Adult Day Care May Be Dementia Caregivers’ Secret Stress Weapon


Caregivers who use adult day care services to help them look after a loved one with dementia may experience less stress than those who forgo this important resource, says a new University of Pennsylvania study.

Over the course of eight days, researchers monitored the moods and blood levels of DHEA-S (a hormone thought to buffer the effects of stress on the body and mind) of more than 150 dementia caregivers who sought out the services of an adult day care center at least twice a week.

Stress depletes an individual's DHEA-S reserves, which then typically rebound after the source of the stress is removed. The connection between the amount of DHEA-S in an individual's body and their overall health is still a bit fuzzy, but too-low levels of the hormone have been associated with osteoporosis, cardiovascular disease, stress and immune system dysfunction.

Lead author Steven Zarit, Ph.D., head of the Department of Human Development and Family Studies at Penn State University, and his colleagues found that caregivers' overall demeanor and DHEA-S levels were both elevated on the day immediately after their loved one spent time at an adult day care center, leading to the conclusion that using this service can have significant stress-relieving benefits for those caring for a family member with dementia at home.

"Regular use of adult day services may help reduce depletion of DHEA-S and allow the body to mount a protective and restorative response to the physiologic demands of caregiving," the authors note in "The American Journal of Geriatric Psychiatry."

Demystifying adult day care

The term "adult day care" may conjure up scenes of older adults being treated like children and playing with toys, but nothing could be further from the truth.

"People are not aware of all the cognitive stimulation and health benefits that an individual can get by going to a center," says Debbie Stricoff, director of adult day services at the Visiting Nurse Service of New York (VNSNY) CHOICE Adult Day Center. "It's a center to promote wellness; a place where people can improve their functioning."

Stricoff argues that a societal shift needs to occur in how adult day care is perceived. "These are places where people's conditions can actually get better."

Each day care program is different, but the CHOICE Center offers those with dementia a host of activities, ranging from informal socialization time, to exercise and art-therapy classes, to reminiscence activities. Caregivers are sometime invited to participate in group crafts and holiday celebrations.

The right adult day care center can offer caregivers an invaluable respite opportunity, while providing engaging activities for individuals living with Alzheimer's and other forms of dementia. Stricoff says it's important to keep in mind the following criteria when scoping out the centers near you:

  • Ensure there are enough staff members to look after and attend the men and women at the center. The National Adult Day Services Association, a nationwide organization geared towards developing and advocating for adult day services, recommends that programs catering men and women with dementia have a one to four staff-to-participant ratio.
  • Peruse the activity calendar to see whether they offer events and activities that your loved one would enjoy participating in.
  • Be on the lookout for odd odors or an unclean facility.
  • Check to see what transportation options are available to get your loved one to and from the center.
  • If your loved one has specific dietary needs, be sure to inquire whether the center can accommodate them.
  • Ask about the types of personal care services (e.g. toileting, eating) are offered.
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Adult Daycare in my community is keeping me sane! My 90 year old husband would be sleeping his life away without it. He has moderately severe dementia, but is a generally happy person and enjoys being with others. He goes MWF from 9:30 to 4:30. There are about 25 others there - many are Spanish speaking, but all get along well. Great staff, all CNA's with additional Alzheimer's training. Ratio is 1 to 6. We need MANY more of these facilities! I tried an assisted living facility, but he needed more direct supervision than was offered and wasn't really so far gone that he needed a memory care facility. The rates are $50/day for 3 or more days, $60/day for 1 or 2 days. They are open from 8:30 to 5 and serve breakfast, lunch and a snack.
Day care is definitely the best thing I have done for my mom and ME. Mom goes 5 days a week from 10 until 4. When she started the program two years ago it was a couple of half days a week. Without the center's loving attentive staff to keep mom engaged is so many different activities I believe her decline would be more rapid. Without them I would not be able to do this. And I use therapeutic lying most days to get mom to go. But once there she usually has a wonderful time, even though she cannot remember what she did.
My husband is 65, physically very fit, and has had dementia for several years. I've visited adult day centers, hoping against hope that I could find one that didn't cater to frail elderly with a preponderance of women and activities tailored for such a population (and, yes, some centers treat older adults like pre-school children, at least in their presentation of activities). My husband needs lots of physical activity to work off his excess energy, has lost most of his nouns so "reminiscence" and other memory-stimulating exercises frustrate him, and likes spending time with men. We belong to a group called The Memory Care Café (started in the Netherlands), which consists of those with dementia and their caregivers (so equal numbers of men and women), and he likes going to various places, e.g. Irish Cultural Center to listen to music, although he doesn't participate in the conversation over coffee afterwards. However, his mood and ability to communicate improve after these get-togethers. I've tried a high-energy in-home caretaker, but he only tolerated her for two mornings before refusing to have anything more to do with her. My DHEA-S levels must be at rock bottom. I don't get sick (can't allow myself to) and, although I try to put into practice all of the ways to keep my husband well and happy recommended in the many dozens of books and articles I've read, I find myself getting cranky oftener and at unexpected times and then feeling guilty as well as having to cope with the difficult behavior that this engenders in my husband. We live in San Francisco, which offers a lot of services for the frail elderly, but younger early-onset men are underserved. Please don't suggest that I start my own adult day center; between house maintenance, financial planning and administration, the increasing number of daily chores, and trying to stay in touch with friends who help me to de-stress, I don't have time to take on another project.