Alzheimer’s Day Care: A Guide for Caregivers & Loved Ones

Updated

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

Alzheimer’s day care is a valuable and growing program for busy caregivers who may need some respite. Like any program, whether it be assisted living or in-home care, you may want to do some research to pick the best situation for your loved one.

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As a caregiver for someone with Alzheimer’s disease, you are familiar with the challenging aspects of providing care. It can be exhausting. Most people are not as familiar with Alzheimer’s day care, but if you and your loved ones are looking for another way to help out a family member, it can be an idea worth considering.

Our tips on finding the best one can help guide you in your decision. 

What is Day Care for Alzheimer’s Patients?

Alzheimer’s day care is one form of respite care for caregivers. Adult day care is a program for people who have medical, psychological, and cognitive problems. The purpose of the program is to provide a safe and enjoyable environment.

It has several advantages over other types of respite, such as the following:

  • Day care is flexible. You can choose the days and hours that work for your schedule. 
  • In most cases, adult day care can be more affordable when compared with other options.
  • Stimulating activities and opportunities for social engagement are very positive for people with Alzheimer’s. Your loved one might even improve their mood.
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What Are Some Signs a Loved One May Need Alzheimer’s Day Care?

You may want to seek out Alzheimer’s day care for many reasons. However, there are two fairly common ones that might seem familiar to you. One, you need a break from caregiving duties and two, your loved one could benefit from more stimulating and socially engaging activities.

No matter how devoted you are to being a caregiver, it can be challenging to provide those activities in a home environment day after day. After some time, it may be a combination of the two reasons mentioned above. 

Here are some other signs that someone may need day care:

  • Your family member has behavior that is difficult for you to manage. This can include outbursts, wandering, anxiety and more. Boredom can be the cause of some of these behaviors and a new environment full of distractions might be helpful in redirecting those behaviors.
  • Your parent refuses care at home. A parent who refuses help can make caregiving frustrating to deal with. Sometimes a new environment with a fresh approach can break that cycle. The care staff at day care might even have some helpful suggestions on how to get your parent to accept care.
  • You are unable to provide all the care that your family member needs due to other responsibilities. If you are someone who works and is trying to provide care for a loved one, there may not be enough time in the day. You may also have siblings that don’t help with care. Adult day care is a viable and cost-effective solution for respite from caregiving.

Tips for Finding the Right Alzheimer’s Day Care

Depending on the size of the community you live in, you may not have many options. But don’t let that dissuade you from doing some research. Even one adult day care location deserves a close examination.

1. Look at the National Adult Day Services Association

The National Adult Day Services Association is one source of information, if the day care is a member of their organization. If a day care is not listed nearby, the best way to find a day care in your area is to search for results in your city or region.

Talking to your Area Agency on Aging may give you more detailed information on specific programs. 

2. Licensure

Some states require that adult day care be licensed and/or certified. Ask about this when you are reviewing different options. Request to see a copy of the license.

If the day care is not licensed as required, you may want to avoid that one. Without licensure or certification, there is no agency that regulates the facility or investigates complaints.

3. Transportation

Transportation can be a huge consideration for families. If transportation is not offered, you will have to find an alternative that can be costly or difficult to work around your schedule.

Find out if transportation is provided, what the fee is, and what the range or “catchment area” is for pick up.

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4. Complaints

The best place to find out about complaints is via the Ombudsman program in your area. Some adult day cares are certified, some are licensed, some are both and others don’t have either. A call to the Ombudsman program will help guide you in the right direction. 

Complaints might take the form of care issues and others might be focused on programming problems. If a day care has numerous complaints that should be a red flag. 

5. Ownership and liability insurance

Who owns the day care and how long have they been in business? Some adult day care programs are locally owned and others are part of a larger network of programs across the country. One may or may not be better than the other, but find out who is responsible for complaints or problems. Is it the manager? What can you do if you need to go beyond that person? 

You may also want to ask what type of liability insurance they have and what it covers. If your family member is hurt or hurts someone else, what is the process to resolve that incident?

