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Day Care Centers for Alzheimer’s Patients in Türkiye: Demographic Change and Care Ethics, Political and Economic Implications

Year 2024, Volume: 7 Issue: 2, 93 - 100, 30.12.2024
https://doi.org/10.51819/jaltc.2024.1582925

Abstract

Advancements in healthcare have extended life expectancy, accelerating the global shift towards aging populations and creating a growing need for comprehensive geriatric care. Among the most pressing challenges is dementia, with Alzheimer's disease (AD) standing as a significant societal and policy concern. AD is a progressive neurodegenerative disorder characterized by the irreversible decline of cognitive functions, including memory, reasoning, and problem-solving, leading to a loss of independence. Its onset, influenced by genetic, environmental, and lifestyle factors, poses profound socio-economic and emotional challenges for patients and caregivers alike. Current healthcare and social support systems often fall short in addressing the complex needs of individuals with Alzheimer’s and their families, highlighting critical gaps in policy and service provision. Family caregivers bear the dual burden of emotional distress and financial strain, with limited access to adequate support. Expanding specialized services, such as daycare centers, staffed by multidisciplinary professionals, including gerontologists, psychologists, physiotherapists, and social workers, provides a sustainable solution. These centers not only enhance the quality of life for patients but also alleviate the socio-economic pressures on families and the state. Addressing Alzheimer’s care within the broader context of demographic transformation requires an integrated approach, combining public awareness, early diagnosis initiatives, and robust policy reform. Investments in community-based care infrastructure and caregiver support are vital to fostering fair and inclusive outcomes in aging societies. This transformation must be prioritized to mitigate the marginalization of older adults and ensure societal resilience in the face of aging population trends.

Ethical Statement

Although ethical committee approval was not required due to the structure of this article, all authors adhered to scientific ethical values in the selection of sources, writing standards, and authorship rights definition.

