Enhancing quality of life of families who use adult day services: Short- and long-term effects of the adult day services plus program.

Purpose: This study examined the short- and long-term effects of Adult Day Services Plus (ADS Plus), a low-cost care management intervention designed to enhance family caregiver well-being, increase service utilization, and decrease nursing home placement of impaired older adults enrolled in adult day care.

Design And Methods: We used a quasi-experimental design, to recruit 129 caregivers from three adult day centers. Two centers offered adult day services and ADS Plus (n = 67); the third center (n = 62) offered only routine adult day services. ADS Plus involved a staff social worker who provided care management and support to family caregivers through face-to-face and telephone contact. Education, counseling, and referral services were offered for 12 months.

Results: At 3-month follow-up, ADS Plus participants (n = 106) reported less depression (p =.016), improved confidence managing behaviors (p =.013) and enhanced well-being (p = .001) compared with controls. Long-term effects analyses (n = 69) showed that, compared with controls, ADS Plus participants continued to report less depression (p = .005) and enhanced confidence managing behaviors (p = .007). Also, intervention participants used adult day services on average 37 days more than controls (p = .003) and had fewer nursing home placements (n = 8) than controls (n = 17).

Implications: ADS Plus is cost efficient and is easy to implement within adult day centers. It affords important clinical and public health benefits, including enhanced caregiver well-being, greater adult day service use, and fewer nursing home placements.