveal similarities and differences in the structure and function of the two systems. In both countries, adult day services (ADS) is an integral component in the array of services available to older adults. In this study, I compared structural characteristics of programs, participant characteristics, and examined the National Adult Day Services Association classification model of ADS in demographically similar areas of Canada and the United States. Directors of 47 ADS programs in demographically similar provinces and states in Atlantic Canada, Maine, and Vermont responded to a mailed survey. Adult day services programs in each province and state exhibited some unique structural and participant characteristics. Statistically significant differences emerged between ADS programs in the two countries on the following structural variables: town population, center affiliation, center location, levels of government support, participant fees, organizational structure, hours of operation, months of attendance, hours attended per day, service frequency, and service provision. Participant characteristics that significantly varied between the two countries involved educational level and functional characteristics. A minority of programs exhibited a match between participant needs and services provided. However, very few programs belonged to the most mismatched category of providing core services to intensive level participants. The findings of this study support the importance of individual programs providing services appropriate to meet the needs of participants rather than adhering to a predetermined model of care.iii Acknowledgements

‘I shall miss the company’: participants’ reflections on time-limited day centre programming

“…Criticisms of day centres are rife in the literature, with their being described as being poorly co-ordinated and unprofessional (Nies et al, 1991;Reilly et al, 2006), segregating (PricewatershouseCoopers, 2007;Karpf, 2014), inaccessible (Clark, 2001;McLeod et al, 2008), paternalistic (Roulstone and Morgan, 2009;Duffy, 2010;Age UK, 2011), infantilising (Ritchie, 2003;Tse and Howie, 2005), unstimulating (Manthorpe and Moriarty, 2014) and undesirable (Weeks and Roberto, 2002;Heenan, 2006). Older people are conscious of these concerns and have reported hesitation about attending, though often feel happy with the service and how they are treated after a few visits (Powell et al, 2000;Ritchie, 2003;Lund and Engelsrud, 2008;Caiels et al, 2010).…”