What is an Adult Day Care Center?

Adult day care involves specialized programs that are designed to enhance the social, mental and physical care as well as health needs of seniors. At the senior center, the elderly are supervised and provided with assistance and companionship. The centers generally operate Mondays to Fridays during work hours, with some providing half-day services on Saturdays as well as some evening care.

Most adult day care centers are non-profit facilities with a few publicly funded and for profit.

There are two main types of adult day care and the focus is usually on:

1. Social activities along with recreation, meals and limited services for health issues.
2. Serious health care services along with meals, social and therapeutic services.

While most adult day centers serve the general population, some cater to specific groups, such as persons with Alzheimer’s or some forms of dementia; and meals, social and health care activities are also included.

Activities and Services Provided by Adult Day Care Centers

Without adult day care, many seniors would have been institutionalized; therefore it plays a critical role in preventing or delaying this action. The goal of adult day care is to help the elderly to maintain or to improve on their social, physical and mental abilities and skills, while addressing their health needs. The centers offer a wide range of activities such as local outings, holiday and birthday celebrations, entertainment with music, singing and art and craft. There are also interactive games, light exercises, group discussions and film shows.

The structured programs and activities may include:

• Socialization, exercise and recreation.
• Health screening, medical care and medication management.
• Counseling, physical therapy and respite care.
• Meals and transportation to and from the center.

At some adult day centers, seniors interact with children especially for art and craft activities. In addition, some seniors get the opportunity to give back to their community by sharing about their life experiences with school children and other community groups.

Benefits of Adult Day Care

Adult day care offers a great opportunity to keep the family unit together. Instead of being institutionalized, the senior will be able to stay at home, without requiring round the clock attention from his or her primary caregiver. It also allows the primary caregiver to work outside the home, run errands and to get a break from providing care to their relative on a 24/7 basis.

For the adult day care participants, there are many great benefits, including:

• A pleasant and safe supervised environment .
• Customized care based on needs.
• Assistance with activities of daily living.
• Support from and socializing with peers.
• Helping to develop seniors’ independence and sense of belonging.
• Nutritionally prepared meals based on health needs.
• Stimulating social and educational activities.

When to Use an Adult Day Care Center

Sometimes making a decision to use an adult day care center can pose a challenge for members of the family. Caregivers may feel as if they are giving up on their love ones and turning them over to strangers and the elderly may feel as if they are giving up their independence. However, using an adult day care center benefits all parties and should be an important component of a balanced home health care plan.

Seniors should always look at the possibility of using an adult day care and signs that it is time for the family to explore this option may result if the:

• primary caregivers are unable to continue to provide round the clock care.
• elderly is unable to be left safely and alone at home.
• senior is in need of peer support, interaction and socialization.
• senior requires help with structuring his or her own activities of daily living.

How to Find the Best Adult Day Care Center

When looking to find an adult day care center you should first identify the needs of both the senior and the family. This should take into consideration whether the senior’s main needs are more for social or medical.

Conducting research to find out if the adult day care is right for your family is very important.

A quality adult day care facility should include the following procedures:

1. Assesses the needs and abilities of each participant before admission.
2. Develops, monitors and adjusts individual treatment plans for every participant.
3. Uses staff and volunteers who are qualified and properly trained.
4. Implements standards and guidelines for both the state and national level.
5. Provides very clear guidelines regarding termination and offers referrals for other community services.

In addition, an extremely good adult day care program should provide a range of in-house services and activities in a safe and secure environment. These should meet the daily needs of participants, such as personal care, meals, transportation, recreational and rehabilitation.

Equipped with your information, you should then proceed to locate and learn more about the adult day care centers in your area. Good sources for references and information may include:

• Your local and national agencies that deal with aging, such as the National Council on Aging.
• Social services and mental health centers.
• Your family doctor and therapist.
• Recommendations from current users.
• Listings for ‘adult day care centers’ in the Yellow Pages.

*When contacting the adult care facilities, you should ask questions regarding the agency’s license, owners and length of time in operation, days and hours of operation, activities, programs, meals and staff qualifications.

Once you have identified the centers you would like to consider, you should visit them and speak with the staff and other families that use the center, since standards and services may differ. This will help you to determine if the facilities and programs offered meet with your requirements. Take along the recommended checklist by the National Aging Information Center to help you in your decision-making.

Costs and Funding for Adult Day Care

Costs for adult day care centers will vary depending on types of services, geographic location and type of reimbursements. Generally, the cost ranges from $25 to $100 daily and it is not usually covered by Medicare. However, some private medical insurance coverage and government or state assistance such as Medicaid and Veterans Administration may be available if you use a licensed facility. In addition, caregivers may benefit from tax credits for dependent care.

Other Resources and Links

Eldercare Locator, a public service of the U.S. Administration on Aging. The Eldercare Locator is your first step for finding local agencies, in every U.S. community, that can help older persons and their families access home and community-based services like transportation, meals, home care, and caregiver support services.

