title: Enhancing quality of life of families who use adult day services: Short- and long-term effects of the adult day services plus program.
abstract: OBJECTIVE
  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.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Center for Applied Research on Aging and Health, Thomas Jefferson University, 130 South 9th Street, Suite 513, Philadelphia, PA 19130, USA. laura.gitlin@jefferson.edu
authors.forename: Laura N
authors.initials: LN
authors.lastname: Gitlin
authors.forename: Karen
authors.initials: K
authors.lastname: Reever
authors.forename: Marie P
authors.initials: MP
authors.lastname: Dennis
authors.forename: Esther
authors.initials: E
authors.lastname: Mathieu
authors.forename: Walter W
authors.initials: WW
authors.lastname: Hauck
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003631:Day Care, Medical / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010346:Patient Care Management; D011788:Quality of Life; D013995:Time