References

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  • Bayram, S., & Altinbas Akkas, O. (2023). Validation of the Turkish Revised Algase Wandering Scale – Long Term Care Version (TR-RAWS-LTC) for people with dementia in Türkiye. Journal of Aging and Long-Term Care, 6(2), 81-97. https://doi.org/10.51819/jaltc.2022.1294510
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  • Canning, D., & Lubet, A. (2023). Global population aging: Facts, challenges, and solutions. American Academy of Arts and Sciences. Retrieved from https://www.amacad.org/sites/default/files/daedalus/downloads/Sp2015_Successful-Aging-of-Societies.pdf (Accessed: 18 December 2024).
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  • Gaugler, J. E., Marx, K., Dabelko-Schoeny, H., Parker, L., Anderson, K. A., Albers, E., & Gitlin, L. N. (2021). COVID-19 and the need for adult day services. Journal of the American Medical Directors Association, 22(7), 1333–1337. https://doi.org/10.1016/j.jamda.2021.04.025
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  • Oglak, S. (2010). Activities and Results of the Social Care Activity Staff Training Project to Be Employed in Day Care Centers [Gündüz bakım merkezlerinde istihdam edilecek sosyal bakım aktivite elemanı yetiştirme projesi’nin faaliyet ve sonuçları]. İzmir Valiliği İl Sosyal Yardimlasma ve Dayanisma Vakfi. İzmir: Okullar Yayinevi.
  • Ozbabalik, D., & Hussein, S. (2017). Report of Dementia Care Model [Demans Bakım Modeli Raporu]. Turkish Republic Ministry of Family and Social Services [Türkiye Cumhuriyeti Aile ve Sosyal Politikalar Bakanlığı]. https://www.aile.gov.tr/media/9332/demans-bak%C4%B1m-modeli-proje-kitab%C4%B1.pdf (Accessed: 18 December 2024)
  • Pamuk, D. (2015). The role of pets in the lives of older individuals [Yaşlı bireylerin yaşamında evcil hayvanların rolü] . Mediterranean Journal of Human Sciences [Akdeniz İnsani Bilimler Dergisi], 5(2), 297-306. https://doi.org/10.13114/MJH.2015214573
  • Prince, M., Comas-Herrera, A., Knapp, M., Guerchet, M., & Karagiannidou, M. (2016). World Alzheimer Report 2016: Improving healthcare for people living with dementia. Alzheimer’s Disease International (ADI).
  • Republic of Türkiye Ministry of Justice. (2008). Regulation on Day Care and Home Care Services to Be Provided in Older Peoples’ Care Centers [Yaşlı Hizmet Merkezlerinde Sunulacak Gündüzlü Bakım ile Evde Bakım Hizmetleri Hakkında Yönetmelik]. Official Gazette No. 26960. https://www.resmigazete.gov.tr (Accessed: 18 December 2024)
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  • Say Sahin, D. (2019). Common health problems of older adults and medical ethics issues that arise during treatment and care [Yaşlılarda sık görülen sağlık problemleri ile tedavi ve bakım esnasında ortaya çıkan tıp etiği sorunları]. In U. Yanardag & Z. Yanardag (Eds.), Old Age and Social Services [Yaşlılık ve Sosyal Hizmet] (pp. 83-99). Ankara: Nika Yayinevi.
  • Scheltens, P., Blennow, K., Breteler, M. M. B., de Strooper, B., Frisoni, G. B., Salloway, S., & van der Flier, W. M. (2021). Alzheimer’s disease. 7th Annual Conference on Alzheimer's Disease, Lisbon, Abstract Book, 565-575. https://doi.org/10.1016/S0140-6736(20)32205-4
  • Schneekloth, U. (1996). Development of care dependency in old age [Entwicklung der Pflegebedürftigkeit im Alter]. Journal of Gerontology and Geriatrics [Zeitschrift für Gerontologie und Geriatrie], 29, 11-17.
  • Schwerdt, R., & Tschainer, S. (2002). Specific requirements for the care of people with dementia. [Spezifische Anforderungen an die Pflege demenziell erkrankter Menschen]. German Centre for Gerontology (DZA), Old Age and Dementia as a Challenge to Health and Care Provision [Deutsches Zentrum für Altersfragen (DZA), Hochaltrigkeit und Demenz als Herausforderung an die Gesundheits- und Pflegeversorgung], 3, 181-288.
  • Shibusawa, T. (2024). Working with Families in an Aging Society. World Social Psychiatry. 6. 16-19. 10.4103/wsp.wsp_69_23.
  • Tufan, I. (2007). First Aging Report of Türkiye [Birinci Türkiye Yaşlılık Raporu] (pp. 23) Antalya: GeroYay.
  • Tufan, I. (2015). Structural Change of Aging in Türkiye [Türkiye’de Yaşlılığın Yapısal Değişimi]. İstanbul: Koç Universitesi Yayinlari. Tufan, I. (2016). Demographic Transformation in Türkiye, Its Risks and Problems, Measures to Be Taken, and Future Goals [Türkiye’de demografik dönüşüm, yarattığı riskler ve sorunlar, alınması gereken önlemler ve gelecekle ilgili hedefler]. Ankara: Grafiker Matbaacılık.
  • Tufan, I. (2016). In Need of Care - Care of Older People with Alzheimer's Disease in Türkiye. [Bakıma Muhtaç- Türkiye’de Alzheimer Hastası Yaşlıların Bakımı]. Istanbul: Koç Universitesi Yayinlari.
  • Tufan, I. (2019). Living longer in Türkiye: Gerontological interpretations of empirical findings [Langlebigkeit in der Türkei. Empirische Befunde gerontologisch interpretiert]. Heidelberg: Springer. https://doi.org/10.1007/978-3-658-26024-8
  • Turkish Republic Ministry of Family and Social Services [Türkiye Cumhuriyeti Aile ve Sosyal Politikalar Bakanlığı] (2024). 140,000 older individuals benefit from the home care system [Evde bakım sisteminden 140 bin yaşlı yararlanıyor]. Retrieved January 18, 2024, from https://www.aile.gov.tr (Accessed: 18 December 2024).
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  • World Health Organization (2022). World Health Statistics. Geneva. https://www.who.int/news/item/20-05-2022-world-health-statistics-2022
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Year 2024, Volume: 7 Issue: 2, 93 - 100, 30.12.2024
https://doi.org/10.51819/jaltc.2024.1582925

