Selecting an Adult Day Care Center

by Nancy Bryce
More About Nancy…

Adult day care centers, also known as adult day centers, provide social, medical and emotional support for those with Alzheimer’s disease and dementia. They also afford the caregiver relief from exhausting responsibilities of caring for a loved one with Alzheimer’s Disease. Many prefer the term "adult day center" in describing the program because "adult day care" implies the adult person with Alzheimer’s Disease is being cared for like a child.

What is an Adult Day Center?

According to the National Adult Day Services Association (NADSA), adult day centers provide a planned program that includes a variety of health, social and support services in a protective setting during daytime hours. This is referred to as a "community-based service" and is designed to meet the individual needs of functionally and/or cognitively impaired adults. Many of the adult day centers are located in hospitals, senior centers and privately owned businesses.

What services do they offer for persons with Alzheimer’s Disease or related dementias?

While many adult day care programs focus on people with dementia, many elderly people can benefit. Day care programs may provide:

  • social activities
  • counseling
  • meals
  • transportation
  • recreation
  • medical help
  • emotional support
  • mental stimulation
  • personal care such as bathing and shaving
  • exercise
  • education and
  • therapies: occupational, physical and speech.

Donna Albright, Adult Day Care Aide at the Riverside Adult Day Care in Newport News, Virginia, discussed some of the special activities designed for its participants. They play mind stimulation-type games, BINGO, have sing-a-longs, and make craft projects.

What services do they offer for the families of those with dementia or Alzheimer’s?

Adult day care offers benefits to families as well as care recipients. For families, adult day care provides:

  • assistance with care
  • relief from care
  • reassurance
  • short- or long-term care
  • services at affordable prices
  • transportation to and from the facility.

When is it a good time to place your loved one in a day center?

Daniel Kuhn, MSW and Author of, Alzheimer’s Early Stages: First Steps in Caring and Treatment, advocates adult day centers when the individual with Alzheimer’s Disease:

  • appears unable to provide himself or herself with any structure for daily activities.
  • is isolated from others for more than a few hours a day and misses companionship.
  • cannot be safely left alone at home.
  • lives with someone who works outside the home or needs regular time away from home for other reasons.

What to look for in an adult day center.

Nancy Wexler, Director, Gerontology Associates in California and author of Mama Can’t Remember Anymore, strongly recommends adult day centers. She said, "in advising my clients on the selection of an adult day care center, I work hard to find programs which are sensitive to the special needs and predicaments of Alzheimer’s victims."

It is also important to look for a day center that meets your specific needs and makes you and your loved one feel comfortable.

What is the daily cost of adult day centers?

The average cost of adult day centers is $40 or $50 per day, but can vary considerably depending on your location. Medicare does not cover this cost. Although the cost is significant for most, many believe it is worth the price. Lela Knox Shanks, author of Your Name is Hughes Hannibal Shanks, A Caregiver’s Guide to Alzheimer’s says, "Day care has been like an oasis in the desert for Hughes and for me. The costs are now a necessary and integral part of our household budget, as much built in as food and heat and electricity, because AD is now a normal part of our lives."

How do you find a day center close to you?

  • ElderCare Online’s Neighborhood Networks offer links to state and local resources, state offices on aging, Area Agencies on Aging and local Alzheimer’s Association resources
  • The National Adult Day Services Association offers a directory of day care programs
  • Look in the Yellow Pages under "Adult Day Care" or "Aging Services"
  • Your family doctor
  • Local social services or health department
  • Mental Health Centers
  • Local senior center

Begin making calls to the adult day centers in your area.

Call for fliers, eligibility criteria, monthly activity calendar, a monthly menu and application procedures. Review the materials looking for the following:

  • Who is the owner or sponsoring agency?
  • How many years have they been in operation?
  • Are they licensed or certified?
  • What are the hours of operation?
  • What days are they open?
  • Is there door to door transportation?
  • What is the menu?

Visit the day centers that meet your needs.

Albright from the Riverside Adult Day Center recommends the person with Alzheimer’s Disease and the caregiver come in and take a tour of the facility. Some questions to ask yourself and/or the staff during your visit:

  • Is the facility cheerful?
  • Is the staff friendly?
  • What services and activities do they offer?
  • What is the cost?
  • What is expected of caregivers?
  • Do they offer transportation door-to-door?
  • What are their hours of operation?
  • Is the facility clean and odor free?
  • Do volunteers help out?
  • Are participants involved in planning activities or making other suggestions?
  • Are the persons with Alzheimer’s Disease treated with respect?
  • Is there a place to isolate sick persons?
  • Is the furniture comfortable, sturdy and suitable for the person with Alzheimer’s Disease?
  • Is the facility wheelchair accessible?
  • What is the staff/participant ratio?
  • What are the credentials of the staff?

Check references

Check references by talking to two or three people who have used the center you are considering.

Try it out

Choose the day center that meets your needs and the needs of the individual with Alzheimer’s Disease. Remember that it may take many visits before the participant feels comfortable and adjusts to the new setting and routine. Talk with the staff about how to make the transition easier.

Shanks recalled her favorable experience as her husband, Hughes Hannibal Shanks, went to day care. "Day care was in fact a blessed relief for both of us," she said. It "gave Hughes a new life. The members of the staff, usually caregivers by choice who have had some training or experience in caring for persons with dementia, were immediately less judgmental and more accepting of Hughes than I was. They were not emotionally involved with him or personally threatened by his deterioration, not having known him before AD."

Sources:

Written with help from "Your Guide to Selecting an Adult Day Services Center," published on the web site for The National Adult Day Services Association (NADSA)

Resources:

- "About Adult Day Centers," brochure number 19471B-9-93, published by Channing L. Bete Co., Inc., 200 State Road, South Deerfield, MA 01373 (800) 628-7733
- Your Name is Hughes Hannibal Shanks: A Caregiver’s Guide to Alzheimer’s by Lela Knox Shanks.
- Alzheimer’s Early Stages: First Steps in Caring and Treatment by Daniel Kuhn, M.S.W.
- Mama Can’t Remember Anymore by Nancy Wexler

Available from ElderCare Online™             www.ec-online.net             2000 Prism Innovations, Inc.