Assessing Barriers to Utilization of Adult Day Care Centers in a Rural County

Introduction. Adult Day Care programs provide cognitively or functionally-impaired adults with medical, social, and therapeutic services and offer respite and education to family caregivers. We explored underutilization of Vermont's VNA Adult Day Care centers by comparing demographics, services provided, referrals, transportation constraints, and satisfaction surveys between centers and to national guidelines. Methods. Three different methods were used to collect the data for this project: A survey assessing satisfaction was distributed to clients at each of the three sites of the VNA; A standardized telephone interview was conducted with community referral services; A structured interview was completed with each site director. Results. Clients across all three programs are happy with the quality of activities, improvement in mood, and respite for caregivers. A portion of the clients, especially those at Prim Road, have difficulty arranging transportation. Our survey also shows that clients choose to attend the program based upon recommendations by family, friends, and healthcare providers. Referrers perceive the three VNA sites differently in the activities and opportunities for socialization provided. Discussion. A national study by the Robert Wood Johnson foundation, Partners in Caregiving, determined that adult day programs in Chittenden County appear to be in excess capacity of the population. Despite satisfaction of the program, all three adult day centers are not operating at capacity. This appears to be due to several factors including transportation complications and referrer perceptions. Recommendations include extending hours of operation; marketing centers more aggressively; and shifting client population to take advantage of existing public transportation.