Comparing the care environment at farm-based and regular day


People with dementia should be able to live in the community, and day care services

are recommended as a means for people to live in their own homes for as long

as possible. In this study we wanted to compare the quality of care at one type of

small-scale day care situated at community farms to regular day care provided in

connection with residential care facilities for elderly people. A total of 42 participants

from 10 farm-based day care offers and 46 participants from seven regular

day care offers were included. A qualitative observational design using the validated

Maastricht Electronic Daily Life Observation tool was used. The data were collected

between March and June 2018. Ecological momentary assessments of the activities

taking place, level of engagement, physical effort, location, social interaction and

mood were conducted while the participants attended their day care offer. The results

showed that familiar daily activities were common at farm-based day care, and

a linear mixed model analysis showed that farm-based day care attendees used more

physical effort, spent more time outdoors, had more social interaction and experienced

more positive mood compared to regular day care attendees. These findings

contribute with valuable information about care provided at different types of day

care services, and indicate that farm-based day care has more activities with the

potential to meet the social and activity needs of people with dementia compared to

regular day care. There are two main implication of this study. First, regular day care

services should focus on including more familiar daily activities found to be important

for attendees’ sense of identity and feelings of contributing. Second, regular day

care services should utilise the potential of available outdoor areas as time spent outdoors

has been found to facilitate physical activity, relaxation, health and well-being.