I've been participating here for a while now, and it seems to me that many more people post about bringing in help than sending their LO to an Adult Day Program. I've done both, and while I have to say there are advantages either way, I think using an Adult Day Program to provide respite care has been the better solution for both of us. For one thing, the center is always open (no calling in sick or getting substitute home health aides); it is more cost effective (about $80 for a full day vs. $20/hr); the hours are flexible vs fixed; and my husband gets to interact socially. The only advantages of bringing help in have been that they can help with personal care; I don't have to get him ready and take him to the program; and household chores get done by someone else other than me. Maybe this thread can help someone who is trying to choose between the two options.
This is all just my own opinion and my own preference. Only if you have money to pay privately or a long term care insurance policy, does anyone have options for anything. $80 a day for 5 days a week = $400 a week. To most people, that is a LOT of money, and totally irrelevant if you don’t have it. If you use it 3 days a week, that’s $240 a week. Still a lot of money if you don’t have it. In home care at $20 an hour for 3 hours a day, 3 days a week is $180. Yes, it’s only 3 hours a day vs 6-8 hours a day for Day Care, but in those 3 hours, your spouse can get showered, shaven, dressed, and fed. It really depends upon what you are looking for. Perhaps a combination of both.
Day Care seems to me to be all about giving the person with AD a place to go, something to do, and socialization, while giving the caregiver a respite from 24/7 caregiving. In home care seems more about giving the caregiver a respite from the physical work of caregiving. Maybe a little bit of respite to go out and do some errands while the health aide is doing their work in your house.
If Medicaid or Medicaid Waiver is paying, you take what they will give you, and it is quite limited in most states. Here in Florida, the State has frozen all funds for EVERYTHING related to caring for dementia patients and others needing care. If the funds are released, they will go to those on level 5, who need around the clock nursing care.
If I had a choice, I would choose a combination. Maybe 3 days in Day Care and 2 days of in home care.
getting mine out to do anything in mid stages was alot of fustration. just getting them dressed on time and out the door would have been a deal breaker for me as far as structured time activities. as some of you know if they are not compliant they wont budge much less get dressed and into a car and to a daycare. once there yes they would probably have a good interaction but for me convenience would have to be considered. in home care on the other hand for me is at my schedule and does give some relief as to what i need to help me destress. and i can choose the hrs and how long or short. as joan states fiancials are also a huge factor on how much in home or outhome help one can pay for so i also agree if you can manage some of both its a working combo. divvi
I would have loved to have DH go to daycare even for a few days a week, but the one closest to our home is really NOT a match for him (besides being full and not accepting new clients) because the population is mostly elderly women and all activities are geared towards their experiences. I think DH needs more social interaction and still responds appropriately when in social situations. As Joan ponts out, finances play a big part in our decisions and most options are expensive, even with LTC insurance (DH's only pays 1/2 of the daily live-in rate and would not pay for daycare). I would think the use of both an aide and daycare would be the ideal combination for both the AZ spouse and caregiver. Unfortunately I've heard many caregivers say there's not a daycare center any where close to where they live.
I would love it if my DH would go out..he won't unless his pals plan a lunch or something with him. As to getting him ready for something like that? Not a chance to make a schedule for him...he is a dilly dally expert..was that if he knew he had an appt he would get the shower etc out of the way before he came out to breakfast..not now..it is prod prod prod... I would like him to have a companion but it won't work at this point unless it is one of his pals and even then it can be iffy.. The cost would be a killer in addition to everything else..
The first thing I was advised to do when Eric was diagnosed was to get him out to daycare. We have one 5 minutes away, and it would have worked out very well except he refused to go. And he was stubborn.
If any of your loved ones are veterans and you feel they would go to day care, check with the VA for day care benefits. My husband attends a VA contracted day care three times a week and they pay the cost ($65 per day). He has no service-connected disability. If your income in on the higher side you might have to pay a copay which I believe is $15 per day. I was given a list of facilities in my area to check out and let the VA know which one I preferred. The VA also has a transportation benefit.
My husband's day care is pretty evenly divided between men and women so they try to do different activities for each. They have found that crafts work well for the woman but the men don't really want to participate in that. For the men they sometimes will build easy models of cars, planes, etc.
