What’s the value of adult day care and how can I convince a resistant elder to attend?


Q: What’s the value of Adult Day Care and how can I convince a resistant elder to attend?

A: While caring for my elderly parents, I was advised so often to get them enrolled in a local Adult Day Care program to give them a life outside of bed all day "just waiting to die", as my father would always say. I scoffed at the idea, as I couldn't get my father in the shower, so how in the world was I going to get him to go there? And what was Adult Day Care anyway—like a nursing home or something?

A year later (and at my wit's end) I decided it was worth a try after I went for a tour of the beautiful center nearby. I pleaded with my father for weeks before he begrudgingly gave in and consented to go, while Mom was open to the idea right away. At the end of their first day she giggled, "Oh honey, guess what? I won some lovely new earrings at the bingo!"

Unfortunately, my father was determined to sabotage the whole thing. I was so embarrassed when the staff told me they had spent the whole first day trying to manage him, as he wouldn't leave my mother alone holding onto her too tight 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. Several hours later 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 go over to "The Center" (never calling it Adult Day Care) to help with something--like the bingo or the singing classes. Perhaps he could even play his accordion to entertain the seniors. By giving my father a "job" to do and telling him he was needed there, he would have felt honored to go help out.

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 so sweet to stop by the other day?" Of course, I'd have an appointment set up to take the 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 to The Center as many times as needed (a little longer each time) until I was sure my father felt comfortable and safe. I wish I had understood how scary any kind of change can be for an elder, particularly for one as controlling as my father with the beginning of dementia. So basically, a gradual transition would have saved so much aggravation.

But even though I did it all wrong, eventually I succeeded in getting my father to accept the routine of going to The Center. Finally they had someplace to go, friends to see, and numerous activities to look forward to. He loved the "Current Events" time and one day came home declaring over and over, "I have a dream!" Apparently, the program on Martin Luther King Jr. that day made a huge impact on him. And, all the activities tired them both out so they finally slept 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 so pleased, because it wasn't long before my parents became shining success stories, progressing so 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 all over the country about eldercare and caregiving issues, I always tell everyone about the tremendous value of Adult Day Care—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 emphasize that with a little extra creative effort and patience, a significant difference can be made in the lives of elderly loved ones (even the "challenging" ones), as well as their overwhelmed caregivers.

Jacqueline Marcell is a former television executive who was so compelled by caring for her elderly parents (both with early Alzheimer's not diagnosed for over a year) she wrote "Elder Rage." She is also an international speaker on elder care and host of the popular Internet radio program "Coping With Caregiving."

Elder Rage

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I read your comment Wheat and I cried . I thought "wow" and I thought I had it bad! Well, I left retired 5 years ago from my teaching career to come to Florida to be with my parents. My mother and best friend had alzehemier and my father and her would not talk about it. Mother recently passed away and now I am dealing with a father that is depressed and has cronic pain. They had been married for 62 years and now he is alone and scared. My father,as I was growing up was the "rock of Gilbarter " I always new I could count on him and now he has regressed to child like and is very depressed.
My father is in and out of hospitals because he can not take the pain of his back , legs and now his hip. When he is in the hospital or rehab he is a social butterfly but the moment I take him home "the pain" becomes umbearable. I have never entertain the thought of putting him in a home because he has his own home but I now realize he needs the companion of other elderlys. I am now in the process of looking for an Adult day care center and hope he will be happy again,
I presented Adult Day Health to my mom in terms that I knew would appeal to her. I toured the potential programs in advance & once a program had been chosen, I told her that I knew of a COA type place that needed some volunteers. My mother used to volunteer a lot, so I knew this would appeal to her. The staff was aware of the volunteer plan & went along with it. We toured the place together & talked about the things that she could do to help others. She agreed to go & was initially signed up for 3 days a week. When she tried to back out, I reminded her that she had already promised to volunteer there & they were counting on her help! I also told her if she didn't like it after a couple of weeks that we would look for another opportunity for her. I purchased her favorite board game for the program & dropped it off prior to her start date. Day one she stated it was a "little weird" but it was o.k., before I knew it she was disappointed on the days that she didn't have "work" & we increased it to 5 days a week. Now she is disappointed when "work" is closed on the weekends. I had the benefit of knowing how to appeal to my mother's likes & work in this field, but I am grateful for her program because it brings her joy & a sense of purpose again!