Effectiveness of Adult Day Care Programs on Health Outcomes of Thai Family Caregivers of Persons with Dementia

Abstract

Adult day care (ADC) is recognized as a supportive intervention for persons with dementia (PWD) and family caregivers during the day time. The primary aim of this study was to evaluate the effect of the Thai ADC programs for PWD on caregiver outcomes (burden, depression, health status, social support, and quality of life) between baseline and after using ADC for one and three months. The second aim of the study was to explore the caregivers' experiences of how ADC has helped the PWD and family caregivers and how their life has changed. An exploratory prospective study with a single group repeated-measures design and two main open-ended questions was employed. Sixteen caregivers were recruited from two ADC sites including Somdet Chaophaya Institute of Psychiatry and Chiangmai Neurological Hospital. Caregiver outcomes were measured with the Zarit Burden Interview (ZBI), the Center for Epidemiologic Studies-Depression Scale (CES-D), the Short form 12-item health survey (SF-12v2), the Sarason's Social Support Questionnaire (SSQ-6), and the WHO QOL-BREF-THAI. The General Personal Data Survey and the Caregiver Evaluation of ADC (CEADC) were included. Each participant was interviewed for approximately 45-60 minutes after using ADC for 3 months. The results of the repeated measures ANOVA showed that only mean physical component scores (PCS) of the SF-12v2 and mean physical domain scores on the WHO QOL-BREF-THAI were significantly higher than baseline after using ADC for one and three months. Interviews with sixteen participants were audio-recorded, transcribed verbatim in Thai, and back-translated. Seven main categories that emerged from content analysis of the interview data included: "Requiring medical care for persons with dementia", "Challenges for family caregivers", "Seeking help, access to ADC", "Expectations for ADC", "Perception of benefits and effects of ADC", and "ADC in the future." ADC improved caregiver-reported health after using ADC. This study verified the use of Smith's Model of Caregiving Effectiveness in dementia care including efficient use of ADC as an external resource for caregivers. The findings of this study should be interpreted with caution due to the limitations of the study.