Local programs help caregivers

Adult day care allows caregivers critical respite By Brian Goslow BOSTON - Laurie Galvin of Hyde Park was 93 when she entered the Cooperative Elder Services Inc. (CES) Adult Day Care Health Program. She had just stopped driving the previous year, and only then because of two nasty falls that left her needing constant attention. The loss of her license was one thing but losing the ability to be around people was unthinkable to the highly sociable woman. To her, the Milton-based facility, which felt like a supervised senior club, was a godsend. Galvin's daughter, Judy Swett, had taken a leave of absence from her job at Archbishop Williams High School in Braintree to look after her mother. That made her one of the more than 50 million people that the U.S. Department of Health and Human Services said provide care for a chronically ill, disabled or aged family member or friend during any given year. When the responsibility began wearing her down, Swett brought her mom to CES. Having been a devoted 24-7 caregiver, Swett found it difficult to leave her mother behind. The CES staff had to convince her she wasn't abandoning Galvin. "They would tell me, 'You need to take care of yourself as the caregiver,'" said Swett. "'Go, this is your time.'" Swett was so impressed with the concept of adult day care, that after her mother died, she went to work for CES as its social services coordinator. Stella Henry, author of The Eldercare Handbook: Difficult Choices, Compassionate Solutions (HarperCollins Publishers), said feelings of guilt should be expected in caregiving situations. "It's going to be with you wherever you go, whatever you do," she said. However, knowing your parent is safe is an important part of being a caregiver. Investigating day care programs is part of that process. "You have to go see the facility and see if it feels good to you," Henry said. "Families need to be able to tell their loved one, 'You know what? I've gone, I've seen it, it feels good to me.' If it meets your test, ask your parent to try it out for a couple of days." Most seniors will be hesitant about being taken out of their safety zone and into a new situation where they don't know anyone. "They don't want to be the new kid on the block," Henry said. The transition can be more difficult if hearing, vision or bathroom problems exist that would make them feel inadequate in a public setting. Caregiver Arlene Lodgen told her mother-in-law, Ruth, 83, that CES was a social club; she's been there for four years now. "We never used the term day care," Lodgen said. "We told her she'd exercise, have lunch, play games and communicate with other people." Ruth and her husband initially visited CES for two days. "He was hesitant, but she was starting to have dementia and needed the stimulation of being among a lot of people." Seeing how the activities there helped improve her sharpness, Ruth Lodgen's family asked her to play Scrabble at home. "She beat us three out of four," Arlene Lodgen said. "I know she's been stimulated. She's different. Her dementia hasn't gotten worse." Ruth Lodgen is now at the center five days a week. "She meets new friends all the time but the old ones are her comfort zone," said Arlene Lodgen, who's in a good place of her own knowing her mother-in-law is safe. "I ask them to tell me if they notice anything changing in her. They keep talking with me." Anything that relieves caregivers' stress will be beneficial in the long run. According to the National Family Caregivers Association, family caregivers who provide care 36 or more hours weekly are more likely than non-caregivers to experience symptoms of depression or anxiety. For spouses, the rate is six times higher; for those caring for a parent the rate is twice as high. Family caregivers who experience extreme stress often age prematurely. This level of strain can take as much as 10 years off a family caregiver's life. The first program of the day at CES, which operates weekdays from 9 a.m. to 3 p.m., allows clients or "guests" to warm up to each other over muffins, coffee and tea, newspapers and conversation. After morning exercises, part of the group moves onto activity time, while separate group stimulation activities for those with dementia or Alzheimer's are held in a smaller space. Each CES guest receives attention based on his or her individual needs. Familiar, themed activities keep their memories engaged. Building a campfire scene out of foil and paper rolls topped with sticks holding marshmallows brought the participants back to a familiar place. "They had old campfire songs going on," Swett said. Music, "the universal language," has proven invaluable in reaching clients with Alzheimer's. The musical gatherings helped invigorate the fading memory of Francell Best, 80. "She enjoyed singing