Adult Day Health Care: For Patients With Dementia

Jacqueline Marcell Health Guide
  • This week is National Adult Day Services Association Week and I am a huge advocate for NADSA as I constantly spread the word to families, who usually have no idea it even exists when they start their caregiving journey.

    I had no idea what it was all about either when I started caring for my elderly parents. Since they had dementia, rather than Adult Day Care, I was advised to enroll them in Adult Day Health Care, as the professionals there are trained to work with dementia patients.

    I desperately wanted to give my parents a life outside of being in bed all day, "just waiting to die," as Dad would always say, but I had no idea how I’d convince them to go. I couldn’t get my father into the shower-so how in the world was I going to get him to consent to go there?
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    Unfortunately, no one gave me any creative ideas on how to get them there, so I suffered at home with them for nearly a year. Finally at my wit’s end, I decided I just had to figure out a way.

    First, I went for a tour of the beautiful center nearby, and then pleaded with my father for weeks on end before he begrudgingly gave in and consented to go. My mother was fine with it right away, but my father was bound and determined to sabotage the whole thing.

    I was so embarrassed after their first day when the staff told me they had spent the entire day trying to manage my father, as he wouldn’t leave my mother alone–holding onto her too tightly and touching her inappropriately (which he had never done). Then, he threw his lunch on the floor during a terrible temper tantrum and even tried to escape out the bathroom window. When I arrived to pick them up, the staff was completely exhausted and sincerely doubted he would ever accept attending–they hoped!

    Well… if I had to do it again, here’s what I’d do: First, I’d have Mary (one of the social workers) call my father a few times and develop a relationship with him over the phone. Then I’d have her "drop in" with some cookies, because she just happened to be "in the neighborhood." I’d have her ask my father if he could come to "The Center" (never calling it Day Care) to help with something–like the bingo, lunch, or the singing classes. Perhaps he could even play his accordion to entertain the seniors there. By giving him a "job" and telling him he was needed there–he’d have been honored to go help out and may have consented to go sooner.

    But, if that didn’t work… after taking my parents out for a drive one day, I’d casually stop by The Center and say, "Oh look where we are. Why don’t we drop in and say hello to Mary, who was sweet to stop by the other day?" Of course, I’d have an appointment set up to take a tour and meet the staff and other seniors. I’d have Mary ask him for his help with preparing lunch for everyone, as he loved to cook, and then I’d have her ask him if he could look into fixing something for her, as he always prided himself on being able to fix things. I’d also have Mary ask for Mom’s help folding the laundry-one of her favorite tasks.

  • Then, I’d go with my parents as many times as needed, a little longer each time, until I was sure my father felt safe and comfortable. I wish I had understood how scary any kind of change can be for an elder, particularly for one as controlling as my father-and with the beginning of dementia. A gradual transition would have saved us a lot of aggravation.
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    And even though I did it all wrong, eventually I succeeded in getting my father to accept the routine of it. Finally they had someplace to go, friends to see, and numerous activities to look forward to. He loved the current events programs and one day came home declaring over and over, "I have a dream!" Apparently, the program on Martin Luther King Jr. made a huge impact on him that day–as he came home and told us all about him!

    And, all the activities tired them out so they’d finally sleep through the night-which meant I did too. The stress on me to care for and entertain them was dramatically reduced–as was my blood pressure.

    I was pleased because it wasn’t long before my parents became shining success stories, progressing dramatically in their behavior and strength. Even their doctors were impressed and I was delighted that they were better than they’d been in years.

    Now as I lecture around the country, I always talk about the value of Adult Day Health Care for dementia patients-unfortunately, the best kept secret in eldercare. I smile each time I hear the same reluctance, "Oh Jacqueline, they would never go there." Then I explain the whole thing and stress that with a little extra creative effort and patience, a significant difference can be made in the lives of elders with dementia (even the "challenging" ones), as well as their overwhelmed caregivers.

    Yes, I get many "Thank You, Thank You, Thank you" emails.

    You can learn more about Jacqueline and find information about her book at
Published On: September 19, 2006