Exploring remote service provision in adult day centers during the COVID-19 pandemic
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The COVID-19 pandemic profoundly impacted the long-term services and supports (LTSS) sector, necessitating a rapid shift from in-person services to remote. Adult day service centers (ADSCs) – a type of LTSS – offer in-person community-based programs comprised of health and wellness services to historically underserved populations, such as communities of color, low-income, and older adults. Based on data collected from 23 semi-structured interviews with 22 providers from eight ADSCs across a Mid-Atlantic state, this thesis explores the experiences of ADSC providers – such as directors, activity staff, and nurses – as they navigated pandemic-related closures. To ensure uninterrupted services, centers leveraged their existing infrastructure and adapted to a remote service model. An intricate interplay of technical (e.g., access to devices, internet) to non-technical (e.g., digital literacy, sociocultural context, limited staff) variables affected the overall success of remote services. Simultaneously, ADSCs grappled with limited reimbursement for remote services – which directly impacted their operations and the sustainability of remote services. These findings offer insights into the challenges and adaptations providers experienced amidst an unprecedented crisis, shedding light on the systemic issues throughout this period. The study seeks to inform future interventions that promote the sustainability of remote services in ADSCs, with a specific focus on preventing service disruptions for historically underserved populations.