Adult Daycare for Someone With Alzheimer's
The benefits of day services usually outweigh the qualms that caregivers and older adults may have about them
The difference between adult daycare and senior centers
What is adult daycare?
An adult daycare center, or adult day center, provides structured activities and therapy in a safe, supportive environment to adults who need mental and social stimulation. Typical daycare clients have lost a degree of independence due to normal aging, a medical crisis, or a chronic condition such as Alzheimer's disease or other dementias, but they live alone or with a caregiver. Half of all users have cognitive impairment. As the name suggests, it's a day service, not a housing option.
This increasingly available type of eldercare may be affiliated with (or run by) medical centers, nursing homes , assistive-living facilities, or other organizations either on site or at another facility (such as a community center or church). Some are established as "stand-alone" private businesses. There are more than 3,500 adult day centers in the United States.
How is adult daycare different from a senior center?
Senior centers tend to cater to a healthier, more mobile, and more independent clientele. Adult daycare programs generally offer services that are more intensive. Some specialize in Alzheimer's disease, and staff members have special education and/or training in working with geriatric clients and in managing behaviors characteristic of a disease like Alzheimer's.
Why should I consider adult daycare for the person in my care?
Adult daycare is a form of respite care that's provided outside the home by professionals (as opposed to in-home respite care). It's designed to benefit both the person using the services and, especially in the case of Alzheimer's disease, that person's caregiver.
For the elder with Alzheimer's, adult daycare offers:
- A chance to get out of the house
- A break from being with the caregiver
- Interactions with other people
- Stimulating activities
- Other therapies as needed (such as physical therapy or speech therapy)
- Possibly a delay in cognitive decline, in the early stages
- Prolonged independent living
For the Alzheimer's caregiver, adult daycare provides:
- Stress relief, lessened depression
- Predictable hours of relief in order to attend to personal needs, run errands, and release stress
- The ability to continue caring for a patient at home
- Cost savings over mo re expensive in-home care
- Reduced guilt because the patient's independence is supported
- An improved mood in the patient, making care giving easier
- Possible family counseling or training through the center, to help cope
Programs run from several hours to a full day. Participants may attend daily, a few times a week, weekly, or just for special activities. Weekend and evening care are less common, although this is changing as demand for adult daycare rises. (All options vary by center.)
What happens at adult daycare?
Programs typically include organized and supervised hands-on activities that may involve:
- Stimulating recreation (such as crafts, group conversation)
- Music therapy
- Art therapy
- Sensory stimulation
- Physical therapy
- Access to a library
- Entertainment (such as music, movies)
- Outings to museums, parks, or other local attractions
- Support groups and counsel ing
- Socialization activities
- Personal and nursing care (including help in keeping up with medications)
- Meals (usually lunch) and snacks
Activities are usually customized to individual needs and abilities, but at the same time, there's an emphasis on group participation. The setting is often homelike and comforting.
Additionally, some programs offer medically oriented care for patients who need it (administering medication or caring for basic medical or personal needs, such as podiatry services). Some offer counseling and educational services to caregivers and families.
Some adult day programs are connected with children's daycare centers. An advantage to this arrangement is that intergenerational connections that are made. A potential disadvantage that some researchers have found is that the adults can feel that they're being treated like children themselves, if the activities are largely child-centered.
Does a patient with Alzheimer's need a special kind of program?
Any daycare provides caregiver respite. But the ideal type features services tailored to people with Alzheimer's. Some adult daycare programs specialize in people with dementias of all kinds and stages, while others specialize more narrowly in early-stage Alzheimer's. In these dementia-specific programs, you're most likely to find tailored activities and staff who are specially trained in the disease.
A 1991 study found that Alzheimer's-specific daycare tended to provide more support for families and a greater emphasis on therapeutic recreation (rather than on clinical or rehab services) than general adult daycare. Be aware, however, that there's no special licensing required for a facility to call itself an "Alzheimer's/dementia daycare."
Adult daycare is especially useful in the early stage of Alzheimer's, when the afflicted person retains some good cognitive and social skills and might find it easier to become acclimated to the center and people there. There's also evidence that early stimulation of the type provided by adult day centers can slow cognitive decline.
Daycare is also useful in the middle stages of Alzheimer's disease, when the burden of care becomes greater and c aregiver burnout is a strong risk. People in the final stage of the disease tend to be unable to manage daily care tasks without help and are often nonverbal; when the burden of 24/7 care completely overwhelms, it may be a nursing home rather than respite care that the caregiver really needs.
Who can attend and what about the costs?
Can both spouses go together?
Many day programs accommodate both the adult with dementia and a partner without, or a couple whose members each have some kind of disability. If it's a dementia-specific program, though, the healthy spouse may feel out of place. In such cases, look into whether she might be able to volunteer there. What's possible depends on the individual program.
Bear in mind that a key purpose of adult day programs is to provide relief for the caregiver. (And many nonprofit programs described as &quo t;respite" obtain funding because of this.) If the well spouse is the main caregiver, she's supposed to be taking a break while her partner attends. Even if the spouses prefer being together, limited separation through a day program can benefit both of them.
What does adult daycare for a patient with Alzheimer's cost? Who pays?
Daily fees average $56, according to the National Adult Day Services Association (NADSA). Costs vary depending on where you live, the type of program you choose, and how many hours the patient uses it. Most programs are nonprofits, which may cost less than for-profit programs. Ask if a center offers a sliding scale of fees based on income.
Some places charge a fee per session; others charge monthly "tuition." Many centers charge an added fee for transportation, while some offer it free.
Adult daycare may be covered by Medicaid , long-term-care insurance, Veterans Administration policies, and possibly health insurance (though the latter is least likely, with the exception of some long-term care insurance). Medicare will not cover adult daycare services.
Finding the right program
Are there any reasons not to like adult daycare?
Some people hear the phrase "daycare" and, associating it with children's daycare, imagine being talked down to and babied. Getting past suspicions and resentment can be a challenge. Run through the many benefits. Suggest a no-strings trial run: "Let's just go once and see what it's like." You could also avoid describing it as "adult daycare" and find terms more palatable to the person you're caring for, such as "a senior club" or "therapy for people with early Alzheimer's disease."
Most participants quickly come to enjoy the new faces and varied activity. Some, however, refuse to participate and may even become belligerent or disruptive; in such cases, they're usually not allowed to return.
How do I find the right adult daycare program for the person in my care?
To sign up, see " A Step-by-Step Guide to Using Adult Daycare if Your Parent Has Alzheimer's ".