Day Programs for Older Adults: Contested Meanings

Abstract

<p>Adult day programs are one of a number of community support services provided in Ontario for older adults who are living in the community. The purpose of this research is to compare the official policy accounts of adult day programs with the accounts of those who experience them directly. <br /> <br /> Using the approach of institutional ethnography developed by Dorothy Smith (1987), the text embodied by the service definition used by Ontario providers of adult day care is compared with data gathered though in-depth interviews with clients, caregivers, a staff member, a volunteer, and a referring agent. This research seeks to deepen understandings of the function and value of these programs within the long-term care sector. Individuals' experiences with day programs (their stories), and their understandings of when day programs are needed by individuals, of how they are structured, and of what relationships are important in this context are explored. <br /> <br /> The policy discourse about the function of day programs - supervised activities, caregiver support and respite, improved functioning, and avoidance of premature or inappropriate institutionalization - was found to be endorsed by participants. However, it emerged that "relational practices" in the delivery of the service did much more, by enhancing participants' identities and giving meaning to the day program experience. <br /><br /> Adult day programs have been relatively little studied and are not well understood within our health care system. In the current context of service restructuring and the longstanding invisibility of social care, such programs are increasingly jeopardized. The importance of the research lies in bringing forward the voices of those who are most involved with this programming. A potential benefit is that this important service may be given more attention within the system. It is hoped that these results will be useful to both program providers and policy makers working in this area of long term care.</p>