Abstract

References

  • Akdeniz University Gerontology Department (2022). Projects [Projeler.] Retrieved from https://sbf.akdeniz.edu.tr/tr/gerontoloji_projeler-3064 (Accessed 18 December 2024).
  • Alzheimer Vakfi (2022). Alzheimer Disease [Alzheimer Hastalığı]. Retrieved from https://alz.org.tr/alzheimer-hastaligi. (Accessed: 20 November 2024).
  • Barnes, D. E., & Yaffe, K. (2011). The projected effect of risk factor reduction on Alzheimer's disease prevalence. The Lancet Neurology, 10(9), 819-828. https://doi.org/10.1016/S1474-4422(11)70072-2
  • Bayram, S., & Altinbas Akkas, O. (2023). Validation of the Turkish Revised Algase Wandering Scale – Long Term Care Version (TR-RAWS-LTC) for people with dementia in Türkiye. Journal of Aging and Long-Term Care, 6(2), 81-97. https://doi.org/10.51819/jaltc.2022.1294510
  • Beauvoir, S. (1977). The Age, [Das Alter] (Anjuta Aigner-Dünnwald & Ruth Henry, Trans.) Reinbek bei Hamburg: Rowohlt.
  • Canning, D., & Lubet, A. (2023). Global population aging: Facts, challenges, and solutions. American Academy of Arts and Sciences. Retrieved from https://www.amacad.org/sites/default/files/daedalus/downloads/Sp2015_Successful-Aging-of-Societies.pdf (Accessed: 18 December 2024).
  • Forstl, H., Lauter, H., & Bickel, H. (2001). Causes and treatment concepts of dementia. [Ursachen und behandlungskonzepte der demenzen]. In Alterfragen DZ (Ed.), Gerontopsychiatry and geriatric psychotherapy in Germany. Expert opinions on the Federal Government's Third Report on the Older People [Gerontopsychiatrie und Alterspsychotherapie in Deutschland. Expertisen zum Dritten Altenbericht der Bundesregierung], 4, 113-199. Opladen: Leske & Budrich. https://doi.org/10.1007/978-3-322-99712-8_4
  • Gaugler, J. E., Marx, K., Dabelko-Schoeny, H., Parker, L., Anderson, K. A., Albers, E., & Gitlin, L. N. (2021). COVID-19 and the need for adult day services. Journal of the American Medical Directors Association, 22(7), 1333–1337. https://doi.org/10.1016/j.jamda.2021.04.025
  • Gómez-Gallego, M., & Gómez-Gallego, J. (2021). Predictors of caregiver burden of patients with Alzheimer's disease attending day-care centers. International Journal of Environmental Research and Public Health, 18(20), 10707. https://doi.org/10.3390/ijerph182010707
  • Gorres, S., & Nachtmann, J. (2010). Age, living, and technology – the future has begun. [Alter, wohnen und technik-die zukunft hat begonnen]. Institute for Public Health and Nursing Research [Institut für Public Health und Pflegeforschung], 08, Winter 2009/2010, 1-2.
  • Ibrahim, A. M., Ibrahim, M. M., & Zaghamir, D. E. F. (2024). Burden of care and quality of life among informal caregivers to Alzheimer patients in Egypt. Palliative and Supportive Care, 22(1), 182–189. doi:10.1017/S1478951523000573
  • Ikeda, M., Ishii, K., & Watanabe, M. (2022). Long-term care and dementia services in Japan: Policies and practices. Age and Ageing, 51(4), afac053.
  • Kessler, J., & Kalbe, E. (2001). Gerontopsychology: Basics and pathology [Gerontopsychologie: Grundlagen und pathologie]. In W. Sturm, M. Herrmann, & C. Wallesch (Eds.), Textbook of Clinical Neuropsychology [Lehrbuch der Klinischen Neuropsychologie] (pp. 648–673). Swets & Zeitlinger Publishers.
  • Korkmaz Yaylagul, N., Akis, A., & Barlin, H. (2021). Informal care and the importance of institutional support in Alzheimer’s disease: Caregivers’ experience with Mavi Ev. İstanbul University Journal of Sociology, 41(2), 461-487. https://doi.org/10.26650/SJ.2021.41.2.0033
  • Korukcu, O., Kukulu, K., & Tufan, I. (2018). To make people with dementia forget about forgetting: Experiences from a daily care center. Lupine Online Journal of Nursing Health Care, 1(2), 1-5. http://dx.doi.org/10.32474/LOJNHC.2018.01.000107
