Treat Adult Day Care Clients Like Grown-ups, Not Kids, Researcher Says
Adult day care centers that treat clients like children -- and provide little autonomy or privacy -- are more likely to have clients who are withdrawn from their peers than those centers that have a more age-appropriate setting and activities, according to researchers at the University of Utah.
Sonia Miner, an assistant professor in the Department of Family and Consumer Studies, co-authored the study, "Social and Environmental Infantilitzation of Aged Persons: Observations in Two Adult Day Care Centers," with FCS graduate student Melinda Rich. Their findings will appear in an upcoming issue of the International Journal of Aging and Human Development.
Adult day care is a rapidly growing, community based, long-term care option that has become more widespread in the past two decades, Miner writes. The centers can provide a safe, structured atmosphere for clients, and can provide a respite for care givers.
Miner, a gerontologist, examined the social interaction patterns of the elderly in two adult day care centers. But she also wanted to observe the environments of the centers with regard to their age-appropriate surroundings, activities, staff behaviors and privacy issues.
"I went in to observe how the clients made friends and interacted with each other in an adult day care setting," Miner says. "But when I got there, I noticed how the environment of the centers themselves could be infantilizing. Not only did the clients feel like they were in a child-like setting, but I found that the staff seem to treat them that way because of the environment."
Infantilization includes encouraging participation in child-like activities, use of pet names, and directing child-like remarks, gestures, and patterns of speaking toward older persons, including high-pitched intonation, exaggerated or drawn-out phrasing, and simple content and vocabulary.
The U. research added to that definition by including physical environment as another potential agent of infantilization. The researchers suggested that if elderly persons are expected to interact in a setting that is not age-appropriate, their social interaction patterns may suffer.
Miner and Rich observed approximately 72 clients in two adult day cares. Both centers are considered "social day care centers" that provide outlets for mental and physical stimulation through the use of therapeutic and recreational activities. They are meant to serve older people who do not have severe disabilities.
The researchers separated infantilization into three components for each center: speech/behavior, activities, and physical environment.
Speech/behavior
The first center, Center A, tended to have a great deal of infantilizing speech directed toward clients. Examples of staff labels addressed to clients include "good girl!", "kiddo," "sweetie," and "young lady." Several staff also exhibited a public disclosure of client conditions to the researchers, often in front of the clients. "This not only infantilized the older person, but also decreased the client's ability to regulate their own privacy," Miner wrote.
At the second center, Center B, staff and volunteers tended to address the older persons with adult language patterns. "One behavior that did treat the older clients as children was the excessive use of hugging and kissing between staff and clients," Miner wrote. However, "in the majority of cases, clients in Center B were given most of the responsibilities and autonomy that is normally expected of adults." Activities
Forty-seven activities were observed in Center A and infantilization in some form occurred in 74 percent of the activities. The center tended to encourage clients to participate in activities that could be considered inappropriate for their age group, including a hypothetical picnic, playing with a Smurf dart board, and child-like dances and games. "Typically, the aides would aim activity levels to the lowest cognitive functioning client, rather than the highest, or a middle range," Miner wrote.
Activities at Center B included walks on or off the grounds, newspaper reading, music therapy, speakers from the community, professional visits and sports. Fifty-nine formal activities were observed and 24 percent showed some sort of infantilization. Clients were free to pursue independent activities, and had a large degree of autonomy.
Physical environment
Center A was located in a former elementary school building. Much of the design resembled a classroom setting, including chalk boards, bulletin boards, non-private toilet stalls and uncomfortable seating arrangements.
Center B was in a building that had more of a "country club" environment, with a "living room," fireplace, dining area, kitchen, private bathrooms and access to a courtyard.
Taking all of the observations into consideration, the researchers found "that in Center A (a more infantilized setting) the clients tended to be withdrawn, asleep, non-communicative and only spoke when they were spoken to by a staff member," Miner wrote. In contrast, "Center B clients formed close friendships with other clients, participated independently of the group, and felt comfortable to do the scheduled activities when they were interested."
The research findings suggest that adult day care centers can be designed with the expectation that the environment will convey its own messages to client and staff members alike, Miner wrote. In addition, "staff members can be made aware of the effects of infantilizing behaviors and can be encouraged to treat older clients in an age-appropriate manner and allow for expressions of autonomy, independence, privacy regulation and friendship formation."
Contact: Sonia Miner, 581-5725; [email protected]
RSS