Definition of Adult Day Services

Adult day services are community-based group programs designed to meet the needs of adults with impairments through individual plans of care. Adult day services are structured, comprehensive, nonresidential programs that provide a variety of health, social, and related support services in a protective setting. Services are reflective of needs based on individual assessments. Participants attend on a planned basis. By supporting families and other care givers, adult day services enable participants to live in the community.

Adult day centers are designed to serve adults experiencing a decrease in physical, mental, and social functioning. The adult day center environment recognizes and attends to emotional and intellectual needs, as well as physical. Adult day centers may serve adults who have Alzheimer's disease or related disorders, mental retardation/developmental disabilities, chronic mental illness, physical problems, or behavioral problems such as wandering and difficulty communicating.

Adult Day Services: Most Frequently Asked Questions

Many families contemplate using adult day services, but feel unsure about what can be gained from these services and when to take a first step. This article addresses some of the more practical questions of WHO, WHAT, WHEN, WHERE, AND HOW to begin using adult day services.

"WHAT can be gained from using adult day services?"

SOCIALIZATION AND ACTIVITY. Just like anyone else, an older person should not spend all their time just sitting around the house. Inactivity often leads to boredom, confusion and irritability. Activities at an adult day center provide mental and physical stimulation not generally available at home, while decreasing isolation and providing the opportunities for friendship.

MEDICAL SUPERVISION. A registered nurse monitors the health and the nutritional needs of participants, administers medications and keeps in touch with both family caregivers and physicians about potential problems and suggestions for ways to improve the well being of the older person.

RESPITE. Many family caregivers are well aware that they need a break, but they may be less aware the person they care for also needs a break. Contact with others outside the family provides opportunities for person enrichment for both the older person and the caregiver.

PROMOTION OF POSITIVE SELF IMAGE. Each adult day services participant is approached as a unique individual with strengths and weaknesses, yet with a potential for growth and development. With support for functional limitations, each participant is encouraged to try new activities and is applauded for even small accomplishments. Such small successes are important in building dignity and self-esteem.

"WHO is appropriate for adult day services?"

The prototypical adult day services participant in a person who had been highly social for most of his/her life and whose social activities have now been restricted due to increased disability, What about people who might be described as shy, quiet or introverted? Many of these people do surprisingly well, but it might take a bit more time for them to feel comfortable while getting to know the staff and other participants. Adult day services are generally not appropriate for persons who are agitated and/or unable to interact with others individually or in a group. Medication may be useful, however, in reducing the anxiety and agitation and may make participation possible.

"WHEN is the right time to enter a day services program?"

There is not a singular answer that fits everyone. Each family will arrive at this decision based on a number of factors, including the personality and the willingness of the older person, the care giving arrangement and the caregiver's level of stress. When the older person can no longer be safely left at home alone, the burden of providing constant care makes day services increasingly important.

"HOW do I enter someone in an adult day services program?"

The first step usually involves a telephone call requesting information. A packet of information is sent out and a preliminary visit to the center for the caregiver and older person is arranged. If all goes well, an enrollment application is completed and a schedule for attendance is decided upon.

"HOW do I get my relative to come to a day services center?"

This depends on the personality and background of each individual, as well as, on his/her level of functioning. Very social or cooperative persons often accept the idea very quickly. Trust and acceptance may come very slowly for loners or for those who have been in a position of authority who may tend to be upset or angry in situations where they don't feel in charge. Most participants who enter a day services program benefit from encouragement and sometimes insistence from the family. The attitude of the family had a great deal of influence, If the caregiver is reluctant or hesitant, their ambivalence is often a negative signal to the older person, Families who believe that day services will be a positive experience tend to transmit their own confidence to their relative. When the caregiver can calmly say that they would like their relative to try it for a month, there is a good chance of success.

(Excerpts from National Council on the Aging, National Standards for Adult Day Centers. And "Adult Day Care: Beginning" by Anna V. Polissar, MSW., Director of Bethesda Fellowship House. Reprinted from the Omaha Alzheimer's Disease Chapter newsletter. And the Living Room Support Group Newsletter, July 1991. And "Life After Diagnosis", Partners in Caregiving publication, July 1995).