We are great fans of good adult day activity programs. A good day program will offer benefits that no amount of loving care at home can provide: a combination of stimulating activities and soothing time to regroup, carefully programmed throughout the day; experienced staff who rotate so no one becomes frustrated or exhausted; opportunities for every participant to be successful at something every single day; and friends and experiences that belong solely to the participant.

For the caregiver the benefits are also clear: a chance to spend some guilt-free time away from caregiving responsibilities; the opportunity to watch their loved one grow and flourish; and a supportive professional group who come to know their attendees well and who can give guidance and support.

There are thousands of adult day centers across the country. Some are excellent (like the ideal described above). Some are not so good. How do you tell the difference between an adult day center you would be thrilled for your elder to attend and one you should avoid?
 

There are several steps you should take to find the best day care program for your individual senior.

Step #1: Determine What You Need From An Adult Day Program

___ A. How much time will you need?...Do you need an occasional break, i.e., one or two afternoons a week, from one to three full days each week, or five full days to accommodate your work schedule or other responsibilities?

___ B. Do you need transportation assistance?

___ C. Do you need a day care program that participates in Medicaid or where there is a sliding fee scale?

Step #2: Determine What Your Elder Needs From A Day Care Program In Addition To Supervision and Social Stimulation

___ A. A special diet

___ B. Help with personal care: bathing, shaving, hair care

___ C. Help with using the toilet

___ D. Help with walking or eating

___ E. Health status monitoring: blood pressure, blood sugar, weight, etc.

___ F. Medical therapies: physical, occupational or speech therapy

If you answered "yes" to "E" or "F" you will want to find a day program with a nurse on staff.

Step #3: Use The Telephone First

Locate local adult day care centers through the Area Agency on Aging (1-800-677-1116) or your local senior center. When you call, ask about days and hours of operation, the application process and fees. Then you can decide whether it's worth your while to make a visit. Ask whether they have a brochure they can send you or a website you can visit.

Step #4: Pay an initial visit (on your own if you can). Make note of the following:

___ A. Is the facility clean, bright, well furnished and without odor?

___ B. Is every part of the building wheelchair accessible?

___ C. Does the furniture look comfortable? Are there recliners available for those who need to rest? Do chairs have arms to assist with standing?

___ D. Is there a "sick" room where participants can be isolated?

___ E. Is there a spacious bathing room for anyone who may have had an accident or who participates in a bathing program?

___ F. Is there a quiet room for those who may need down time?

___ G. Do participants help plan activities?

___ H. Does everyone, staff and participants, appear to be cheerful and happy to be there?

___ I. Is there a volunteer program? A pet program? Do children visit?

If the facility looks like a place you might consider, ask the following questions:

___ J. Who owns the facility, and how long has it been in operation?

___ K. Is the center licensed?

___ L. What is the enrollment?

___ M. How many staff does the facility have, and what is the staff to participant ratio?

___ N. What are the staff credentials, and what additional training is provided?

___ O. What medical or cognitive conditions does the facility accept? Are wheelchairs allowed? Is incontinence accepted?

___ P. What are the days and hours of operation?

___ Q. Is transportation available?

___ R. Is there financial assistance available?

___ S. What are typical activities, and can participants choose whether they wish to participate? What arrangements are available for those who do not want to participate in a particular activity?

___ T. What are the costs for part and full day? Is there a discount for attending several days per week or per month?

___ U. At what stage will the center suggest that it is time for your senior to withdraw from the program?

___ V. Are there support services or programs for families and caregivers?

Step #5: Give Any New Adult Day Center A Real Try

Take a trial run at the adult day activity center that appears to meet your needs best. Expect that your elder may be reluctant to attend. It often takes several visits before an individual feels comfortable in new surroundings. Those with dementia are often frightened until new places become familiar. Experienced staff will anticipate reluctance and will know how to overcome these initial fears, so don't be too quick to conclude that a good day program won't work.