Day centres have a positive influence on older people's mental health, social contacts, and quality of life

Orellana K, Manthorpe J, Tinker A. Day centres for older people: A systematically conducted scoping review of literature about their benefits, purposes and how they are perceived Ageing & Society. 2018; 1-32.

Review question

•      What are the benefits, purposes, and perceptions of day centres for older people without dementia?

Background

•      “Day centre” is a generic term that describes building-based services that offer a wide variety of programs and services. In this review, day centres specifically refer to “community building-based services that provide care, health-related services, or activities for older people who are disabled or in need, which people can attend for a whole day or part of a day” (from the review).

•      Day centres have been an integral part of social care in England since 1948, when the government began allowing authorities to contribute financially to organizations that provided recreational facilities for adults with disabilities.

•      Despite some older people expressing a wish to access them, day centres are no longer viewed as a core service and their decommissioning or closure is increasingly common. This is in large part because day centres are viewed as insufficiently attuned to individual needs and wishes.

•      The aim of this systematic review is to examine the benefits, purposes, and perceptions of day centres for older people.

How the review was done

•      Review authors searched 12 interdisciplinary databases in October 2014 for articles suitable for inclusion in this review.

•      Websites, research repositories, and journals were hand searched for additional articles.

•      Literature was included if it concerned older people and day centres, was published after 2000, and explored the role, purpose, or place of day centres for older people.

•      In total, 77 papers were included in this review.

What the researchers found

•      The review found four aims of day centres from the literature: 1) to provide social and preventive services; 2) to support continued independence of attenders; 3) to support attenders’ health and daily living needs; 4) to enable family caregivers to have a break or continue with employment.

•      The literature suggests that social isolation and poor wellbeing are factors that cause older people to utilize day centres. Additional reasons for attending include to improve or maintain health, to alleviate responsibilities of family caregivers, and to introduce structure to their lives after retirement or losing a spouse.

•      Some studies concluded that certain attendees of day centres may experience better outcomes than others. These included people living alone, the functionally or mobility impaired, people with low income, or those who were younger.

•      Day centres are perceived by some attenders as undesirable welfare services for people who are old, isolated, ill or miserable. Other reasons given for non-attendance include: preferring to be at home, lack of interest or need, difficulty seeing other users with dementia or disability, feeling that activities were not of interest or culturally appropriate, and feeling that centres offered insufficient opportunities to contribute by volunteering.

•      Perceptions of day centres were found to be more positive in North America, where they appear to be more engrained in the culture and are more widely recognized and respected.

•      Overall, positive psychosocial outcomes, improved social participation, improved mental health and quality of life, and reduced depression and anxiety are well-documented benefits of day centre attendance.

Conclusion

•      Day centres were found to play a variety of roles for older people and in care systems. Centre attendance and participation positively impacted older people's mental health, social contacts, physical function, and quality of life.

•      Review authors found that day centres for older people without dementia are under-researched. In addition to not being studied as whole services, there are considerable evidence gaps about how day centres are perceived, their outcomes, what they offer.