6. Hours of operation and staffing

This may not seem important at first, but you may need coverage in the evenings or on weekends. You will want to find out if there is some flexibility with the hours that your loved one can attend. Do they have to arrive at a certain time, or are half days available?

Make sure that the staff to participant ratio meets state standards. Ask about the participant limit in the program and if there is a waiting list should the program be full. You may want to request a list of staff and their credentials and areas of expertise. 

7. Cost

The cost of adult day care is typically lower than what you would pay for in-home care, which is part of its appeal. Ask about the cost and if there are any sources of financial aid.

Some centers have added costs for certain services in addition to the base daily rate. You don’t want to be counting on a certain rate only to find out later that continence or bathroom care is an additional charge.

8. Services

This is a big category and very important. Adult day care centers vary in what they provide. Some of the services that might be available:

  • Social activities like crafts, movies, music, and community outings. Music has been shown to benefit people with dementia in several ways. You may be familiar with the non-profit program Music and Memory which uses personalized playlists to reduce pain and anxiety and improve mood. Even if the day care you are considering doesn’t use this specific program, music should be an important part of any programming.
  • Medical services like nursing, physical, and occupational therapists. Not every program will have medical support but for your loved one it may be critical due to complex medical problems. You will want to know that the program can handle reasonable medical issues.
  • Meals and snacks. Can the program accommodate dietary needs and restrictions like low sodium, a diabetic diet, or other preferred nutritional needs? Does your family member have swallowing problems and are there staff that can supervise that during meals.
  • Personal care. Your loved one may need help in getting to the toilet or even washing their hands. Is there adequate staff to assist with these activities?
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9. Accommodation of disabilities

There might be limits to what an adult day care can safely provide. Be honest about what your loved one needs. Ask if they can accommodate the following:

  • Someone confined to a wheelchair
  • Incontinence care
  • Diabetic blood checks
  • Medication management
  • People with severe hearing loss
  • Vision impairment or blindness
  • Behavioral problems

You may want to find out whether the staff is scheduled based on the level of care needed for their participants or whether staffing is consistent. 

10. Visit the program more than once

One time may not be enough to fairly evaluate whether the program is right for your loved one. Plan on several visits and pay attention to the following:

  • Observe how the staff interacts with participants. Are they kind, patient, and encouraging or more direct?
  • Does it look like there is enough staff to attend to the needs of all participants? Do some participants look lost or anxious?
  • Some people may need individual attention. Are they left alone or does the staff recognize their needs?
  • Meeting with the program manager can give you an idea of the philosophy and mission of the program. Ask him or her how to get in touch with questions or concerns.

11. Participant make-up

As important as this is, it can be tough to assess. The reason is that the makeup of people can change daily. Alzheimer’s is a disease that manifests differently for each person. Someone may be at the beginning of the illness where others are at a more severe stage. Ideally, you would want everyone at a similar stage, but this is not always possible.

At the very least consider asking about and observing the following:

  • Is there a significant portion of the participants that are experiencing behavioral problems like aggression or sexual acting out? This could be very upsetting for your loved one and cause them to want to quit the program.
  • Does the staff make an effort to introduce people that are at similar stages of the disease? If people are left on their own, this is unlikely to happen.
  • Conversely, what if it is your loved one that is causing problems? How do staff and management handle this? What are their criteria for asking someone to leave the program?

12. Other considerations

Last, but not least, the transition to adult day care may not go smoothly. It isn’t just a matter of deciding on a place and dropping your loved one off at the front door.

For the experience to be successful try the following strategies:

  • Start with a few hours a day for a couple of days a week.
  • If your loved one doesn’t want to go back, find out why. The environment might be too stimulating and you can let the staff know. Some individualized attention might resolve the problem.
  • Stick with it and don’t give up. Try using encouragement and gentle coaxing.

Alzheimer’s Day Care For You and Your Loved One

Finding respite is a process of landing on the best place for the moment. That moment might change as you and your loved one’s needs change.

Alzheimer’s day care is worth a try and you may find that it works in combination with other options. Stay flexible and patient during the journey.

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