Find Adult Day Centers in your area National Adult Day Services Association (NADSA)

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Dementia Care and Communication

When caring for a person with Alzheimer’s or other form of dementia, always speak gently, using short sentences comprised of simple words. Avoid yelling or becoming exasperated, even when repeated requests or conversations are necessary. Eliminate distractions, when possible. Remain positive and talk with, rather that at, the person. Avoid interrupting but provide help with forgotten words, when necessary.

Dementia Care Routines

For optimal success and comfort on a daily basis, routines are an important component of Alzheimer’s or dementia care. Although the details may not be remembered, the sameness of established routines is comforting. Based on individual preferences and needs, develop routines for dressing, bathing, meals, exercise, activities, outings and bedtime. In addition, have a plan for providing physical care that requires assistance with lifting or an increased level of physical strength. Plan to have a younger relative close at hand during these times, if possible.

Daily dressing should be made as simple as possible. Avoid buttons, zippers or laces and opt for elastic waistbands and Velcro closures instead. Allow clothing to be chosen from a limited number of items and lay the items out in logical order for dressing, assisting only as needed.

Make Preparations

Reduce the stress of bathing or showering by having everything ready ahead of time and carefully explaining step-by-step exactly what is going on. For comfort and safety, use a bath or shower seat and non-slip tub mat. Install grab bars where needed. For added convenience, use a handheld showerhead. Always test the water temperature before use and never leave the room, even for just a minute.

Dementia Care Schedules

Sleeping and eating should occur on a regular schedule. A set bedtime and naptime, as appropriate, will help keep things running smoothly. Meals and snacks served at specific times helps to provide structure to the day. Keep in mind that several small meals are usually better than three large meals.

Exercise For Dementia Home Care

Adequate exercise is critical for the caregiver as well as the person to whom care is being provided. Creatively incorporate exercise into the daily routine whenever possible. Discover forms of exercise that are mutually enjoyable such as walking around the neighborhood, swimming or gardening.

Activities and outings present a special set of challenges. During any activity be alert for signs of impending frustration. Plan activities based on existing skills rather than attempting those requiring that new skills be learned. Schedule outings and appointments for the time of day when cooperation is most likely and take along a family member or friend, when possible.

Dealing with Hallucinations from dementia

People afflicted with Alzheimer’s disease or other forms of dementia may experience hallucinations or delusions. Should this occur, discuss the problem with the primary care physician as it may indicate physical illness. In the absence of physical illness, techniques to deal with hallucinations or delusions include distraction through a change topic or physical in location. Avoid arguing or attempts at reasoning, as these tactics will most likely lead to further agitation.

Considering Pets For Home Care Patients

Finally, consider whether a pet would be beneficial. Pets provide companionship and often have a calming effect. When selecting a pet, choose one with an appropriate disposition. An adult cat or calm lap dog is usually a good choice. Check the local animal shelter or humane society for assistance in adopting a pet that is already housebroken and displays the desired behaviors and character traits.

Home Caregiver Back-up and Respite Care

As a caregiver, it is imperative to have a backup plan, as there may be time when personally providing care is just not possible. Consider the impact that illness or injury could have on your ability to care for your loved one. Having a contingency plan for emergencies, illness or other unforeseen circumstances provides peace of mind and ensures continuity of care.

It is best to have at least one specific alternate person in place that knows the routines and can step in should the primary caregiver be unavailable. Identify various family and friends who may be called upon in the event of an emergency. In addition to providing hands-on training, develop a written set of instructions that includes the daily routines, medications and any tidbits of information that might be helpful. Encourage all alternate caregivers to visit regularly to retain familiarity with the established routines and keep abreast of inevitable changes in the person suffering from Alzheimer’s disease or other form of dementia.

Remember To Take A Break From Being A Home  Caregiver

It’s also critical that the caregiver takes a break now and then. Caring for a loved one with Alzheimer’s or other dementia is an around-the-clock job that can be draining emotionally and physically. To continue providing optimal care in a loving and nurturing environment, the caregiver needs time away to recharge. Seek adequate respite on a regular basis. Ask for help from family and friends. See what community resources are available, such as adult day care. These programs provide an opportunity for socialization and ensure safety during the caregiver’s absence providing the caregiver with a much needed and well-deserved break.

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Contemplating Dementia Home Care

The first thing to determine when contemplating home care is whether it is in the best interest of the person for whom the care is needed. Realistically assess whether the home environment can be modified so that it is safe and conducive to proper care. Also, assess current commitments and personal limitations. While it is rewarding and highly admirable to provide elder care for an aging loved one, caring for a person with Alzheimer’s or other dementia is a full time job.

Once the decision has been made to become the primary caregiver, a host of other considerations must be addressed. The main purpose of home care is generally to allow the person to remain as independent as possible in a safe, loving and nurturing home environment. Creating this environment and ensuring adequate care around the clock requires planning and may necessitate significant modification to the home and adjustment of individual schedules.

Educate Yourself On Dementia Home Care

To the extent possible prior to commencing care, learn about various techniques that have proven successful when dealing with the particular type of dementia in question. Research strategies such as graded assistance, which helps individuals to accomplish various tasks with a minimal amount of help. Consult the primary care physician to ensure that any recommendation under consideration is appropriate.

