The purpose of this study was to gain understanding of the meaning of the daily routines and activities at a day-care center for persons with Alzheimer disease, as experienced by the staff. With the use of the qualitative research techniques of participant observation and ethnographic interviewing, data were collected for 4 weeks at a small adult day-care center for persons with mid- to late-stage Alzheimer disease or related disorders. Analysis of the data revealed that the foremost guiding principle for all activities during the day was prevention, that is, to prevent participant behavior that would be harmful to self or to others. Secondary to this overarching guideline, other characteristics of a “good day” versus a “rough day” were also identified. The findings are discussed as they relate to activity program planning and to sources of staff satisfaction in the care of persons with Alzheimer disease.

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