those old hymns and band music from back in the day," said Shirley Woodson, Francell's sister and part-time caregiver. She was relieved and unconcerned about her sister's safety when she was at CES. "When she felt the need to talk to me, they would just call me on the phone and say, 'Francell wants to talk to you.' I never felt that was putting them out." Best recently moved out of town and into another day care program. Swett has to frequently remind Helen S., 77, "We're here to serve you." The former nursing home nurse's assistant likes to help clean up after lunch. A live-alone senior, Helen, who asked that her last name not be used, said CES helps her memory and appetite. "It helps to talk to people and have a good nourishing meal of meat, potatoes and dessert," she said. "When I get home, I'm not even hungry because they have great tasty meals." She works those calories off during exercise time. "We sit around in a circle and touch one arm to the floor, then the other one. Exercise is good." There are about 200 adult day care centers around the state. Some are stand-alones, others are connected with assisted living facilities or other institutions. The Leominster-based Adult Day Care Center at the Manor on the Hill shares activities with the Manor's assisted living community. Not only does this make for a greater social experience but it also gives clients a chance to learn more about what it's like to live in the residential setting. "A lot of people who come into day care see other people living in assisted living, and say, 'Oh, I could do that,'" said assistant director and registered nurse Joanne Bangrazi. "If it fits their lifestyle and situation, it's a nice stepping stone into the next step." Two or three activities are always taking place at the Manor's day care program. "We try to gear it to a higher-functioning group in the sense that I don't have any bedridden people," Bangrazi said. Bowling and volleyball games adapted to individual physical abilities keep clients functioning well biologically. Those needing memory care participate in reminiscent programs. Valentine's Day activities always stir client memories. "We'll talk about how they met their spouse," Bangrazi said. Although their short-term memory may not be very good, most people have wonderful long-term memories, she explained. Carolyn and Ken Racicot have seen many changes in the adult day care profession since they opened Elder Day Services of Southern Worcester County Inc. (EDSSWC) in Dudley in 1989. "People are coming aboard much older then they did 18 years ago," Carolyn Racicot said. "If somebody would come on in their early 70s then, now they're coming aboard when they're 90. We're living longer and we're in better shape." Insurance regulations have also affected change at EDSSWC. It used to offer boating and horse-riding activities, but they've been discontinued for safety reasons. Just the same, clients are kept busy with a wide choice of activities. "It can be board games, gross motor games for the legs and arms (which include horseshoes, golf, ring toss and balloon volleyball) or arts and crafts," Carolyn Racicot said. As many of its clients need medical observation, nurses and nurses' aides are on duty throughout the day. "There's no real guide for any of us because every family situation is different," said Henry, adding that she wrote The Eldercare Handbook with baby boomers in mind to provide an understanding of what they can and cannot do as a caregiver. "Hopefully this teaches you what to ask of yourself and of others. Caregivers are not good at asking for help. They're extremely idealistic and think they can do it all and create a problem by thinking nobody else can do it." She learned this firsthand, having lost both her parents to Alzheimer's. As co-founder of the Casa Del Mar-Residences, an assisted living and long-term health care facility in Los Angeles, Henry regularly meets with families who believe they have tried everything to help their loved one. The growing number of day programs is an invaluable option. "I've seen the value of adult day care centers in the ability to keep people at home much longer than if that level of care wasn't out there," she said. Not only will the relative be engaged in word games, reading horoscopes and doing puzzles, they'll also make things that'll stay with the family long after they're gone. "My mother made a collection of scarecrows and gave them to the children in our family," Swett said. "They're little things that mean a lot to us." For more information on the Cooperative Elder Services Inc. day care program, call 617-333-9387. For information on the Adult Day Care Center at the Manor on the Hill, call 978-537-1661. For information on Elder Day Services of Southern Worcester County Inc., call 508-949-3598 or 888-273-1179.