Got chewed out by grandpa's adult daycare, what do I do?

Adult day services do not like respite drop-ins. Why is this you say....as an on call employee of an adult care center, we had to plan our activities and staffing for the number of anticipated clients, and be able to call in people like me if we knew that there would be extras. These centers are not meant to be drop ins. It messes things up. I would be upset if that were the case. And I would really be upset if the family did not contact us re a planned client's absence. We order lunches for the anticipated clients, as well as other stuff. So, all that being said I think socialization is good, friendships are formed, and a little change is good for grandpa. At least take him 2 days a week. And yes places do depend on insurance, private or whatever. There are many people who would be so happy to give their loved ones the opportunity of day care, and themselves a planned respite to shop, get doctors appts., etc. So if you love being the full time caregiver go for it. Maybe consider an adult community center or church instead, for occasional activities, or a caregiver to come to your home when you want a break. But don't bring cookies. If you DO choose day care, come for lunch we would love to have you! And make arrangements for the van if you need it.

I think you should start by contacting Medicaid and find out the rules that apply to payment for adult daycare. If the Daycare is licensed by Medicaid there will be strict guidelines they have to abide by

Playing devil's advocate, I understand that schedules change constantly when taking care of an elder. You have to be available whenever you are needed to do whatever is in their best interest, which I believe the day care is. Outside socialization for him, whether he is antisocial or not, is very important for you and him. In my case I am able to work appointments around day care, so mom is still able to attend most days. How far is the day care from where you are living? It will take a while for grandpa to become accustomed to going and I know it is difficult to get them ready, believe me!! But the outside activity could potentially slow the progression of the disease. You may find that he makes friendships which would be very good for him whether he remembers or not. In my case taking mom each day is a challenge as she does not remember ever being there before. But, each day when I pick her up she tells me she has had a wonderful day. She often says I had a fun day, but I don't remember what I did.

Did his doctor recommend the program? Or how did you find it and why did you start using it? If his doctor recommended the program you could potentially find yourself in hot water for not taking him. Adult Protective Services could be called and a request for investigation of you for isolating him or any number of things.

I think you should take him starting with three days a week, during that time, get together with friends, go out for coffee, go to a movie, do something for you and you alone. It is an exhausting job to have 24/7 responsibility for someone/anyone, especially those with dementia and we need to take the help where we find it.

The above answer is spot on! Do see what the guidelines are and be sure this DayCare if following them!

But do you also "drop by" randomly on the days you do leave Grandpa there just to be sure the residents are being treated properly? If it's not allowed, ask yourself why. Sometimes, it's because the patient sees you and immediately wants to go home and gets upset if they can't go with you. (And many Alz patients do just that.) Sometimes, it's because you might catch the employees goofing off or neglecting the patients. So, have you thought about taking snacks by shortly after lunch, or around brunch, or any other time of the day as an excuse to check on him? (Do this on a day you really didn't want to take Grandpa, so if he does get upset, you can take Grandpa home.)

I always get nervous for the elderly when "money" seems to be the issue, especially Medicaid money, because it usually means the facility is not making enough money to stay afloat, which means cutbacks on services and can also mean they hire cheaper employees which are not always the best for the patients (some of the cheapo employees are drug addicts who will actually steal the elderly's pain medications and other meds. I know this for a fact).

But then, on the facilities behalf, they're probably doing the best they can if they have a lot of Medicaid patients, Medicaid has a weird system of how they pay that makes no sense to anyone, even Medicaid workers can't explain it fully because they don't understand it fully. For example, using a bill of my Grandma's, she received an EOB for an office visit to her regular physician who had charged $100, and Medicaid "allowed" $69 of it as legitimate expense for the treatment/time spent, then they paid the physician $11 and the rest the doctor's office had to write off. So the physician got $11 to treat Grandma for 20 minutes, THAT'S ABSURB! The EOB for the medical tests the doctor performed came to $1,267, Medicaid allowed just under $675 as allowable expenses and paid the laboratory $111 (not even 10% of the original bill) and the lab had to write off the rest. (These ridiculous amounts that Medicaid pays is standard, so I'm not using a low ball example, I literally have hundreds of such bills for Grandma.) So, the DayCare, if they have a lot of Medicaid patients, really does need to have the establishment full most days just to get any money at all. And they usually have to skimp on services rendered because they can't afford to provide much and not go broke. It's a vicious cycle and the reason so many Elderly DayCare facilities are private pay. They have to at least break even and most of these are the owners/workers only job, so it has to be profitable so the families of the owners and workers don't starve to death.

