Which sounds better? "Let's go, Dad. We need to get you dressed for day care." Or "Hey, Dad, let's get you ready. The guys at the club are waiting!"
If your Alzheimer's-afflicted dad is dragging his feet about going to day services and you need to get to work, which do you think would be more effective? It's pretty obvious that the more respectful, dignified question would get the best response.
Whether called "day services," "day care," "the club" or "volunteer work"—whatever seems right for the sake of the specific elder—these adult day services have been a well-kept secret for years. Far too many people don't realize they have this care option.
Just for the record, I try to stay away from the "day care" term, because there is a certain stigma of childhood that goes with it. I am a proponent of treating elders with dignity, no matter how "child-like" they may have become. So, I prefer the term "day services." For more on the dignity issue, you can read "How "Role Reversal" or Other Catch Phrases Skew Your Thoughts."
Variable terminology aside, adult day services can be extremely helpful. When an elder is in the earlier stages of Alzheimer's, probably able to live at home with some care, but at risk for wandering or leaving a stove turned on if left alone for long periods, day services can be a life saver, literally.
Many people will try in-home care for awhile. They will hire an agency to bathe and dress the elder, but then what? What does the elder do all day? Day services can be a good option, at least a few days a week, as the elder gets out and is able to socialize with peers.
In cases where one spouse is healthy but can't care for the other spouse day and night, or when the healthy spouse just needs time off, day services can be an option.
It can also work well if the elder with Alzheimer's disease lives with adult children. In most homes, both adults must work. Often there are children of varying ages involved, as well. When everyone must go to school or work, who looks after the elder? Day services can fill the gap.
Many adult services have a handicapped accessible bus that will pick up the elder. There should be someone on the bus trained to work with the elder and who can become a familiar face. Other times, you may have to drop the elder off, or maybe that just works better for your elder. Generally, there are choices.
Day services provide social stimulation for the elder, as well as activities and safety. Many have a nurse on call or on the premises, to administer medications.
Three Types of Adult Day Services
I recently wrote a newspaper article on our local adult day centers, so I did some prior investigating. Even though I try to be aware of changes, they happen so quickly—and every type of care center in my area is undergoing constant change for the better—that it's hard to keep up.
For the story, I focused on finding three centers that were very different from one another, as I know how different people can be. What is perfect for one elder is a disaster for another, and that isn't necessarily because the center is bad. It's about personalities and where the elder is in the downward spiral.
The first center I visited is attached to a fine nursing home. The woman running the center considers this the best option, and for many elders, it is. The nursing home entrances are secure, so the day center clients can walk the halls if they choose. They have a physical therapy room that is open to the day center when it isn't in use by the nursing home, for prescription therapy. Many elders enjoy using the exercise equipment.
This center has a number of elder veterans, and they enjoy sitting around a cozy table sharing stories. The veterans have no problem hearing the same stories told every day. They all do it. The faces are familiar, as these people have not yet reached the later stages of Alzheimer's or other dementia where they don't recognize faces. When the elder reaches the later stages of Alzheimer's, he or she generally needs full nursing home care.
This particular nursing home is blessed with a young, forward-thinking administrator. He knows every day center client by name, and isn't above wiping a runny nose as he listens to yet another rendition of a story he's heard many times over.
There is always a nurse on call if one is needed. The center has videos, a kitchen for supervised baking, and a cozy sitting room with a fireplace, where people can go for a little quiet time. They exercise, play games and generally have a good time.
The center has outdoor activities in the summer, and people can work in the garden if they like. This is a loving center, where I would be happy to have my loved one spend time, if this atmosphere worked for him or her.
Another center I visited was residential-home centered. Actually, it's a group of care homes, scattered about the metro area. Some homes in this group focus on long-term care and others focus on short-term, overnight, weekend and day services. For people who love a family atmosphere and are more comfortable in close settings, this is ideal. The providers are passionate about what they do, and are looking to add more homes to their network.
The third center I visited is a free-standing day service. It's newly built and filled with technology. The staff looks toward serving not only elders, but younger brain-injured clients. They expect, sadly but realistically, a number of Iraq war veterans to become regular clients. However, they are also set up for elders.
As I toured the spa-like whirlpool equipped bathrooms, the handicapped-accessible sauna, the exercise room, and the high-tech touch-screen computer center, I couldn't help but be impressed. The CEO conned me into a game of "carpet ball," which is an adaptation of pool and shuffle board, though I wouldn't bite when he offered a game at the regulation pool table. While I chatted with the administrator, the CEO "bowled" a game on the Wii game system that is set up to work with both huge television screens. Ladies who live in the assisted living center next door come over every Tuesday to "bowl" on Wii, and the CEO wants to start an area league for them. This center even has a heated work shop, so elders can do woodwork and "fix" things.
As impressive as this center is, I think that it would not have worked for either of my parents. However, many elders are enrolling, and for some it will be wonderful. I think it's truly a gift for younger people who need these services. I could have spent a day there just talking with the people who run it. As with the other centers, the people in charge are filled with genuine enthusiasm for what they can do for their clients.
Does your elder need day services? Will he, she and/or you benefit? Consider it an option if the elder isn't ready for a nursing home and isn't yet in assisted living. Assisted living would give the elder many of the same services, so when an elder has made that transition, day services wouldn't be needed. If the elder's needs have crossed the threshold to full nursing care, then they can't be cared for in a day services setting, either.
However, if you need services five days a week, or three; if you are a spouse that needs three afternoons to yourself or for errands; or if you need a drop-in site for emergencies, then check with local adult day services, probably still called adult day care in most areas. Check as many day service center as you can. Go at different times of day to see how things look. And, as always, check references. If everything looks good, you may want to try it. If your elder adjusts well, you'll have found one more care option to help you during this particular leg of your caregiving journey.