Senior Safety First

When providing Alzheimer’s or dementia care, ensuring a safe environment is essential. Thoroughly examine the home, inside and out, for potential hazards. Lock up medications, lighters or matches, guns and knives. Use childproof latches on cupboards or drawers that contain cleaning supplies or chemicals. Secure anything that might be a health or safety hazard. If in doubt, err on the side of caution.

Eliminate clutter and remove throw rugs as they are a potential tripping hazard. Clear flat surfaces of breakables and ensure that pictures or mirrors are hung securely and not located where they might be brushed against in passing. Upgrade lighting, if necessary, so that all areas are adequately illuminated.

To prevent wandering, have secure locks installed on exterior doors and all windows. To ensure immediate access to provide assistance if needed, remove the lock from the bedroom and bathroom door. Keep a recent photograph on hand and make sure that a medical bracelet or other form of identification is worn or carried at all times in case of wandering or other accidental separation.

Create A Comfortable Environment For Dementia Home Care

In addition to ensuring safety, the environment should be as comfortable and soothing as possible. People with Alzheimer’s or other dementia are often easily agitated. Eliminate chaos and keep excess noise to a minimum. Ensure that meals are eaten in a calm atmosphere without distractions. When watching television, keep the sound adjusted appropriately and avoid programs that might cause confusion or agitation, especially those that contain violence of any kind.

Be proactive in the areas of temperature and personal comfort. Be aware of room temperatures and keep the thermostat at home set to provide a comfortable level of heating or cooling. For outings, take at least a sweater and a change of clothing in case of weather changes or accidents, either from spilling or incontinence. Always test the temperature of food, beverages or bath water.

Sleeping often presents unique challenges. Ensure that the bedroom is quiet and dim at night. Play soothing music or provide other background noise, such as the sound of the ocean. Use night lights in the bedroom, hallway and bathroom for safety. Develop a bedtime routine to calm and signify the end of day.

Part 2 of ” Guide to Dementia and Alzheimer’s Care at Home ” will cover important topics for successfully caring for an elderly loved one at home who is suffering from Dementia or Alzheimer’s Disease such as;

• Dementia Care and Communication
• Dementia Care Routines
• Make Preparations
• Dementia Care Schedules
• Exercise For Dementia Home Care
• Dealing with Hallucinations from dementia
• Considering Pets For Home Care Patients
• Home Caregiver Back-up and Respite Care
• Remember To Take A Break From Being A Home Caregiver

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In Part Two, we will discuss what steps you need to take once a decision has been made regarding senior care. We know that this wasn’t a easy decision to come to, but now that it has been made, it is important to proceed as painlessly as possible.

Get Organized

The first thing you need to do is make sure that you have all of the senior’s records in order. This includes obvious things like their date of birth and social security number. You will also want to gather and organize all their medical information. You need to have information about their medical service providers. This includes the names, addresses, and phone numbers of his or her doctors and copies of insurance cards and policies.

Medications List And Schedule

You should also take inventory of all medications that the senior takes, including over the counter drugs, vitamins, and supplements. It is important to know the dosage of all these medications so that you can let doctors know, inform future care workers, and you might even need to administer them yourself sometimes.

Senior Health History

You should also put together a complete health history. You need to know the date and results of recent medical tests and examinations. This includes tests like MRIs, xrays, and CT scans.

Build A Contact List

It is also vitally important to assemble a contact list. This list should consist of emergency contact numbers and the numbers of friends and family who may need to be alerted to a crisis. You should also include on this list: tasks, documents, reminders of activities, and other important information that your senior’s care giver may need.

Elder Home Care Supervision

For the best results and easiest transition, it is important to stay involved with the home care providers and medical professionals. Though their intentions may be sincere, sometimes they cannot fulfill all their promises and may accidentally forget appointments. No one will take care of your loved ones like you will.

Build An Elder Care Support System

The next step is to talk to as many people as you can who have faced, or are facing, a similar situation. Speak with other family members, friends, church members, and neighbors. By doing this you will build a support system to help you through this tough time, and you will find out about how others have handled this situation. You will probably receive a wide variety of differing opinions, but that’s OK. You can then sort through these pieces of advice to keep what will work for you in your situation and discard what won’t work.

A Caregiver Has To Communicate

It’s also important to talk to the senior about this process as much as you can. He or she may be confused and unable to understand, but you must have patience and try to put yourself in his or her shoes. This can be a frightening time for them even more than it is for you. They probably want to make as many decisions for themselves as they can, and you should definitely let them as long as they are not putting themselves in harm’s way. If you don’t truly respect them and their feelings, this can cause a rift in your relationship, which is the last thing anyone wants at this time.

Take Care Of Yourself

Finally, it is important to take care of yourself. This process can be grueling and emotionally draining for any of us. Not only is it hard to see such a dramatic change in our favorite senior’s behavior, but all the effort required to take care of them can be overwhelming. Relax as much as you can, and sleep well knowing that you are doing the best thing by placing them in the safety of elder home care.

Read:Elder Care – First Steps to Elder Home Care Part 1

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