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Adult day care for Alzheimer's patients

by Carol Bradley Bursack, Editor-in-Chief

Spouses and children of people who have been diagnosed with early-onset Alzheimer's disease often feel neglected by forums, chat groups and even in-person support groups. It's easy to see why, since our greatest risk of developing Alzheimer's disease comes with age. However, there are legions of people who care for spouses or parents who are diagnosed with Alzheimer's disease in their forties or even younger. Adult day care can be a good option for these younger folks, too.

Caregivers of individuals with early onset Alzheimer's face unique challenges, not unlike those who care for parents or children who have suffered debilitating brain injuries. These younger people often don't quite belong with the older generation found in many adult day care settings.

What is adult day care?

Adult day care, or day services as some are called, is one of the newer forms of caring for people who need help during the day. I toured a number of adult day centers in my community and they each had a different personality. Some are attached to nursing homes, which works great for elders who will soon need to be transitioned to a nursing home, though they can work well for other people, as well. Some are small residential type homes where only a few people are cared for. And some are free-standing buildings. A free-standing adult day center in my community seems well positioned to care for people with early onset Alzheimer's.

From the start, this center kept in mind the many returning Iraq War veterans who have suffered brain injuries. They built the facility with a leaning toward technology and with a younger feel. This isn't to say they won't take elders, but the young feel of this center is unique. They make an obvious effort to appear to be a club or gathering place, rather than a day care. They even avoid the label "day care" and use "day services."

This center provides an electronic pool table where people can use specialized controls depending on their ability. They have computer games that can be played using adaptations for unique abilities and disabilities. They have dry saunas that are wheelchair accessible and a specialized gym. Also, of course, they have a number of Wii game systems, which are even showing up in nursing homes, as the numbers and types of games expand.

Adult day care and Alzheimer's

What made me think of this center was a recent phone call from a woman whose husband has early onset Alzheimer's. He is getting ready for assisted living as she can no longer handle his care. But she talked about how her husband had enjoyed the programming at the adult day center he attended. I didn't ask her which one, as this particular free-standing center isn't the only one that offers programming appropriate for younger people. This woman's call drove home the point to me, however, of how important it is for people to feel that they belong somewhere. Social stimulation, peer interaction and interesting occupations are important components for a good quality of life.

Many centers include workshops where people can create, with safe tools and supervision, useful or decorative objects. Art projects, music, exercise, and of course computer use, can be helpful for younger people with Alzheimer's. All of these activities can help them feel better about themselves, and many will help keep their brains flexible for a longer period of time.

Obviously, adult day care isn't only for younger people. One woman I know leaned heavily on the adult day care attached to one of our finer nursing homes. When the day came where she had to make the move to place her husband in the nursing home, she and a staff member simply walked him from his day care down the hall and up the elevator to him new room. It was a fairly smooth transition, as the home was familiar to him.

Another tip from a reader brought to light the aspect that adult day care for his wife made it easier for him to prepare for her eventual death. He would use some of the time she was at day care to go home to the empty house and get used to sitting in his chair without having to have "eyes behind his head," as he put it. She was not there. That feeling was painful, yet he was able to relax, and he made a point of integrating this into his consciousness. He thought it worked so well that he called me and ask me to suggest this to others.

Adult day care definitely has its uses. I've read where a few places in large metro areas are offering night care based on the same model. Since many people with Alzheimer's are very active at night--just when the caregiver is worn out and needs to sleep--these centers pick up the elder and take him to the center for the night, where he is treated to games and peer stimulation. Then he is taken home (or picked up by family) in the morning and able to sleep or be awake through the day, with a rested caregiver. Let's hope this trend spreads. It could help many.