Perhaps you could take snacks to the employees once a week to show them how much you appreciate them. That goes a long way in assuring your Grandpa gets treated properly. A little kindness goes a long way.

Just don't forget to drop in randomly to keep them honest!

Good luck to you and God Bless YOU for taking such great care of your Grandpa!

I have a sister in adult daycare and it keeps her mind active. Most of these places have a waiting list, and they need a commitment from the client to keep their funding and keep the place open. If all the clients showed up only occasionally, the place would close up. Three days a week will be good for him, boredom kills.

Jessie-
I agree, these places are normally licensed for a maximum number of participants each day. And if Grandpa doesn't show up that is a space that could be used by another. Good point! The daycare needs to fill their permitted slots on a daily basis especially if it is Medicaid funds that pay for it. I don't know what the rate is but it is quite low.

Well this is how it has been for me, mom was reluctantly released from respite care in December . They said she needed to be placed in a long term residential care. I just said, let her come home I will care for her. I did everything that they suggested and one thing was for her to go to daycare. Well it sure was exhausting, the cleaning of her, the dressing of her, the big breakfast, I did it. The bus would be here anywhere from 10 am to 11:30, you just never knew it was a real anxiety producing event. She'd be ready to go and we had to wait, sometimes at noon they'd call and say the bus broke down. The effort was still made and the anxiety of waiting was terrible. She'd be obsessive compulsive and go to the bathroom a million times, each time I had to rearrange her clothing, she'd stuff rolls of toilet paper in her pants and pockets. By the time they came, I was a wreck and the few hours I had to myself became a time for me to calm myself. The bus was broken down more often than not, they had two week constant vacations and I was told their is no staff. I was told well, she will be back early today, so you could not do anything, I have a bicycle to get around on, the stress of trying to get to a bank or haircut or any appointment left me so stressed out. I had to be here when she came back. They would bring her back and more often than not say she will not be able to come back for two weeks with more reasons. So, I understand the limitations of this. I would say if they can take him, let them. I did it for nine months with great detriment to myself, but it is good for them. Good luck.

I always called when my mother wasn't going to be there on her scheduled days. It's just a courtesy. We were private-pay so we didn't have to follow Medicaid rules but I know Medicaid will not pay for no-shows even though the center has held a space open for your grandfather. They expect no-shows occasionally but it sounds as if your grampa is a chronic no-show and they need the reimbursement to stay in business.

Is this facility set up as a drop-in respite provider? The one my husband attended was not. He could go one day a week or 5 days a week, but it needed to be arranged in advance and be consistent. Occasionally I would call them and say "Coy cannot come in as usual on Monday, but would it be OK for him to come on Wednesday instead?"

The program my husband attended was absolutely excellent. I cannot say enough good things about it. I would recommend it (and have) to others in this area. But it was not set up to be a drop-in care center, and that would not have been allowed.

What I see in this post is perhaps a misunderstanding of the nature of Adult Day Health Centers. They expect scheduled attendance, on consistent days. If you need a drop-in center on random days, that is what you should be looking for.

Oldfriend2me's answer was really helpful as far as advice from the provider, which you must remember is a business and in it to make money. Whatever the medicaid provider rules, you also have to ensure that the business is willing to work with you. That said, as others have mentioned the place you go to should have clearly communicated their needs/issues to you. It sounds as if they are not good at that so perhaps it would be helpful if you started that conversation by telling them what your needs are and why and asking them what theirs are as a facility, and trying to find some common meeting ground between the two.