Daycare centers are one of the central services for elderly with disabilities in the community. Developed about 30 years ago, according to the 'social model', there are now 172 centers countrywide serving 15,500 elders living in the community. The centers provide socio-cultural activities, personal care and rehabilitation services, all under one roof. The service is funded by long-term care benefits of the National Insurance Institute, the Ministry of Social Affairs and Social Services and local social service departments, as well as by private payments. The Brookdale Institute has assisted in the development and implementation of the centers from the outset and conducted a comprehensive census and survey during the 1990s, resulting in the introduction of significant changes to the service.
The service began to develop at an accelerated pace in the mid-1990s, when it was perceived as providing a significant response to the social needs of elders with disabilities, as well as respite for family members. However, currently, only 10% of the elderly with disabilities attend the daycare centers.
A central question is whether the level of use of the centers reflects the demand and the interest on the part of the elderly or if it reflects a lack of knowledge, negative image of the service or barriers connected to the manner of operation of the centers. In addition, issues connected to the patterns of service utilization at the centers and to the target population were raised.
To address these questions, Eshel’s Committee for Community Services launched a comprehensive evaluation study. The study included three components: 1) a census of the centers and their clients; 2) interviews with long-term care beneficiaries attending the centers and their family caregivers; 3) interviews with beneficiaries not attending the centers and their family caregivers.
The study data focused on the following topics:
Changes in the occupancy rate and level of use of the centers and in the attributes of the clients who use the centers
Patterns of operation of the centers and the basket of services offered
Socio-demographic, functional and cognitive characteristics of the clients
Patterns of utilization of the services offered, client satisfaction and client preferences
Level of interest of non-users and their family caregivers, and barriers to use of the centers
Desired changes in the centers – in the usage patterns and the services offered – in the view of directors, clients and potential clients.
The study findings were discussed by Eshel's Committee of Community Services and at meetings with center directors and community-based professionals. As a result of the study, an inter-ministerial professional committee was established to examine the findings and the implications for further development of daycare centers. As part of its work, the committee is developing a number of pilot programs to address issues raised by the study.
The study was conducted in cooperation with JDC-Eshel and funded with its assistance.