The National Insurance Institute’s Fund for Development of Long-Term Care Services initiated a pilot program for the implementation of a second shift in day care centers for older adults (Ofek Centers; hereinafter: the centers) (hereinafter: the program). The goals of the program were: to offer a community-based solution in the afternoon hours in response to the needs of older adults with functional limitations; to put to better use the centers’ facilities; and to expand the involvement of volunteers. The program was implemented in collaboration with the Ministry of Welfare and Social Affairs and various NGOs in 2018-2021 in four centers in four local authorities across Israel: Bat Yam, Nof Hagalil, Pardes Hanna-Karkur, and Tel Aviv-Yafo.
The Myers-JDC-Brookdale Institute was commissioned through a public tender issued by the National Insurance Institute’s Fund for Development of Long-Term Care Services for a summative formative evaluation of the program. The present report focuses on the findings of the summative evaluation and is based on the findings of interviews conducted in 2021, toward the end of the program, as well as on administrative data provided by the centers and by the National Insurance Institute.
- To document the number of older adults who took part in the program as well as the content of the activities in which they participated.
- To characterize the program participants according to socio-demographic characteristics, level of functioning, health status, and the nature of their social ties.
- To analyze organizational processes related to the implementation of the program.
- To learn about the value of the program, in particular, and the centers, in general, for older adults and their family members and about their satisfaction with the program and the centers, in general.
- To examine the impact of the program on the operation of the centers in the morning hours (hereinafter: the first shift).
- To evaluate the economic feasibility of the program.
The study population included frail older adults who visited the centers (those eligible for long-term care benefits for whom supervision is not required as well as those ineligible for long-term care benefits who were referred by the social services departments), their family members, and officials and professionals involved in the program.
The present evaluation study used both quantitative and qualitative research methods, including the following:
- Interviews with older adults who visited the centers, conducted in three rounds: at the end of the first year and at the end of the second year of the program implementation – for the purpose of formative evaluation; and at the end of the third year – for the purpose of summative evaluation. Altogether, 449 interviews were conducted with the program participants and with nonparticipating older adults (those who visited the centers during the first shift).
- Interviews with family members of older adults who visited the centers. At the end of the third year of the program implementation, interviews were conducted with 101 family members –of older adults who participated in the program as well as of nonparticipating older adults.
- Interviews with officials and professionals involved in the program, conducted in three rounds: six months following the launching of the program and a year later – for the purpose of formative evaluation; and toward the end of the third year of the program implementation – for the purpose of summative evaluation. Altogether, 22 interviews were conducted.
- Analysis of administrative data of the centers related to the number of visitors in each of the centers, the number of program participants, the program activities, the program human resources, and economic data.
- The implementation of the program allowed more older adults to join the centers, especially those for whom the afternoon hours were more convenient (due to other matters they had to attend to, or other activities they engaged in, or the at-home care they received in the morning hours).
- At the end of the second year of the program implementation, the number of the program participants reached 106. Their number dropped significantly following the COVID-19 pandemic.
- The activity in small groups allowed the instructors to personally attend to each of the participants and thus enhance their sense of belonging to both the Center and the group. Accordingly, most of the program participants reported that they met or maintained phone contact with other participants even outside the Center activity hours.
- Highest participation rates were found in the following program activities: lectures, physical activity and fitness classes, and music playing and sing-along sessions.
- The program alleviated the loneliness of the participants and enriched their lives.
- The program eased the burden on family members.
- Satisfaction with the program and with the centers, in general, was very high. About half of the program participants reported that they were interested in visiting the centers more frequently. Satisfaction with the activities was found to be the major factor contributing to the overall satisfaction with the Center.
- The opportunity to make the most of the leisure time, the preservation of cognitive and physical functions, the attention and care offered, the alleviation of loneliness and social engagement, the life-enriching hobbies, and the stimulating learning of new things were perceived by the older adults as the most significant factors that add value to the centers.
- The main challenges involved in the implementation of the program included: marketing, recruitment of participants, and expansion and diversification of the activities.
In view of the highly valuable contribution of the program, the following recommendations are suggested for its future implementation and success:
- The National Insurance Institute and the NGOs running the program should promote the program branding and marketing. The marketing strategies should be tailored to the target population and the relevant entities in the community (the communal ecosystem of the centers) with whom partnerships may be established. A position should be allocated for a national marketing officer for the program and/or that marketing experts be engaged to that end. The National Insurance Institute should inform those eligible for long-term care benefits of the services provided by the centers and of the program available as part of the services.
- The activities offered as part of the program should be diversified and enriched. To offer a diversified range of attractive activities, a position should be allocated for a program developer in each day care center, that volunteers be recruited to run some of the activities and manage operational tasks, and that the program participants be invited to take part in the planning of the activities. It is also recommended that a national activities coordinator be appointed on behalf of the Fund for Development of Long-Term Care Services to manage the coordination and exchange of information between the centers.
- The program should be expanded and offered on a more frequent basis. Given the preferences of the older adults and their family members as well as the views of the program operators, the program should be expanded and offered three times a week rather than twice a week.
Citing suggestion: Berg-Warman, A., & Cohen,Y. (2022). The Program for a Second Shift in Day Care Centers for Older Adults (Ofek Centers): Formative and Summative Evaluation. RR-895-22. Myers-JDC-Brookdale Institute. (Hebrew)