  • Lenzen-Großimlinghaus, R., & Steinhagen-Thiessen, E. (2000). Geriatrics and Geriatric Rehabilitation [Geriatrie und geriatrische rehabilitation]. In H. W. Wahl & C. Tesch-Römer (Eds.), Applied Gerontology in Key Terms [Angewandte Gerontologie in Schlüsselbegriffen] (pp. 290-295): Kohlhammer.
  • Mayer, K., & Baltes, P. (1996). Introduction (Einleitung). In K. Mayer & P. Baltes (Eds.), The Berlin Age Study [Die Berliner Altersstudie] (pp. 7-13). Akademie Verlag.
  • Miller, J. E., & Cameron, K. (2024). Progress on mental health policy to improve service access and quality for older adults: Recent successes, proposed legislation, and strategies for sustainability. Public Policy & Aging Report, 34(2), 39–43. https://doi.org/10.1093/ppar/prae007
  • Niederfranke, A. (1999). The aging is female: Women and men age differently [Das alter ist weiblich: Frauen und männer altern unterschiedlich]. In A. Niederfranke, G. Naegele, & E. Frahm (Eds.), Living situations and living environments, social security and old age policy [Lebenslagen und Lebenswelten, soziale Sicherung und Altenpolitik] (pp. 7-52). Opladen/Wiesbaden: Westdeutscher Verlag. https://doi.org/10.1007/978-3-322-83339-6_1
  • OECD (2017). 2013 OECD Recommendation of the Council on Gender Equality in Education, Employment and Entrepreneurship. Paris: OECD Publishing. https://www.oecd.org/els/2013-oecd-recommendation-of-the-council-on-gender-equality-in-education-employment-and-entrepreneurship-9789264279391-en.htm. https://doi.org/10.1787/9789264279391-en
  • Oglak S. (2018). Turkey Long-Term Care: Challenges and Opportunities. In K. Christensen and D. Pilling (Eds) The Routledge Han-book of Social Care Work Around the World. (pp.187-201). Routledge: Oxon, UK
  • Oglak, S. (2010). Activities and Results of the Social Care Activity Staff Training Project to Be Employed in Day Care Centers [Gündüz bakım merkezlerinde istihdam edilecek sosyal bakım aktivite elemanı yetiştirme projesi’nin faaliyet ve sonuçları]. İzmir Valiliği İl Sosyal Yardimlasma ve Dayanisma Vakfi. İzmir: Okullar Yayinevi.
  • Ozbabalik, D., & Hussein, S. (2017). Report of Dementia Care Model [Demans Bakım Modeli Raporu]. Turkish Republic Ministry of Family and Social Services [Türkiye Cumhuriyeti Aile ve Sosyal Politikalar Bakanlığı]. https://www.aile.gov.tr/media/9332/demans-bak%C4%B1m-modeli-proje-kitab%C4%B1.pdf (Accessed: 18 December 2024)
  • Pamuk, D. (2015). The role of pets in the lives of older individuals [Yaşlı bireylerin yaşamında evcil hayvanların rolü] . Mediterranean Journal of Human Sciences [Akdeniz İnsani Bilimler Dergisi], 5(2), 297-306. https://doi.org/10.13114/MJH.2015214573
  • Prince, M., Comas-Herrera, A., Knapp, M., Guerchet, M., & Karagiannidou, M. (2016). World Alzheimer Report 2016: Improving healthcare for people living with dementia. Alzheimer’s Disease International (ADI).
  • Republic of Türkiye Ministry of Justice. (2008). Regulation on Day Care and Home Care Services to Be Provided in Older Peoples’ Care Centers [Yaşlı Hizmet Merkezlerinde Sunulacak Gündüzlü Bakım ile Evde Bakım Hizmetleri Hakkında Yönetmelik]. Official Gazette No. 26960. https://www.resmigazete.gov.tr (Accessed: 18 December 2024)
  • Rott, C. (2004). Demographics of old and very old age [Demographie des hohen und sehr hohen alters]. In A. Kruse & M. Martin (Eds.), Encyclopedia of Gerontology: Aging Processes from a Multidisciplinary Perspective [Enzyklopädie der Gerontologie: Alternsprozese in multidisziplinärer Sicht] (pp. 51-65). Bern, Göttingen, Toronto, Seattle: Huber Verlag.
  • Rubenstein, L.Z., Siu, A.L. & Wieland, D. (1989). Comprehensive geriatric assessment: Toward understanding its efficacy. Aging Clinical and Experimental Research, 1, 87–98 (1989). https://doi.org/10.1007/BF03323881
