“The Sun Came Up Because You Got Here…”: A Qualitative Exploration of Person-Centered Care Strategies Used by Adult Day Care Centers to Manage Behavioral and Psychological Symptoms of Dementia

Abstract

In order to reduce care partner strain and support aging in place for people living with Alzheimer’s Disease and Alzheimer’s Disease Related Dementias (AD/ADRD), adult day centers (ADCs) must manage behavioral and psychological symptoms of dementia (BPSD). The purpose of this paper is to identify person-centered care strategies used by center staff to manage BPSD. Six focus groups with center staff (n = 31) were conducted. Data were analyzed using directed content analysis guided by Kitwood’s conceptual approach to cultivating personhood in dementia care. Themes were identified and organized within Kitwood’s framework. The results demonstrate that staff incorporate evidence-based person-centered approaches to AD/ADRD care that align with Kitwood’s principles of comfort, attachment, inclusion, and identity. Staff individualize their approach to people with AD/ADRD within a group setting. They monitor, engage, socially stimulate, and, when needed, de-stimulate them. Centers are flexible social environments with underrecognized expertise managing BPSD using person-centered approaches.

Temporal Patterns of Behavioral and Psychological Symptoms of Dementia and Caregiver Distress: Associated Daily and Individual Factors

“…An example of temporal patterns of BPSD is commonly referred to as sundown syndrome, an increase in severity and frequency in the late afternoon and evening (Boronat et al, 2019). Understanding how key BPSD symptoms fluctuate as caregiving unfolds throughout the day, specifically whether there are temporal patterns with which the BPSD symptoms present during certain times of day, and how caregivers respond to these varying BPSD occurrences, can have important implications for individualized interventions that take regular fluctuations into account (Boafo et al, 2023). Guided by the stress process model (Pearlin et al, 1990), which highlights the importance of individuals’ subjective perceptions of stressors, emphasizing the distinction between occurrences of stressors and appraisals of the stressors, the current study aims to examine the temporal patterns of BPSD occurrences and caregiver distress appraisals for persons with ADRD living in the community and their family caregivers, and associated factors.…”