Medical professionals and health care organizations have been discussing the progressive growth of aging adults and the number of informal caregivers who are providing more than $350 billion annually in uncompensated care for several years as baby boomers age and become part of an enormous movement of those seeking or giving care to family members or loved ones. It is estimated that over 10 million Americans provide more than 150 million hours of care to approximately 5.2 million elders each week, with a large proportion of participants having some degree of cognitive impairment. Informal caregivers have been the backbone of the nations long-term care system. Enter Adult Day Services!
The theme of National Adult Day Services Week, September 19-25, “A Smart Choice,” was established to raise awareness of the availability and accessibility of adult day programs nationwide. This special week, which coincides with Healthy Aging Month, was first proclaimed on September 27, 1983, by former President Ronald Reagan when he recognized how adult day centers provided supervised community settings in which partially disabled or frail men and woman could obtain care that may not be available in their homes. The centers provided opportunities for seniors so they would not be forced into institutions. The first ADS program of record was a geriatric “day hospital” program established in 1960 in North Carolina.
Today, we know of countless selfless caregivers across our nation who are caring for loved ones, but we also recognize the burden and hardships they can endure, although it is often difficult for them to acknowledge on their own at times, especially for those who care for loved ones with a form of dementia. Individuals may struggle to find a balance as they juggle job responsibilities, family, and personal needs, and sometimes there may be guilt by association if you consider other alternatives. However, an adult day program, the research shows, reduces caregivers ‘stress. They also suffer less depression and anger, and report greater overall well-being (Penn State).
While caregivers can engage a Senior Care Manger to develop a comprehensive plan of care based on home assessments safety needs and medication management, hire well trained home health care providers, which are all viable sources that give the caregiver respite, there is yet another option in the continuum of care ─ one of healthcares’ best keep secrets ─ Adult Day Services!
The goal of adult day services is to delay or prevent premature institutionalization by providing a cost effective alternate to long term care. Adult Day Services have brought a new vocabulary and broader meaning to familiar terms like treatment and rehabilitation. ADS are concerned with maximizing the quality of clients’ lives with a holistic and interactive approach to the many services that are provided.
Day services provide structured activities; programs and companionship with compassion for seniors who need assistance or supervision, and cannot function independently in the community, but do not require 24 hour institutional care. The programs encourage socialization to enhance self-esteem and encourage independence. Everyone is unique and every client is a winner; there is no right or wrong, but an environment for positive self expression and affirmation.
Adult Day Services differ from other forms of care in its unique focus on the strengths and abilities of a person with functional or cognitive impairments, on health rather than illness, and it is important to validate past roles, and social interactions with respect as the foundation.
In general, there are three types of Adult Day Services: Social (which provides meals, recreation and some health-related services), Medical/health (which provides all of the social activities as well as more intensive health and therapeutic services), and Specialized (which provide services only to specific care recipients), such as those with diagnosed dementia or developmental disabilities.
On Marco Island, Sanitasole is a combined social/medical health services model – we care for all types of clients including those with cognitive decline and can manage them in the group setting unless, they may be a threat to themselves or others in the program. We are the only center for senior day services on Marco; although other specialized programs are available in the Naples and Fort Myers area.
Caregivers typically select the type of center a care recipient attends based on the care needed; however, depending on the location (FL), a physicians order (statement of health) is required to attend the center, so therefore there is a continuum of care that includes the family, the physician and the personal services rendered. An in depth evaluation is also performed prior to admission to the program.
The more common facility in the US is the adult day health services model, designed for adults who need supervised care in a safe environment outside their homes during the day hours. These services also afford caregivers respite from the demanding responsibilities of caregiving without the worry about their loved ones health or well-being.
The medical model with all of its social components adds licensed staff, which is able to oversee medication management; communicate with client’s physicians; observe for changes in conditions; and most importantly they are trained in care of older adults. These centers are mandated to have specialized training. Sanitasole is a licensed facility in the state of Florida that offers these types of services.
According to recent research, people who might sit home alone with a remote, or who might move into a facility because they can’t stay at home, instead spend several days a week being active, social, stimulated well nourished and monitored by nurses at an ADS. With education, exercise, both physical and intellectual, health screenings, garden therapy and music appreciation, computers, pool work-outs, arts and crafts, day trips and rehabilitation services being just a few of many of the service offerings at various centers, at the end of the day, the participants go home to familiar surroundings’, perhaps tired but fulfilled in their own way.
Personal care programs help with ADL’s (Toileting, grooming, eating and other personal activities of daily living). According to the National Institute on Aging, when older people lose their ability to do things on their own, it doesn’t happen just because they have aged. More likely it is because they have had an illness or become inactive.
Adult day centers generally operate during normal business hours five days a week. Some programs offer services in the evenings and on weekends, and may open earlier in the day to allow caregivers or adult children to work or tend to personal affairs, allowing family members freedom to work, or to stay engaged in club or community activities, or just take time out for them.
The National Adult Day Services Association was formed in 1979 and each individual state now regulates and licenses day centers through the Agency for Health Care Administration with a biannual renewal process.
There are approximately 4,600 centers operating in the United States providing care for more than 160,000 care recipients each day with 35 percent of the adults living with an adult child, 20 percent with a spouse, 18 percent in an institutional setting, and 13 percent with parents or other relatives, while 11 percent live alone.
However, without greater public recognition of the role ADS can play in maintaining adults of all ages and other erroneous perceptions that ADS are for the poor, rich, or for “old people”, education is key, so come by your local adult day service provider. We want to help you, the caregiver from being a statistic for caregiver burnout. Make the smart choice!
Paula Camposano-Robinson, RN
Paula Camposano Robinson, RN, is co-founder and owner of Sanitasole Senior Health Services. This is an information-only column and is not intended to replace medical advice from a physician. Email me at probinson@sanitasole.net or visit http://Sanitasole.net, for more information. Phone: 239.394.9931.
