Tag Archives: adult day programs

Sensitivity Among Caregivers

Some people take on the role of caregiving when it doesn’t really suit them. I’ve seen staff members in care facilities who don’t understand the needs of people with dementia. In families, we can also be blockheads. Stress makes us gruff or impatient, and that helps no one.

Between the Pond and the Woods

On a recent visit to my mom’s activity program, I watched an aide cleaning up after lunch. She was angry at someone — could have been a staff member or someone with dementia — but it made no difference. Plates were flying into a basin, crashing into each other. Knives and forks clanged as she threw them. Noise like that upsets people who are impaired and sensitive to the slightest emotional rupture. I don’t know what this woman thought she was accomplishing. But the whole show was wrong for a setting where dementia patients were trying to transition from a meal to a group activity. If she had been a bratty teenager, you could banish her to her room. But these were the actions of an employed adult. Could better job training change this?

One of the most exciting elements of the recent New Yorker article, “The Sense of an Ending”, was its explanation of how one care facility revolutionized its approach to staff training. Dementia caregivers were asked to put themselves in the place of their patients. They “spooned food into each other’s mouths and brushed one another’s teeth….to be on the receiving end of activities that they performed for their charges every day.”  After these experiences, the education director at the care facility said, “You can feel how threatening it is to have something touch your mouth when you have not brought it to your own lips.”

This comment has lingered with me.  Sometimes when I feed my mom, I think something is cool enough for her to eat and believe she’s being difficult if she refuses it. Now I think more about how shocking a warm — or cold — spoon might feel if you can’t see it coming. I’ve also been guilty of trying to get her to eat faster when I’m busy. But she needs extra time to chew and swallow. Since she has no control over the other parts of the dining process, maybe slow eating is the only way she can retain some ownership of her meals.

I’m trying to stop more often and put myself in Mom’s shoes when helping her with intimate tasks. But how do you get poorly paid caregivers with minimal training to show that kind of sensitivity at work? Most of us spend our lives doing unto others what has been done to us. Now and then we are wise enough to add a bit of learned behavior to that basic recipe. But given the numbers of people likely to develop dementia in the coming decades, I think our society needs to require that Adult Day and Residential Care programs hire staff who have (at least) completed a Certified Nursing Assistant program and show sensitivity to the needs of those they help. Better training would improve the quality of care for dementia patients and might give family caregivers who rely on these services more peace of mind.

Professionals Who Go the Extra Mile — Adult Day Services for the Elderly

Taking care of a person with dementia requires a degree of patience I did not know I had. For years my world revolved around writing assignments and deadlines. It’s a career that requires perseverance and self-discipline. Ten years of freelancing for national clients convinced me that I was pretty good at it. But everything changed when my mom moved in. I felt clueless and overwhelmed. The transition was hard for both of us. Once I found the incredible people at the Adult Day program in our county, managing my work and her care became much easier.

Until Mom moved in with me, I had never heard of Adult Day Care. To me, the name sounded belittling, and I was careful not to say “day care” around my mom. No matter what stage of dementia someone has reached, you’ve got to show respect for who they are.

We are lucky to live in a county with a great Adult Day Service Center which is operated by Blue Mountain Health System. I interviewed Roxanne Downs, the director of the program to get more details about how services are organized. Although the program is located in Carbon County, this Palmerton site also has contracts with Monroe and Lehigh Counties which can refer clients who need services.

Ms. Downs feels that current services for seniors in Carbon County are well managed and located in sites that are accessible for most people. The aging population in our county is growing,  just as it is in the rest of Pennsylvania. But Roxanne feels that the county — like most others — is not financially prepared for the growing wave of elderly people.

Like most Adult Day sites, her center focuses on taking good care of their elderly participants. To do this, they work closely with their families. The center has a caregiver support group that meets regularly to discuss topics of interest to family caregivers. Past sessions have covered elder care law, the nature of Parkinson’s Disease, and trends in gerontology. Staff members at the site interview the elder’s primary caregiver every six months to adjust each elder’s care plan. The program operates on a medical model which helps identify and address health issues together with families.

Apart from meticulous daily care, the center offers handicapped accessible showers for people who have limited accessibility at home. They have a nurse on staff who can do blood work on site. This reduces the family burden of making appointment for ongoing labwork. A hairdresser is there offering weekly cuts for elders. Occupational and speech therapy can also be arranged on site.

I love the people who work there because they have been so good to my mom. Whenever any issue comes up, I get a phone call immediately and we create solutions together. Every day I am thankful for the kind attention they have given my mom and I am certain that their activities have helped my mom retain some abilities despite the progression of her disease. If you need this kind of support so you can work full-time and still care for a family member, the links on the front page will guide you to similar programs around the state of Pennsylvania. My December article in the Journal Newspapers also provides more details about elder programs in the Pocono region.

If your county doesn’t have a program like this, it may be time to become an advocate for launching one. You can begin by calling your Area Agency on Aging — and follow up with a call to your state legislator. Don’t be afraid to ask for what you really need. The elders in our community deserve the kind of support they once offered to us.