Dropout from farm-based day care for people with dementia in Norway: a followup study

Background: Farm-based day care services (FDCs) for people with dementia are intending to provide social
relationships and meaningful activities in an agricultural landscape and offer respite for next of kin. As this requires
a certain cognitive and physical functioning, it is of interest to investigate how this service contribute during the
course of dementia. In this study we aim to explore the individual characteristics predicting dropout from FDC.
Furthermore, we investigate whether the participants who drop out of the service continue to live at home with
another day care service or if they move to a residential care facility.

Methods: The study includes 92 people with dementia attending FDCs in Norway, assessed with standardized
instruments at baseline between January 2017 and January 2018. They were followed for 1 year, and dropouts from
FDC during this period were mapped. The association between individual characteristics and dropout was assessed
using a Cox proportional hazards regression analysis.

Results: Thirty-eight people stopped attending FDCs during the study. Twenty-six moved to residential care.
Among the 12 who continued to live in their own homes, 9 people started in a regular day care service. Higher
score on educational level and more severe dementia, as well as lower scores on social support, increased the
probability of stopping FDC.

Conclusion: FDCs appeared as a service that is stable over time for most participants, as more than two-third could
use the care facility until the need of residential care. The transfers within care services and levels of care seemed to
be characterized by continuity. More research on the growing population of educated older adults with dementia
are warranted, to facilitate for their course of care needs. Finally, extended knowledge is needed to improve the
collaboration between private and public networks, such as day care services, to improve the experience of social
support for people with dementia.

Keywords: Dementia, Day care, Farm-based day care, Care farms