For those attempting to keep their loved one at home, adult day care can be a saving grace, providing patients with social stimulation and allowing caregivers needed respite and time to perform errands they may not be able to get done with their loved one around.
"Just that part of getting up, getting out, keeping the normalcy in your routine can be very, very therapeutic for the individual and essential for the caregiver," said Elizabeth Geary, director of Day Haven Adult Day Services in Ronkonkoma.
Most adult day centers operate several days a week for up to 12 hours a day. They have trained staff supervision and often provide meals, outings and personal care services. Some also provide transportation. Fees vary, but according to the Alzheimer's Association, the average cost is $64 a day.
Some day care centers are intended for the public but many are becoming more dementia-specific, experts said. Adult day services are divided into medical and social model. Medical model services, in which medical services are provided and participants must have a diagnosed medical need (a diagnosis of Alzheimer's does not qualify) are largely funded by Medicaid. Social model services, in which no medical attention is given, typically rely on a combination of local government and private funds.
Geary said the key to successful dementia-specific day programming is to have small groups and make activities simplified while also adult in nature. "It's supporting their sense of themselves in the midst of their struggle to hold on to as much functional capacity as they can and as much normalcy as they can," she said.
The cognitive and social stimulation that day care provides can often delay admission to assisted living facilities and nursing homes, experts said. Similarly, there are mental and physical benefits for the caregiver. "We have caregivers who end up with medical complications far in advance of the moment when they place their loved one in a nursing home," Geary said. "And that's because the physical strain on them was too much for too long and they had a heart attack or they had a stroke."
But social model programs such as Geary's often teeter from year to year on local budgets and private donations or grants. Many are forced to limit or reduce their hours or days so that those seeking five or six-day a week services must go to multiple day care centers. A state Office for the Aging grant helps pay for the dementia-specific programming at Day Haven, as well as case management services. But the grant was cut from the state budget this year so now the center is trying to find alternative funding to continue the programming.
Broadlawn Manor's adult day services in Amityville housed both medical and social model day programs until this past April when director Kathy Behan was forced to close the social model portion. The closing of the program, which had been in operation since 1997, left 54 participants with nowhere to go. Six managed to get a medical diagnosis to qualify them for Behan's medical model service but that program is now filled to capacity and, like many day care programs across Long Island, has a waiting list.
"There's no funding for social day care," Behan said. "There's no way you can support the kind of program that we ran. It's too costly and you can't put that on the backs of patients."
Fred Jenny, executive director of the Long Island Alzheimer's Foundation in Port Washington said adult day care is an underutilized "hidden treasure" service. "A lot of times folks know that their relative might be forgetful, that they might have a tendency to wander . . . they might not eat properly and that they might be isolated and lonely," Jenny said. "But if you were going to try and look for the service to take care of all that in the Yellow Pages, what would you look under?"
Rosalie Silver, 54, of Port Washington wants to keep her mother, Bella Temer, 81, at home for as long as possible and she credits the Long Island Alzheimer's Foundation's day services as being a crucial part. Bella attends the Foundation's Memory Lane Club program which is designed for those in the mid to moderate stages of the disease.
"For me, it's a godsend," Silver said. "I don't know what I'd do without them."
In addition to allowing her to get work done from her at-home travel business, Silver said she enjoys witnessing the effects the club has on her mother, giving her cognitive stimulation and "that little spunk" that lights her up.
"Sometimes I go there and she's laughing or singing," she said. "It's nice to see."