June 2011 Edition
Adult Day Services Provide Respite, Normalcy
By Elyse Umlauf-Garneau
My dad's not ready for full-time assisted living, but he can't stay alone all day. I worry about my parents when I'm at work. Mom is overwhelmed by boredom and loneliness.
Some families caring for elderly relatives have found that adult day care offers an ideal solution for seniors who need assistance during the day.
One such person is Rick Lauber (http://cdncaregiver.blogspot.com), an Edmonton, Canada-based author of Caregiver's Guide for Canadians. His mother was ill and couldn't care for her husband when he was diagnosed with Alzheimer's. Adult day services provided relief. "The program offered my dad the opportunity to remain socially involved and in activities that stimulated him mentally and physically," he recalls. "
The care also offers crucial respite for caregivers. "We knew dad was safe and that we could relax," Lauber comments.
"It fills that gap when it's unsafe for people to be alone but when they're not ready for greater care," comments Lynn Ivey. When her mother experienced memory loss and her dad became a full-time caregiver, Ivey sought ways to ease her dad's exhausting schedule.
Not only did Ivey find the necessary day services for her mom, but she also found a new career. Ivey left a banking career to found the Ivey, an adult day services center in Charlotte, N.C., which opened in 2008.
A step up
The local senior center may be the ideal spot for healthy seniors to socialize and hang out, but adult day services offer a step up for those needing greater care.
That higher level of attention may include:
- Meals - Seniors who rely on frozen dinners or convenience food are often getting loads of unnecessary fat and salt. Many centers provide snacks and healthy meals prepared on site to ensure that meals fulfill clients' nutritional needs. The services also lighten the grocery shopping and cooking load for caregivers.
- Medical supervision - On-site nurses can administer clients' daily medications and also spot potential health problems before they turn into crises. "We assess clients' health and social needs and create individualized care plans for each person," Ivey comments.
- Personal care - Bathing at home can be challenging and dangerous. Ivey's facility features spa-like bathing rooms, where clients can take their regular baths. They also can receive bathing assistance, if needed. It also features an on-site nail and hair salon that eliminates another weekly errand for caregivers. When incontinence is a problem, many adult day services programs have plans in place for clothing changes, bathing, and so forth.
Weighing the options
Typically, people seek adult day services when they're in crisis mode. If you can, it's best to check options well before they're needed.
Here are some things to look for:
- Staff to client ratio: Be certain there's sufficient staff to assist clients. A 2010 MetLife study found the average staff-to-participant ratio was about one care worker for every six participants in adult day facilities. That's a change from 2002, when the ratio was one to eight. "The MetLife National Study of Adult Day Services" is available at www.metlife.com/assets/cao/mmi/publications/studies/2010/mmi-adult-day-services.pdf
- Transportation: Sometimes transportation is provided, sometimes it's not. Determine whether you can get your parent to the center or whether you'll need a center that offers transportation.
- Good vibes: Lauber suggests carefully observing how staff members interact with clients. Are they patient, friendly, and gentle? Also assess whether clients seem happy and engaged. "Look for laughter, smiles, and noise," says Ivey.
- Activities: The center should provide a full roster of fun, stimulating activities each day that address both physical and intellectual needs. Typical activities include music and entertainment, intergenerational events, outings, exercise, hands-on art, gardening, and games. One of Ivey's clients with memory loss still can play the piano and sing beautifully, and he does both at Ivey's center. "It allows people's talents to come out again," she comments.
- Costs: Fees for such services vary, but the MetLife study found that costs for a full day at a care center averaged $61.71 and that flat daily fees averaged $57.96. Medicare doesn't cover such care, though long-term care policies may have provisions for day services. "Compare the costs to nursing or in-home care and you'll find that adult day care is the least expensive of all forms of care," comments Ivey.
One subtle benefit of adult day services is their ability to restore some normalcy to family relationships. Kids can be kids and spouses can be spouses.
Ivey says her mother still wanted to hold her husband's hand and snuggle with him, for instance. But after caring for her all day, he just wanted a break from her. That can be a sad loss for both partners.
Ivey says that using adult care outside the house can help to restore that normal, close marital relationship that people once had.
Lauber found adult day services through a doctor referral. You can also locate them by visiting the National Adult Day Services Association (www.nadsa.org/services/index.php) or the Family Caregiver Alliance (www.caregiver.org/caregiver/jsp/fcn_content_node.jsp?nodeid=2083) or by doing an online search for services specific to your city.
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