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This article presents an argument for reforming Australian public policy in favor of social care, rather than family, residential, or community care, for the elderly, sick, and disabled. After noting policy assumptions that families are the focus of caring and women are the natural caregivers, the paper describes changes in Australian family structures that militate in favor of policy reform. Trends related to marriage and childbearing, women in the labor force, family incomes, the aging population, legislation, and employment practices are analyzed. The paper then considers the impact of financial cutbacks on community care. The terminology of "care" and "caring" is analyzed, and hidden assumptions and connotations of this terminology are discussed. The paper then provides estimates of the numbers of Australians with particular needs for care and offers evidence that women are the main caregivers for children, the disabled, and the elderly. Discussion then turns to the caring role, covering such topics as the caregivers' need for specialized knowledge and instrumental and emotional support; stress levels; the hierarchy of public support; and research needs. Costs of care are considered next, with an emphasis on the indirect social costs of the enormous contributions that families are required to make to care provision. Next, Australia's Home and Community Care (HACC) program, the main funding source for caregiver support, is described, and a care plan linking HACC agencies with informal sources of care is suggested. New directions for care are recommended with respect to community support for caregivers, housing, research needs, empowerment, employer roles, and new family roles. Finally, a social caring model that would ensure nationwide availability of adequate public services is outlined. (AC)

Evaluation of an intergenerational shared-site program included observations and videos of 20 children and 27 elders. Interpersonal communication and empathy were cultivated over time. The best activities promoted interaction and relationship building. Environmental factors and teaching style affected outcomes. Making and interpreting videos proved challenging for evaluators. (Contains 16 references.) (SK)

Gives an overview of the aging population in nations such as Nigeria and of adult education's role in their adjustment and well being. Recommends adult day programs rather than isolation in homes for the aged. (Contains 16 references.) (SK)

Examines the social environments, staff behavior and social interaction of 72 elderly clients in adult day care centers, using qualitative research techniques. When the staff and environment were more infantilizing, provided less autonomy and fewer opportunities for privacy regulation, clients had lower social interaction with peers. In contrast, in a more adult setting, there was greater privacy regulation, autonomy and social contact among clients. (BF)

A study was conducted of juvenile offenders serving as volunteers working with frail elderly (some with dementia). Both generations experienced personal benefits from participation. Key characteristics promoting social inclusion were trusting partnerships, inclusive practices, and champions, project supporters who served as a bridge between the two communities. (SK)

The ability of 10 adults with mental retardation to exhibit linguistic control within peer and staff dyads was evaluated. Participants produced significantly more utterances with staff than with peers; however, they did not exhibit significant amounts of directives or questions, the two types of verbal control bids studied. (Author/CR)

Case studies of young women with learning disabilities showed they increased practical living skills at a day center but had little autonomy in long-term life decisions and little opportunity for productive activity and social interaction. Low expectations of others and the segregated day center program hampered their ability to reach adult status and engendered dependency. (SK)

Examines the ethical aspects of the experience of providing day care to dementia patients. Results, based on telephone interviews (N=40), indicate that ethical challenges arise in everyday incidents when participants, staff, or family members "cross the line" of acceptable behavior. Staff responses ranged from benign manipulation to termination of day care. (RJM)

Reports on the prevalence of behavior disorders in a sample of residents (N=360) in adult day health care programs. Findings indicate relatively high rates of behavior disorders. Most prevalent were the affective disorders (seeking reassurance, depression, crying) and verbal-vocal agitation. Differences between formal and informal caregivers' assessments were minimal. (RJM)

Evaluation of the effectiveness of a training program for behavioral aides providing individualized support for adults with severe disabilities and challenging behaviors in a day treatment center found all five participants were able to show marked increases in their clients' social and physical community integration. The training program focused on challenging behaviors, valued activities, and physical and social integration. (Author/DB)

Attitudes of administrators of adult (n=34) and child (n=192) day care centers were affected by more frequent exposure to intergenerational programming. Educational attainment had no effect on attitudes. Younger respondents were more positive than older ones. (SK)

Compared older adults who volunteered to work for community organization at office or in adult day care center on social-psychological and demographic predictors. Found that day care center volunteers were higher than office volunteers on sympathy whereas office volunteers were higher than day care center volunteers on educational attainment, involvement in clubs and organizations, and role taking. (Author/NB)

A survey of 150 elderly people with disabilities in Hong Kong found that a high proportion was living alone in the community with only minimal networks for emotional support. Effective measures to promote family care of disabled elderly people and approaches to integrating the formal and informal care sectors are discussed. (DB)

