Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: SUNDAY, April 24, 1994 TAG: 9404260014
SECTION: HORIZON PAGE: B1 EDITION: METRO
SOURCE: CAROLINE TERENZINI KNIGHT-RIDDER NEWSPAPERS
DATELINE: LENGTH: Medium
But in real life the chances are good that at some time we will wake up dependent on others for help in daily living, from bill-paying to bathing.
That help is most likely to come from our spouse or our offspring, who themselves may have some limits to their abilities or have competing job and household responsibilities.
Hence, there is often a need for someone to share in the care of an elder.
One option is adult day care, which, like the more ubiquitous programs for children, provides daytime supervision and activities, only in this case it is for adults 60 or older who have some degree of dependence.
The American Association of Retired Persons reports that only 2 percent of people age 65 to 74 live in nursing homes and that less than 20 percent of people in their late 80s do.
The AARP figures mean the great majority of elders live at home, either alone or with family members.
``There's a notion that Americans don't take care of their elders,'' said Dr. Heidi J. Syropoulos, a geriatrician in State College, Pa., ``but they do.''
Adult day care is ``another option in the continuum of care,'' says Jane Taylor, director of the Centre County (Pa.) Office of Aging. She describes adult day-care programs as offering ``an opportunity to reconnect with people in a nonthreatening environment, where nobody's going to laugh at you if you can't remember your husband's name.''
Advocates of adult day care say the stimulation and professional supervision such programs provide can postpone the need for nursing home care for up to two years. Day care can also ease the transition, if necessary, to full-time placement, Taylor said.
``For most people who use day care, it's really a very positive experience,'' said Steven H. Zarit, a professor of human development at Pennsylvania State University. ``They're out in a positive environment rather than being home and isolated.''
Boredom and inactivity can aggravate agitated behavior associated with dementia, he said, but when older people get out during the day, they may be calmer at home and sleep better at night.
At the same time, Zarit acknowledged, adult day care ``is not necessarily for everyone.''
Some families wait too long, he said, and by the time they're ready to try day care, ``they're exhausted, and the older person can't make the adjustment.''
``Using day care involves a change of routine, and sometimes it's easier NOT to do it,'' Taylor said.
``And people who make a decision to care for an elder at home often feel they have to stick with that decision.''
Peggy Cohn, a private geriatric-care manager in State College, Pa., said older adults often have strong opinions and preferences.
``There's still a fair amount of resistance among elders themselves to going out and being with people. It takes a lot of patience on the part of families. It's like sending a child to school; some have negative experiences.
``I've always had reservations about adult day-care services, mostly because older adults don't want to do that. But there's definitely a need.
``For example, families dealing with dementia are very, very stressed. It makes it difficult to carry out daily activities with predictable results.''
According to AARP figures, 10 percent of care givers have given up jobs to take care of someone, and 20 percent have reduced their work hours to provide care.
``The two most likely care givers for older people are the spouse or a daughter - rarely a son,'' Zarit said. ``If the care giver is the spouse and the older person's disability is more than minimal, the care giver will need a break.
``If the care giver is a daughter, she'll have a lot of competing responsibilities.''
Syropoulos agrees that adult day care offers respite for a care giver, but ``before signing an elder up for day care, important things to keep in mind are: What is your stress level? Have you exhausted community resources, such as a home health aide or Meals on Wheels? Could you try it just two times a week, for a break?''
Cost, too, is a consideration. Adult-day care programs can run as high as $55 a day, none of which is eligible for Medicare or Medicaid reimbursement.
Cost, however, is not the only reason we're reluctant to send Dad to a personal care home or to enroll Mom in a nursing home.
Caring for a loved one is still something we feel strongly about, and for some, adult day care might be part of the answer.
by CNB