My first exposure to adult day care was while on one of my daily visits to the nursing home where my dad, mom and my mother-in-law all resided. I was fetching something from the kitchen for one of my elders when I ran into one of our city commissioners who had a mother living at the home. The woman was a nurse by profession, but as we visited, she told me that she was going to start an adult day care. I thought that was a great idea. To the best of my knowledge at the time, we didn't have such a place here in our metro area. I've since learned that one of the nursing homes had started one earlier.
Anyway, the whole concept came too late for me and my elders. Several years later, when I met the woman again, I asked her how her venture had gone. She said the day care had failed. She was, as she put it, before her time. The woman then bought a franchise of a widely known in-home care agency and has run that ever since.
Adult day care is now thriving in my metro area, and has many incarnations. I think that's excellent, in that one size doesn't fit all when it comes to elders' needs.
Here, I'll answer here some of the most frequently asked questions I've received about this useful option for caregivers.
Q. What are the different options available in adult day care?
A. Not every city has a lot of options, but there seem to be three major types.
1. Free standing: This kind of adult day care (or adult day service, which I prefer to call it) is not connected with a nursing home or assisted living. The one in my area, in fact, is more like a health club. It's very new, and is expecting to be caring (sadly) for many Iraq War veterans who have suffered brain injuries. Because of this, they are very high tech. They have computers that can be used by blinking one's eyes. They have many types of fitness devices and a wheelchair accessible sauna. They even have a game that resembles pool, but can be played by those who can't use their arms. They, of course, have a couple of Wii systems. In fact Wii bowling is so popular that they've started a league.
2. Connected to a nursing home or assisted living center: This option is preferred by many who know their elder will transition into nursing care. The family and the elder get to know the staff at the home, as well as the physical plant. We have several good ones in our area, each with a little different personality. So, as always, it's good to tour several. One of my favorites has a child day care in the same building. The outstanding administrator of this home makes a point of knowing all the day care people by name, and visits daily. The woman who runs it is a natural. I knew her when she was a CNA at the nursing home. She is the one who pushed for a day care at the facility. When I visited, I saw happy people baking in the kitchen, others playing cards and some using exercise equipment in the physical therapy room, as the therapists were gone and the room was open. There were a couple of ladies who like to sit and watch videos in the charming sitting room (television isn't allowed as it's too hard to control the content).
3. Private home setting: This is typified by people with the attitude that they "live with those they serve." The home I visited was in a nice neighborhood and was licensed for four people who needed care. One advantage they had was that they could take an elder for a night or a weekend, where other day cares aren't set up to do that. Some people like the closeness and feel that it's more "family like." Others may feel it's a bit too cozy. Again, it's about visiting the facility. You'll know the personality of your elders and what may suit them best.
Q. Do you need a contract to use a center?
A. That depends on the facility. The the ones I talked with wanted time to assess the elders' needs. Once that is done, they like some idea of what you're planning for, but they are very flexible. Some want you to book father ahead than others. Some want at least a morning or afternoon block of time, where others will charge by the hour. Most don't need a long-term contract of any kind. I'd be careful of any who ask that of you.
Q. Do they pick people up or must you drop them off?
A. Most have some sort of pick-up bus or service, but no rule applies to all. For many elders, it's best if you go along the first few times, go in and make sure they are comfortable, and then drop them off. For others, it's better to say, "Your bus to go to the club is here," help them on and wave goodbye.
Q. Even with the word adult, day care sounds like it's for kids. What do I tell my dad about where he is going?
A. That's why I don't like the term "day care" even though it is recognized now for adults. I prefer the term day services, and some people use that. However, even that smacks of "kiddieland." I advise people to call it "the club," or telling them it's an opportunity to volunteer. Many buy that and enjoy going with that in mind. The centers can keep them busy. Obviously, this depends greatly on the mentality of the person going. I'm thinking of middle stage and later Alzheimer's. If a person is fine mentally, but is going for the social aspects (which can be very valuable), then you need to call it whatever it says on the sign on the door. But when you approach the elder about giving it a try, relate it to a club, a volunteer opportunity or church circle. Keeping their dignity is important for an elder, and rightly so. Do your best to let them know that this is a place where they can associate with peers and that the social outlet will be good for them. They can also be useful there.
Q. Is this good for working caregivers?
A. It seems to be one of the best options available, if the elder lives with you. In-home care is good, too, in many cases. I've seen several successful blends, where an in-home care person gets the elder ready to go to day care, and is home to receive them afterward.
Q. Is it expensive?
A. Adult day care is expensive, but so is in-home care and so are all of the other options. It's likely less expensive than the others, if you don't need full day care every day. Many people like the flexibility it offers, and only use it a couple of days a week.
Q. What services are offered at day care?
A. Many offer a hair salon, standby nursing care, and some offer bathing services. Each will be different. Those attached to nursing homes may offer more options if you have a diabetic or someone more likely to need a nurse in an emergency. You need to ask each one what services they have available.
Q. What are the most positive aspects for the caregiver of using adult day care?
A. The obvious one is time to have for errands, work or just being alone. One column reader added this valuable twist and I've felt the need to pass it on, as I hadn't thought of it before. He said that he dropped his wife off at day care and then went home. He'd sit and enjoy not having to "have eyes in the back of his head." Okay, that's obvious. But he also said that it helped him learn to walk into an empty house without his lifelong partner being there with him. It helped him prepare for her death and the inevitable loneliness that would follow. This gentleman suggests the day care option to many people as "'pre-death" therapy. He was gradually able to get used to the empty house, so when his wife died, he was more prepared. That is definitely something to think about for spousal caregivers.
For more information about Carol go to www.mindingourelders.com or www.mindingoureldersblogs.com.
Published On: April 01, 2009