  • Say Sahin, D. (2019). Common health problems of older adults and medical ethics issues that arise during treatment and care [Yaşlılarda sık görülen sağlık problemleri ile tedavi ve bakım esnasında ortaya çıkan tıp etiği sorunları]. In U. Yanardag & Z. Yanardag (Eds.), Old Age and Social Services [Yaşlılık ve Sosyal Hizmet] (pp. 83-99). Ankara: Nika Yayinevi.
  • Scheltens, P., Blennow, K., Breteler, M. M. B., de Strooper, B., Frisoni, G. B., Salloway, S., & van der Flier, W. M. (2021). Alzheimer’s disease. 7th Annual Conference on Alzheimer's Disease, Lisbon, Abstract Book, 565-575. https://doi.org/10.1016/S0140-6736(20)32205-4
  • Schneekloth, U. (1996). Development of care dependency in old age [Entwicklung der Pflegebedürftigkeit im Alter]. Journal of Gerontology and Geriatrics [Zeitschrift für Gerontologie und Geriatrie], 29, 11-17.
  • Schwerdt, R., & Tschainer, S. (2002). Specific requirements for the care of people with dementia. [Spezifische Anforderungen an die Pflege demenziell erkrankter Menschen]. German Centre for Gerontology (DZA), Old Age and Dementia as a Challenge to Health and Care Provision [Deutsches Zentrum für Altersfragen (DZA), Hochaltrigkeit und Demenz als Herausforderung an die Gesundheits- und Pflegeversorgung], 3, 181-288.
  • Shibusawa, T. (2024). Working with Families in an Aging Society. World Social Psychiatry. 6. 16-19. 10.4103/wsp.wsp_69_23.
  • Tufan, I. (2007). First Aging Report of Türkiye [Birinci Türkiye Yaşlılık Raporu] (pp. 23) Antalya: GeroYay.
  • Tufan, I. (2015). Structural Change of Aging in Türkiye [Türkiye’de Yaşlılığın Yapısal Değişimi]. İstanbul: Koç Universitesi Yayinlari. Tufan, I. (2016). Demographic Transformation in Türkiye, Its Risks and Problems, Measures to Be Taken, and Future Goals [Türkiye’de demografik dönüşüm, yarattığı riskler ve sorunlar, alınması gereken önlemler ve gelecekle ilgili hedefler]. Ankara: Grafiker Matbaacılık.
  • Tufan, I. (2016). In Need of Care - Care of Older People with Alzheimer's Disease in Türkiye. [Bakıma Muhtaç- Türkiye’de Alzheimer Hastası Yaşlıların Bakımı]. Istanbul: Koç Universitesi Yayinlari.
  • Tufan, I. (2019). Living longer in Türkiye: Gerontological interpretations of empirical findings [Langlebigkeit in der Türkei. Empirische Befunde gerontologisch interpretiert]. Heidelberg: Springer. https://doi.org/10.1007/978-3-658-26024-8
  • Turkish Republic Ministry of Family and Social Services [Türkiye Cumhuriyeti Aile ve Sosyal Politikalar Bakanlığı] (2024). 140,000 older individuals benefit from the home care system [Evde bakım sisteminden 140 bin yaşlı yararlanıyor]. Retrieved January 18, 2024, from https://www.aile.gov.tr (Accessed: 18 December 2024).
  • Turkish Republic Ministry of Family and Social Services [Türkiye Cumhuriyeti Aile ve Sosyal Politikalar Bakanlığı] (2018). National aging strategy document. Retrieved from https://www.aile.gov.tr
  • Turkish Statistical Institute [Türkiye Istatistik Kurumu] (2020). Older People in Statistics [İstatistiklerle yaşlılar]. Retrieved from https://data.TUIK.gov.tr/Bulten/Index?p=Istatistiklerle-Yaslilar-2020-37227. (Accessed: 20 November 2024).
  • United Nations (2022). World Population Prospects 2022. Retrieved from https://population.un.org/wpp. (Accessed: 20 November 2024).
  • World Health Organization (1992). The ICD-10 Classification of Mental and Behavioral Disorders. Clinical Systems and Diagnostic Guidelines. Geneva.
  • World Health Organization (2022). World Health Statistics. Geneva. https://www.who.int/news/item/20-05-2022-world-health-statistics-2022
  • World Health Organization (2023). Global dementia report. Retrieved from https://www.who.int. (Accessed: 20 November 2024).
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Details

