Adult Day Care and Respite Services

September 19, 2005

Speaker: Denise Gienapp, Director of Adult Wesley Day Services Program

 

Sometimes it is difficult for the spouse or immediate caregiver to recognize it is time to look at alternatives.  Adult Day Services is one of those services that can help with transition.

 

The focus of the Day Service program is look at what the person with Alzheimer’s Disease can do rather than what they cannot do.

 

When is a person ready for Adult Day Services?  It is different for everyone. Issues are with quality of life.

 

Benefits of adult day services for the person with Alzheimer’s Disease:

  • It provides an opportunity for the person with Alzheimer’s Disease to get out.
  • It is like a club
  • It offers a variety of activities, kind of like a cruise ship with something for  everyone.
  • A good facility looks at what is important for each person to keep them active and tries to meet those needs and fulfill those pleasures.
  • Involvement in a program helps make the day go better for the person with Alzheimer’s Disease.
  • Speakers, learning, activities, friends all comprise the types of services available through the day services programs
  • Schedules of activities with routine times ease transitions

 

Benefits for the caregivers:

  • Provides education for the caregivers and family
  • Help with particular issues or concerns
  • Day services staff keep an eye on health issues via regular blood pressure checks, blood counts and so forth
  • Day services staff can help with difficult activities such as physical therapy, bathing, transferring positions, podiatric care.

 

Now adult day centers have to be licensed and certified. This oversight was asked for by the industry.  The Iowa Department of Inspection and Appeals serves as the licensing body in Iowa.

 

There are three adult day services programs in the greater Des Moines metropolitan area:  Wesley, Willis (near Mercy), and a new  program in Ankeny called New Horizons.  In the case of Wesley Adult Day Services the program operates from 7:30 a.m. to 5:30 p.m. Monday through Friday.  Some funding is available to help with the costs. Average cost is $32 / half-day; $41 / day or $51 for an extended day.  Medicaid waivers are available. Some facilities have a scholarship fund to assist with the pay.  There is also Iowa Care Givers Fund (no income guidelines).  If a family thinks the price is too expensive, they can ask for help.

 

Q:        Is there help for persons with military service background?

A:        The VA also has some funding available.  Tim Dempsey, VA Social Worker, or Tom Molly, VA Social Worker, at 699-5999, can help with the paperwork for VA Financial help.

 

Q:        How do you get a person to go if they are reluctant?

A:        Call it a club, or let them know it is an opportunity to volunteer.

 

Comment:  Wesley Adult Day Services uses a “best friends” approach to partner staff with the person with Alzheimer’s Disease to assure they meet others, interact, have assistance with meals, toileting, and so forth.  It is important to honor the person in order to engage them.

 

Q:        Is transportation available to get a person to Wesley?

A:        Wesley does not have transportation, but Willis and New Horizons do.  Wesley works with the Des Moines Paratransit.

 

Comment:  When looking into the use of adult day services, it is important to visit the facility ahead of time, and tour it.  It is ok to come unannounced.  It is important to make sure you are comfortable with the program.  Look for such things as whether they accommodate dietary requirements for persons with diabetes, diverticulitis, or persons who need finger foods and other such accommodations.

 

 

Handout from Denise:

Adult Day Service Facts

 

What Are Adult Day Services?

Adult Day Services are community-based group programs designed to meet the needs of functionally and /or cognitively impaired adults through an individual plan of care.  These structured, comprehensive programs provide a variety of health, social and other related support services in a protective setting during any part of a day, but less than 24-hour care.  Adult day centers generally operate programs during normal business hours five days a week. Some programs offer services in the evenings and on weekends.

 

Who Use Adult Day Centers?

Adult day centers are designed to serve adults who are physically impaired or mentally confused and may require supervision, increased social opportunities, assistance with personal care, or other daily living activities.

 

A survey conducted of adult day centers nationwide, found that the average age of the adult day consumer was 72 and two-thirds of all participants were women. One quarter of the participants lived alone; three-quarters lived with a spouse, adult children or other family and friends.

 

One half of the participants of the centers surveyed had some cognitive impairment and one third required nursing services at least weekly.  Fifty-nine percent of the participants required assistance with two or more activities of daily living: eating, bathing, dressing, toileting or transferring; forty-one percent required assistance in three or more areas.

 

How Many Adult Day Centers Are Operating?

It is estimated that more than 3,500 adult day centers are currently operating in the United States, providing services to 150,000 people each day.

 

Seventy-four percent of adult day centers are affiliated with larger organizations such as home care agencies, skilled nursing facilities, medical centers, or multi-purpose senior organizations.* Nearly 78 percent of adult day centers are operated on a non-profit or public basis and the remaining 22 percent are for-profit.

 

Even with the growth of this service, more adult day centers are still needed. A survey funded by the Robert Wood Johnson Foundation estimates that more that 5,000 new adult day centers are needed to meet the needs of the growing elderly and disabled population.*

 

Are Adult Day Services Regulated?

Adult Day Service regulations differ from state to state and also by funding source. The Standards and Guidelines for Adult Day Care developed by the National Adult Day Services Association (NADSA) provides important benchmarks for states that have elected to regulate Adult Day Services. Funding sources also define the range of services for which they will pay while an eligible participant is at an adult day center.

 

Outside of the voluntary NADSA standards and the Commission of the Accreditation of Rehabilitation Facilities (CARF) accreditation standards, there are no uniform national standards governing either the operation of centers or the qualifications of staff members.  NADSA has a certification process for program assistants and is developing the same for administrators and directors.

 

*Partners in Caregiving: The Adult Day Services Program (2002) National Study of Adult Day Services, 2001-2002. Winston-Salem, NC: Wake Forest University School of Medicine.

 

What Are the Fees Associated with Adult Day Services?  

The fees for Adult Day Services vary, depending upon the region of the country and the range of available services provided by the center.  Daily fees average $56 per day, and vary according to the services provided and the reimbursement levels where applicable.

 

What Does One Look for When Selecting an Adult Day Center?

A high quality adult day center:

  • Provides a safe, secure environment.
  • Utilizes qualified and well-trained staff and volunteers.
  • Adheres to or exceeds state and national standards and guidelines.
  • Assess individuals before admission to determine their range of abilities and needs.
  • Provides an active day a program that meets the social, recreational and rehabilitative needs of the impaired adult.
  • Develops an individualized treatment plan for participants and regularly monitors their progress.
  • Provides referrals for other needed services in the community.
  • Sets clear criteria for a person’s service and guidelines for termination of services based on their functional status.
  • Provides a full range of in-house services, including personal care, transportation, meals, health screening and monitoring, education programming, counseling and rehabilitative services.