Social Work Services | Spring 2018 Newsletter
Adult Day Care Programs: Crucial Members of the Caregiving Team
Anne Foerg,Former Director of Social Work
It is impossible for a person with dementia to have just one caregiver – whether partner, parent, sibling or friend. This is never truer than when the individual with dementia transitions from the early stages of the condition into the middle stages. A decline in memory, an increase in confusion, and a loss of insight into these deficits results in the person with dementia requiring consistent, in-person support to move through the day. While the person with dementia may still be physically capable of showering, dressing, and feeding him or herself, impaired cognition requires reminders to shower using soap and shampoo, guidance in picking out clothes to wear and how to correctly put them on, and assistance preparing a nutritious meal. Most importantly, the individual in the middle stage requires the presence of a competent caregiver to provide supervision to ensure safety, as dementia impairs the ability to process the environment and make reasoned decisions that keep us out of harm’s way. A smoke detector can only do its job of warning danger if the person hearing its alarm understands what it means and is able to do what is necessary to keep himself or herself safe.
As such, it is quite common for caregivers to reach out during this period of transition when caring for the person has become too much for the primary caregiver to manage alone. They don’t know where to turn when the person for whom they are caring can no longer be left alone, but also cannot be taken on every errand to which the caregiver must attend. Many caregivers often find it challenging to keep the person with dementia engaged and entertained throughout the day, especially when laundry needs to be done, meals prepared, and the to-do list managed. When the caregiver calls CaringKind at this critical time, our social workers help families to understand the importance of building a care team by accessing supportive resources to help manage the needs of the person with dementia and to ensure that the caregivers receive a break from their 24/7 responsibilities.
One of our most important partners at this point can be an adult day program. Social or medical in nature, an adult day program offers numerous benefits to both a person with dementia and the caregiver. Adult day programs provide structured activity targeted to a participant’s level of functioning. Structured routines help mitigate symptoms like confusion, agitation, and apathy by providing a consistent and enjoyable way to interact with the environment, to promote feelings of security. Targeting activities to an individual’s interest and capacity helps limit frustration because they are never asked to do something they cannot.
Adult day programs also provide respite for the caregivers, allowing the opportunity to leave the person with dementia in a safe environment so they can attend to their needs. Caregivers may still be employed in addition to their caregiving responsibilities. Yet they also need time to do things like attend their own medical appointments, socialize with friends, or simply take an opportunity to be alone in order to recharge their batteries. Respite can often come in the form of improved sleep for the person with dementia, as meaningful activity during the day tires them out in the evening. This, in turn, ensures that caregivers will also get a good night’s sleep.
Consider Nadia, who was caring for her mother with dementia. Because her mother was also an undocumented immigrant, she did not qualify for benefits to help cover the cost of in-home care. Yet Nadia and her family still had to work. The CaringKind social worker linked Nadia to an adult day program in her neighborhood, which allowed her mother to attend several days a week through a subsidy provided by the NYC Department for the Aging. Nadia could finally get some quality, uninterrupted sleep while her mom attended the program, which was vital for her to be able to work her overnight job.
Wai was also caring for his mother with dementia when her wandering prompted him to realize that it was no longer safe for her to remain home alone when he went to work. Wai decided to try sending his mother to a local adult day program at the suggestion of the CaringKind social worker. The program provided supervision while Wai worked and his mother began eagerly bathing and dressing every morning, activities she had previously resisted, because she so much looked forward to attending!
Whether Riverdale Senior Services in the Bronx, the New York Memory Center in Brooklyn, Riverstone Senior Services in Manhattan, Sunnyside Community Services in Queens, or the JCC of Staten Island, call the 24-hour Helpline at 646-744-2900 for information on the adult day programs in your community and consider making this service part of your care team!