NEWS FOR SENIORS - SENIORITY: Day Care

By Denise Nelesen, County's Aging & Independence Services

After 51 years together, the Butlers may soon be living apart. This is not a desired separation, but the options are thinning. Ginger, 73, has Alzheimer's disease and is incontinent, can no longer feed herself or do anything for herself. She doesn't talk any longer, so it's hard for Joe to know what she might need.

But the final straw is not any of those things. "Her mobility is going down," he says. "She's going to be dead weight.

Except for Ginger being unable to walk or move well, this retired Army colonel would continue to make the best of this bad situation and keep his wife with him at their retirement community apartment. He's been doing it for the past seven years.

He feels he's been able to manage as well as he has because Ginger is a regular at an adult day health care center not too far from them. She attends each weekday from 9 a.m. to 4 p.m., Joe says. "Without that (break), I'd probably be as bad off as her."

He researched what was available and visited 15 different places in the county before deciding on the Poway Adult Day Health Care Center. He wanted a place where there would be a variety of activities and stimulation for Ginger.

"She likes music and every once in a while she sings a couple of words of a song. And they have pet therapy. She likes to pet everything except the rat."

Adult day care programs come in two forms: health and social. The first provides medical and rehabilitation services along with social programs, plus lunch and snacks. There must be a registered nurse on the premises and medications can be dispensed. Medi-Cal covers the cost of the adult day health program for Medi-Cal beneficiaries; others must pay out of pocket.

The social day care is nonmedical, but is still supposed to provide activities that are therapeutic. All costs are out of pocket. Many adult day care programs have sliding-scale fees and some have scholarships. And families aren't required to use the day care every weekday, but can select days when they want to bring in their family member.

Candidates for both programs are generally physically and/or mentally frail. The goal for adult day care centers is to prevent premature institutionalization by aiding caregivers and helping elders to function more fully. Too often frail seniors living alone or with caregivers sit most of the day watching TV. Even when the disabilities involve dementia, centers have programs that tap into skills the participants still have. They might be able to sing even if they can no longer talk. Or they might still be able to follow an exercise leader.

Joe says that the staff and some of the other participants have "adopted Ginger. They make sure she has a snack. I just trust her with them."

He's certain that the stimulation has helped his wife function better for longer than she would have without this setting. The decision to place his wife in a facility would have come earlier without this support, he says. The help has benefited him as much as Ginger. He's been able to do more than worry about his spouse during the day.

"I play golf once a week. And I'm doing a lot of washing and drying. I'm just a domestic house frau," he says, laughing. He also continues the volunteer work he enjoyed with Ginger, including helping the Voices for Children and the Family Literacy Foundation.

Being able to take a break from caregiving during the week allows him to be more helpful to Ginger when they are together. He encourages other families to consider using adult day cares.

"People see all the old people with debilitating diseases and say, 'I'm not going to put my mother or father in this.' But they don't understand. It would behoove them to spend time at the day care and see what it can offer them. How are they going to take care of them at home? I didn't want just a babysitter for Ginger; I wanted her to have activities."

And he has taken advantage of the caregiver support group at the center. "I've been through the steps of grieving," he says. "I'm already to the acceptance stage. It took a while, but I'm there."