Our daughter works as an activities director for a large adult day care.Their hours are from 7:00- 6:00 and they provide transportation as well. Most of the participants are covered by Medicaid vs. private pay, the fee is $69.00/day. One advantage her center has is that showers can be given by a CNA- which can be a big help for those dealing with behavior issues, or children caring for parents.
We are not there yet but my first preference would be daycare for the social activities. My BIL goes to a Jewish run facility that charges $55/day but does have a slidig scale based on income. I would urge others to asked about fees vs. income and maybe you will be able to get a discount.
divvi--I agree that compliance with daycare attendance can be a major hurdle. For me, the battle was worth it--the advantages outweighed the stress. The battle was, however, only in the early and beginning of the middle stage. Now that he is lateish stage 6, I get no more arguments and he seems to enjoy it more than he ever did. It is a rare example of how something can actually get easier as the disease progresses. In terms of getting him ready, we have now switched to a wardrobe of mostly athletic clothing and if worse comes to worse, he just wears the outfit he slept in. Many times I will put a clean outfit on him the night before, when he is most cooperative, and the next morning there are minimal preparations.
marilyn, how wonderful to hear DH is easier and more willing to get to daycare now further in the disease. it is rare we can find something that gets easier with time. it would be a great benefit to have the showered while at daycare as well. one less struggle at home.
Yes, I believe they do showering at his daycare, but I haven't worked up the courage yet to try it. (So happy he likes it there, hesitant to rock the boat!) For now, our aide is managing to do it at home. I just purchased a hand held showerhead and as soon as someone puts it up, that should help.
I remain interested, an would like to reintroduce the concept of daycare at some point. (Jeff had a very negative reaction to our visit a couple weeks ago, stated he did NOT want to go there. Additionally, the director was unable to get a correct picture of his level of disability during our brief visit.)
I am not sure when/how I might reapproach the topic, but perhaps a surprise visit when there's more activity in the higher-functioning area of the center.
No day care available in the area where we live. I do take him to two support groups 45' away two mornings a week. One is called Brainbuilders where the clients work w/grad students. Another is Circle of Art where clients do art projects, sing, play games, socialize and have lunch. Also have 3 hrs in-home personal hygiene care and a trip to town once a week! Seems to be a good balance for us.
The only adult daycare in our area looks more like a Special Ed class. Our son and I visited and both immediately decided it was not for DH. The patients there were mentally disabled older adults who could not be left at home while their guardians worked. The social stimulation there was geared to them as they played childish games and watched kids movies. DH would regress in that situation.
phil--I know the type of place you're talking about. I accidentally visited one, thinking it was a new daycare that might be good for my husband. Although they said they took dementia patients, I was appalled at what I saw and wouldn't consider it for a second. It was lightyears away from the type of program that he currently attends.
That is part of the problem with our visit to the daycare. It was a low numbers day, and everyone was in the same room which included quite a few developmentally disabled folk. They suggested I visit later when the higher functioning old folk would be playing games and whatnot in a different room, but Jeff had already gotten a very negative idea.
emily--if you decide to revisit the daycare issue, see if there's another center near you that does not include developmentally disabled individuals. I think dementia patients in the early/middle stages can be very put off by being expected to associate with them. I know that I was surprised to see how negative my husband's reaction was towards them. It is just a different population and the programming should be tailored to the differences in abilities/medical conditions.
I think a lot of AD patients resist the idea of day care; dh certainly did, but he had reached the stage (about stage 5) where I could fool him into getting into the van. I would get in with him, and he would think I was going along. Once he was buckled up, I left and said I'd see him at four. He always fell for it. They told me it might take up to six weeks for him to learn to like it, and it did. After that it was never any problem, but I never talked about it ahead of time. I just made sure he was ready and already getting a bit restless when the van came -- he always wanted to go somewhere -- and willing to go out the door with me. Then I would steer him away from our car and towards the van. It helped if he could see the driver (who often came to the door) and if it was a driver he liked. Once he was at the facility he got along suprising well. They told me after a few weeks that he was a sweet man, and very cooperative. I was amazed. At home he usually wasn't. Besides giving me a major break, his being at day care prepared him for respite care and for permanent placement. Both of those were much less of a hurdle than they might have been otherwise. To me, it was worth every penny.
Read the title of this thread wrong. If they had daycare for Caregivers I'd be first in line. I'd be willing to do crafts and music, computer classes, a gentle exercise program, you name it. Lunch out. A whole day away and maybe even multiple days a week?