by Derrick Grant
Caregivers looking after someone with Alzheimer’s Disease or a related dementia should know that not all day services are the same. Adult Day services is a competitive business that often has a low-profit margin and a fast consumer turnover rate, so agencies offering the service will often cast a wide net in hopes of serving as many clients as possible. This makes smart business sense on the part of the agency, but caregivers should proceed with caution. The needs of one individual may differ from the needs of another, and there are times when the needs conflict.
Having worked as the Director of Adult Day Services for an Alzheimer’s specific center, I can tell you firsthand that the day service needs of a person with dementia are not the same as those for a person with straight physical limitations or mental retardation. One of our biggest sources of referrals were actually other non-Alzheimer’s specific adult day centers that were servicing people with dementia and found the individuals’ needs could no longer be met at their facility. We welcomed the opportunity to serve these individuals, but it was often my opinion that the individual would have been served better had he/she come to our center in the first place.
This is not to discredit the work of our day service competition, but when an individual with Alzheimer’s Disease is admitted for day services, it’s typically still early enough in the disease process for the individual to become acquainted with the staff and building, to build relationships, and for the staff to get to know the individual; as the disease progresses, the ability to develop such relationships decreases. If the individual came to our center after leaving another center, he/she was likely to experience confusion and discomfort. Had the individual come to our center in the first place, the relationship would have been established and as the disease progressed, staff would know the individual’s preferences prior to his/her inability to communicate them, and the individual would have at least some familiarity with the environment.
A day service center that caters to Alzheimer’s Disease and related dementias should have the following characteristics:
- activity programs specific to this population
- staff with Alzheimer’s experience and training
- secure environment (door alarms, ankle bracelets, etc. to prevent wandering)
- building design conducive to dementia
- medical monitoring services (as opposed to strictly social services)
The advice in this post depends on the notion that multiple day service centers exist near the caregiver’s home. It’s entirely possible that this is not the case, and that the caregiver may have to settle for day services at a non-Alzheimer’s specific facility. There is nothing wrong with this idea. Most day services do incorporate some type of dementia services for their client pool, and are often more than open to adjusting services to meet individual needs. If you are unsure how your loved one will do at such a center, ask for a free visit and leave your loved one there for a day. Any decent facility will offer the first visit for free as a trial run.
Derrick Grant is the author of ElderGuru.com, offering insight and information on aging services. He has worked as a Licensed Social Worker in a nursing home, as the Social Services Manager at an Area Agency on Aging, as the Director of Adult Day Services, and most recently as a government Policy Analyst and Policy Writer.