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Correspondence: Address correspondence to Laura N. Gitlin, PhD, Center for Applied Research on Aging and Health, Thomas Jefferson University, 130 South 9th Street, Suite 513, Philadelphia, PA 19130. E-mail: laura.gitlin{at}jefferson.edu
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.
Key Words: Care management • Caregiver burden • Depression
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