Grant: Op. Grant: Eval.of Dementia Prog-Strm 2-Azrieli Found. in any relevant res. Area

Most individuals with dementia and their family/friend caregivers want the person in need of care to remain at home for as long as possible. Health systems also want to reduce costly nursing home care. However, doing so safely and well may become challenging with increasing care needs. Day programs aim to maintain or improve older adults' health and well-being. They also provide respite to caregivers. However, we lack robust, Canadian research on the effects of day programs on older adults living with dementia and their caregivers, especially those of equity-deserving groups with multiple, intersecting vulnerabilities. Partnering with key experts (those in need of care, their caregivers, advocates, day program staff/managers, and health system policymakers) throughout the study, we will address these important knowledge gaps. Our team has funding to conduct a prospective cohort study in the York Region, Ontario. Here, we ask for funding to extend this work to three heath regions in Western Canada (Calgary, Alberta; Interior Health, British Columbia; Winnipeg, Manitoba). In collaboration with health systems and regional Alzheimer Societies, we will recruit individuals with dementia newly admitted to day programs, and their primary caregivers. We will compare them to a matched group of clients and caregivers in the community, not using day programs. Combining participants' health administrative data (e.g. time to nursing home admission) with survey data collected by our team over 2 years (e.g., older adults' and caregivers' quality of life), we will compare study outcomes between those who do or do not attend day programs. We will also assess how day program characteristics (e.g., size, staffing, ownership, type of programming), and social identities (e.g., ethno-cultural background) are associated with study outcomes. Finally, to further contextualize our data, we will conduct semi-structured interviews and focus groups with key informants.