Dr. David Chiriboga, PhD

Dr. Chiriboga currently is a professor in the Department of Child & Family Studies in the College of Behavioral & Community Sciences at the University of South Florida. His ongoing work includes a statewide study of mental and physical health disparities in Florida, the effectiveness of family-centered interventions for Medicaid beneficiaries with Alzheimer's disease and related dementias, and a three state study of barriers to health and health care posed by limited English proficiency among older Korean immigrants.

Dr. Karen L. Gilbert DNP MS RN
Certified Dementia Practitioner

Karen Gilbert serves as a Vice President for Alzheimer’s Community Care. She is a Certified Alzheimer’s disease trainer from the Florida Department of Elder Affairs and is a Certified Dementia Practitioner from the National Council of Certified Dementia Practitioners. Karen completed her Doctor of Nursing Practice degree in 2019. Karen received her Bachelor of Science degree from the State University of New York and holds a Master of Science degree from Nova Southeastern University. Dr. Karen L. Gilbert DNP RN MS CDP can be reached at kgilbert@alzcare.org 561-683-2700 Ext. 119.

BY David A. Chiriboga, PhD,, Nan S. Park, PhD,, Karen Gilbert, RN, MS, CDP, Victor A. Molinari, PhD, and Mary Barnes, AA

Abstract
Background and Objectives: Recognizing the important role that dementia-specific adult day centers have in maintaining persons with a neurocognitive disorder in their home, this article examines three critical indicators at the time when people first enroll in such a center: cognitive and functional impairment of the enrollee, and burden reported by their family caregivers. We also considered variations in these 3 indicators by race/ethnicity and by the relationship of caregiver to the new enrollee. Research Design and Methods: We conducted a secondary analysis of data collected by a nonprofit organization operating 11 dementia-specific adult day centers located on the east coast of Florida. Nursing staff conducted intake interviews with enrollees and their caregivers, and assessed functional status within one month of admission. Instruments included the Zarit Burden Scale and components of the Minimum Data Set: the Brief Interview for Mental Status (BIMS) and 4 measures of functional status. Results: On average the cognitive scores of newly enrollees were well-within the range indicated for severe impairment, and these levels did not differ by race/ethnicity. Burden reported by caregivers however differed significantly, with Latinx caregivers reporting the greatest burden and African American/Black caregivers reporting the least. Further, while daughters generally reported higher levels of burden than other family caregivers, Black daughters reported the least. Discussion and Implications: Results suggest a need for greater dissemination efforts about adult day programs to the Latinx community, as well as attention to the disparate burden placed upon differing family relationships of caregivers to enrollees.

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Keywords: Daycare, Dementia, Minorities, Neurocognitive disorders