Specialized Adult Day Specialized Adult Day Care: Care:

An Ideal Choice for An Ideal Choice for Dementia-Specific RespiteDementia-Specific Respite

Presented by Presented by

Mark Cornett, MSMark Cornett, MS

Examples of Respite Examples of Respite OptionsOptions

• In-home 1:1 respiteIn-home 1:1 respite

• Group respiteGroup respite

• Overnight respiteOvernight respite

• Extended period respiteExtended period respite

• Specialized Adult Day Care Specialized Adult Day Care (dementia-specific)(dementia-specific)

Benefits of Respite for the Benefits of Respite for the CaregiverCaregiver

• Lets caregiver manage other responsibilitiesLets caregiver manage other responsibilities

• Supports the caregiver who works outside the Supports the caregiver who works outside the homehome

• Provides for healthier care giving environmentProvides for healthier care giving environment

• Keeps families united longer than without Keeps families united longer than without respiterespite

• Lets caregiver exercise his or her “humanity”Lets caregiver exercise his or her “humanity”

Benefits of Respite for the Benefits of Respite for the PatientPatient

• Gives patient a break from the demands Gives patient a break from the demands from familyfrom family

• Activity as therapy or treatment for Activity as therapy or treatment for Alzheimer’s diseaseAlzheimer’s disease

• Objectivity of respite providers may Objectivity of respite providers may identify needsidentify needs

• Keeps families united longer than without Keeps families united longer than without respiterespite

• Lets patient exercise his or her “humanity”Lets patient exercise his or her “humanity”

NADSA definition of adult day NADSA definition of adult day care (1997)care (1997)

““A community-based group program A community-based group program which is designed to meet the needs which is designed to meet the needs of functionally impaired adults of functionally impaired adults through individual plans of care in a through individual plans of care in a protective, nonresidential setting”protective, nonresidential setting”

ACC definition of ACC definition of “dementia-specific” adult day “dementia-specific” adult day

care (2001)care (2001)

1.1. Center staff is educated regarding the Center staff is educated regarding the conditions that cause dementia and the conditions that cause dementia and the special needs for patients and families special needs for patients and families caused by these conditions.caused by these conditions.

2.2. Center only accepts patients suspected Center only accepts patients suspected as having one of these conditions.as having one of these conditions.

3.3. Center provides basic services to address Center provides basic services to address patients’ and families’ special needs patients’ and families’ special needs caused by these conditions.caused by these conditions.

How ACC-recommended “Basic How ACC-recommended “Basic ADC Services” meet patient ADC Services” meet patient

and caregiver needs:and caregiver needs:

1.1. Staff/patient ratio of 1:5.Staff/patient ratio of 1:5.

2.2. Supervision and assistance in the bathroom.Supervision and assistance in the bathroom.

3.3. Supervision and assistance with eating, Supervision and assistance with eating, including modifications for the including modifications for the “presentation” of food (puree, serve one “presentation” of food (puree, serve one thing at a time, etc.).thing at a time, etc.).

4.4. Constant general supervision and Constant general supervision and reassurance.reassurance.

How ACC-recommended “Basic How ACC-recommended “Basic ADC Services” meet patient ADC Services” meet patient

and caregiver needs:and caregiver needs:

5.5. Caregiver support and education.Caregiver support and education.6.6. ID bracelet.ID bracelet.7.7. Specialized activities: cognitive, Specialized activities: cognitive,

validation, social.validation, social.8.8. Specific care plan with realistic objectives Specific care plan with realistic objectives

(maintenance, slowing reduction of (maintenance, slowing reduction of abilities, identifying/preventing co-abilities, identifying/preventing co-existing conditions, etc.)existing conditions, etc.)

9.9. Medication administration.Medication administration.

How ACC-recommended “Basic How ACC-recommended “Basic ADC Services” meet patient ADC Services” meet patient

and caregiver needs:and caregiver needs:

10.10.Free environment with the least amount of Free environment with the least amount of restrictions.restrictions.

11.11.A social model with a medical emphasis.A social model with a medical emphasis.12.12.At least 60% of staff time is spent on At least 60% of staff time is spent on

behavior management with specialized behavior management with specialized activities.activities.

13.13.No television or film.No television or film.14.14.Scheduled reminders for nutrition and Scheduled reminders for nutrition and

hydration which increase as the disease hydration which increase as the disease progresses.progresses.

Each patient and caregiver possesses Each patient and caregiver possesses an “incurable relational need” that is an “incurable relational need” that is met by dementia-specific adult day met by dementia-specific adult day care. National statistics state that care. National statistics state that 5,415 adult day care centers should be 5,415 adult day care centers should be established immediately to meet established immediately to meet current need (2002). Up to 15,000 are current need (2002). Up to 15,000 are needed for the future “tidal wave”.needed for the future “tidal wave”.