title: Standards of care in day hospitals and day centres: a comparison of services for older people with dementia.
abstract: BACKGROUND
  Current policy in England emphasises the importance of caring for highly dependent older people for as long as possible at home. It is therefore crucial that day care services are effective and widely available.
  
  
  OBJECTIVE
  To compare the type and standard of care provided for older people with dementia in day centre and day hospital settings.
  
  
  METHODS
  A cross-sectional postal survey design was employed. Representatives from three-quarters of identified specialist day care services for older people with dementia in the North West of England provided information on a range of indicators including: basic structural features; delivery of care; service content; and quality measures.
  
  
  RESULTS
  Day hospitals tended to have more day care places and a greater number of attendees, but lower occupancy rates than day centres. Day hospitals reported higher standards of care in relation to systematic assessment and care planning, promotion of rehabilitation, carer involvement and individualised provision of care. They were also more likely to employ building design features to encourage independence and choice for people with dementia. A higher proportion of day centres provided services exclusively to older people with dementia and a greater proportion of staff in day centres had undergone specific training in caring for people with dementia. Day centres were also more likely to have effective transport arrangements in place.
  
  
  CONCLUSIONS
  The standards developed for the study were sufficiently reliable to allow for an acceptable estimate of quality. Day centres and day hospitals appeared to perform two distinct, but complementary functions. These results provide key material for shaping the provision of day care for older people with dementia, especially given the absence of national standards in this area.
authors: Personal Social Services Research Unit, Faculty of Medical and Human Sciences, The University of Manchester, Manchester, UK. siobhan.reilly@man.ac.uk
authors: Siobhan
authors: S
authors: Reilly
authors: Dan
authors: D
authors: Venables
authors: Jane
authors: J
authors: Hughes
authors: David
authors: D
authors: Challis
authors: Michele
authors: M
authors: Abendstern