Primary Language English
Subjects Geriatrics and Gerontology, Aged Health Care
Journal Section Articles
Authors

Sanam Asadi Faezi 0000-0003-4511-4688

Özlem Özgür 0000-0001-5330-0902

Bilge Çetinkaya 0009-0007-7205-9705

Melih Vural 0000-0002-8452-2628

Fatma Sıla Ayan 0000-0003-0576-1338

Publication Date December 30, 2024
Submission Date November 11, 2024
Acceptance Date December 24, 2024
Published in Issue Year 2024 Volume: 7 Issue: 2

Cite

APA Asadi Faezi, S., Özgür, Ö., Çetinkaya, B., Vural, M., et al. (2024). Day Care Centers for Alzheimer’s Patients in Türkiye: Demographic Change and Care Ethics, Political and Economic Implications. Journal of Aging and Long-Term Care, 7(2), 93-100. https://doi.org/10.51819/jaltc.2024.1582925

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Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

The National and Applied Gerontology Association (NASAG) is a leading non-profit organization in Türkiye that promotes healthy and productive aging via evidence-based research. The utilization of multidisciplinary and interdisciplinary research in gerontology is crucial in integrating research, practice, and policy, given the need for evidence-based programming to improve the quality of life in old age. As an advocate for social action for older people, the NASAG is particularly concerned that public policies are strongly and genuinely focused on supporting and protecting the most vulnerable, marginalized, or disadvantaged older people.

The NASAG has been a member of the International Association of Gerontology and Geriatrics (IAGG) since 2007.