Data collected as part of the Adult Day Health Care Evaluation Study revealed relatively few significant differences between program participants and nonparticipants in terms of characteristics of the referral process, demographic and health status variables, the patient's living situation, and information about the patient's caregiver. (NB)

Examined use of time among female caregivers of dementia patients who used home care (n=20) and day care (n=20) respite services. Assessment of caregiver activity during respite and nonrespite days revealed significant program differences in amount of caregiving time and overall differences in amount of noncaregiving time. Use of respite time was also examined. (Author/NB)

Examined caregiver listening responses as they occurred in conversations with an Alzheimer's patient. Videotaped 26 episodes of conversations between caregivers and patients in adult day health care setting. Found that sensitive listening and partial entry into the patient's frame (reality) may be effective response to prevent behavior and anxiety-related outbursts. (Author/NB)

Recent research on severely disabled students leaving schools in Northern Ireland is reviewed. Findings are discussed in terms of attitudes of students and their parents, professionals' attitudes toward school leaving arrangements, and the role of adult centers. Greater coordination between adult centers and schools is seen as vital to improved secondary transitions. (PB)

Evaluates the Post-Hospital Support Program for frail elderly patients at Johns Hopkins Hospital in Baltimore (Maryland) who were returning home to the care of a non-paid caregiver for at least a year. Results showed reduction in caregiver stress and in number of days spent in hospital after initial release. (JS)

Discusses the purpose of adult day care, procedures for providing qualified personnel for adult day care centers, and legislative requirements for nurse aides. (Author)

Adult day care center incorporated feelings group into daily program, based on Yalom's focus group model. Group discussion encourages communication, understanding, and trust, and buffers the effects of physical and emotional losses sustained by participants. Anticipated outcomes include increased self-esteem, decreased loneliness, and regained social skills. (Author)

Examined caregivers' problems, strain, relationship with their dependent, and attitudes toward day care in determining the outcome placements of psychogeriatric day hospital patients. Examined features contributing to the demented elderly's continued attendance at the day hospital in order to determine implications for such services. (Author/NRB)

Survey results indicated adult day care is a resource that families draw upon to help them cope with the care of an elderly disabled member. It enables them to better attend to the person's needs as well as their own and aids in improving family relationships. Gender effects are discussed. (Author/BL)

Conducted group meetings with adult children caring for older relatives at two Chicago area adult day care centers. Sessions focused on problems common to caregivers, information on the aging process, and available resources to assist in caregiving. Caregivers benefited more from the sessions when the administrator and staff were involved and where there was high and consistent attendance. (Author/NB)

Notes that day care programs created to serve physically frail elders are hesitant to accept growing number of clients with severe cognitive impairment. Suggests ways to modify existing programs to accommodate clients with dementia. Discusses adapting screening and intake procedures, the first few visits, behavior management, programming, and staffing. (Author/NB)

Examined effect of adult day care (ADC) on utilization of health care practitioner and inpatient hospital services. Data from three separate ADC studies revealed that, when operative for some time, ADC may result in dramatic decreases in hospital inpatient stays. Findings warrant further research. (Author/NB)

Review of literature concerning effectiveness and cost of geriatric day hospitals revealed many descriptive studies and four randomized control studies. Of four studies, one demonstrated credible improvement in physical and emotional function in day hospital versus conventional care control group. Three randomized studies in which costs were examined revealed substantially greater costs in day hospital group. (Author)

Describes trial use of milieu and activity-based therapy in two adult day centers to increase client involvement in physical and social environments of treatment settings. Reports results from empirical observations and recommends further investigation of this treatment modality in settings for the elderly. (Author/NRB)

Examined the utilization patterns of caregivers (N=597) to dementia victims when services were available. Identified and examined factors influencing service utilization, including amount of burden experienced by the caregiver, the degree of involvement in the care of the patient, and the amount of resources available. Respite-oriented services were perceived as most needed, were utilized most. (Author/ABB)

Findings from a study of 18 Alzheimer's patients in a day hospital program and their caregivers in family support groups indicated that such therapeutic programs may slow behavior deterioration in patients and promote enhanced coping in caregivers. Other findings suggest an improvement in caregivers' coping. (Author/ABB)

Considered impact of physical environment on work-related stress and quality of care in day care center integrating demented people and other frail elderly. Examined positive and negative differences before and after move to new facility. Discusses implications for facility design and other program characteristics. (Author/CM)