Episode Transcript
[00:00:06] Speaker A: Hi, I am your host, Bena Coleman. This is aging in America, and with. I'm just going to say I am with parent projects. I am so excited to have Leslie on today.
She is at honor Health. She'll explain what she does through honor health and her program. But it's a very near and dear subject to my heart. And I think it either is to say somebody else or could be if it is something they're looking for, which is a adult daycare, which we will get into. So, welcome, Leslie.
[00:00:35] Speaker B: Hi, Bina. Thanks for having me.
[00:00:37] Speaker A: Of course, of course.
I truly, I don't think a lot of people are familiar with adult day care. Of course, we know infant care and all that. So if you could, I would love for an explanation from your point of view of what it is.
[00:00:52] Speaker B: Yeah. So adult day services, as we like to call it, just to differentiate a little bit from that child care component, is really focused on supporting that older adult that maybe has health issues that need monitoring, they may have physical or cognitive disabilities, and that they're relying on somebody else's care partner for them, that maybe they're no longer safe on their own. And so this is a place where it's structured and supportive and looks at not only just providing some clinical oversight, you know, medication management for people that maybe have diabetes. Diabetes. And they need blood sugars checked and insulin administered to individuals that may be experiencing some type of dementia and just kind of need that cognitive support. And they do it in this type of environment where we're focused on support and fun for the individual and keeping them engaged at their highest level possible. And so that looks really different. You know, we have musical entertainment. We do lifelong learning, education classes, literacy classes. A lot of them have some type of recreational component to keep them engaged and active while they're there.
And that gives the chance for their care partner maybe to go to work and know that their loved one is safe and that their healthcare needs are getting taken care of, or allow that care partner to maybe take care of themselves, which we know is critical. And so they can make those doctors appointments and they can, you know, maybe just get through the laundry for once, and they know that their loved one is someplace safe. So that's kind of how those adult day services work, is that they're really structured and focused on supporting those older adults that need more hands on care, but may not be at that level where they need to be placed long term, you know, in memory care unit or an assisted living unit. So it's really focused on supporting them within their community and also to help them maintain and be able to stay in that community a lot longer.
[00:02:55] Speaker A: Yeah, that was a beautiful explanation of it because, you know, we touched on this earlier, but a lot of people may not know that this is available to them and like you said, it sounds so silly and trivial, but just to get that load of laundry done for the caretaker to have that peace of mind and that respite for whatever that I don't want to mispronounce it. Adult day service hours are, is such a, such a gift really in the long run.
So thank you for that beautiful explanation.
I told you off air and I'll let everyone know. I do have personal experience. My own father was diagnosed with Lewy body dementia in his late fifties and died in his early sixties. And before we actually placed him in a memory care unit here in Phoenix Scottsdale area, we actually had him in a day center or adult day services up in Scottsdale. And it was so wonderful. I did not live at home. I'm a mom, a wife, I have my own home. But to give my mom that break and that's what I want everyone to know, that yes, I'm still that adult daughter, but there was still someone at home with my dad who did need that break and that service was available to him. We were so fortunate to know about it. Can you let us know, are these out there for everybody? Like where can we look for them?
[00:04:18] Speaker B: Yes. So surprisingly, there's at least 5000 or so adult day services programs within the nation and there's actually a great website. If you're like, hey, you know, I think my parent might benefit from this having the type of social interactions and just that clinical oversight, I think they might benefit. You can actually go to the National Adult Day Services association websites and they actually list it by state. So no matter what state you're in, you can click and kind of see what might be available to you within that area. It's really easy and user friendly. And there's also tips on there too for individuals that may be looking for an additional level of respite care such as adult day services.
[00:05:03] Speaker A: Yeah, I mean, we can talk about that as well. We can touch on it lightly, but there are respite options besides adult day services, which again, I don't think are being utilized as much as they could or should be. So we will put that website or yeah, the website you mentioned, but on our show notes so people have that. So thank you for sharing that.
I had no idea there was 5000. I think that's phenomenal. Is there applications that go into this process?
Is it kind of just you show up with the doctor's note that says, yes, my loved one has Alzheimer's, how does that work?
[00:05:40] Speaker B: So it can vary place to place. Actually, within the adult day services, there's actually almost two different types of programs available. So there's adult day services that's more geared towards independently functioning individuals and actually may look towards like senior adults that maybe are living more independently and maybe don't have that full time caretaker yet. And then there's other programs that are considered adult day health care programs and those are more focused towards the individuals that maybe need more clinical oversight, medication management, and those that may be experiencing a type of dementia. But pretty much for both. Most places you can just call and be like, hey, I'm interested in these services. You know, what do I do? And pretty much every single one of them is going to say, come down for a tour, right. You want to check out the place first, see if it's a good fit for your loved one and the individual. And then usually from there they'll walk you through that process of next if this might be a good fit for your loved one. We do partner, at least here in Phoenix and I'm sure other places do as well with doctors and physicians may provide kind of that referral, but it's not necessary to access adult day services. You do not need a physician's referral. You don't need a specialist referral. It's pretty much open to the community. And so if you feel your loved one has a need for this, you can actually just contact them straight out and you don't need a referral for the types of services. So it's a really great resource that's out there that doesn't require any of those types of additional steps.
[00:07:20] Speaker A: That's phenomenal in itself, just something you can utilize without going through hoops or whatever, you know what I mean?
So I know they're going to all be different. I mean, you touched on that.
I do find it interesting because besides my personal experience, I have had clients that have used them before and some serve lunch and some don't and some are half day and full day. So is it just really, depending on which one is closest to you, which one is the best fit?
Do you recommend if somebody needs a full time a day, full time? Should they drive a little further? Do you have any recommendations on what they should look for?
[00:07:59] Speaker B: I think a big part of it is really looking at what your person's needs are and maybe what some of those diagnoses are that they're dealing with, especially for people with dementia, you maybe want one of those programs that's more flexible, that is offered all day for some people, maybe they only tolerate 4 hours where others maybe tolerate the full 8 hours. And so it's more or less finding something that they feel comfortable with because that's at the heart of the service, right. You want the person who's coming to benefit from the full service. You don't want them to feel out of place, you don't want them to have anxiety, why they're there. Because the focus is really that social health, right. The whole goal is to support those older adults that are experiencing either physical or cognitive issues that are isolating them. And that's what a lot of these diseases, especially dementia, does, is isolate them. And so adult day programs are to really address that social health. So you want them to feel comfortable in it. Most places will generally let you know days and times of availability, what those programs may look like if they're half day or full day. And depending on what your needs are as that care provider, you know, if you are somebody who part of the sandwich generation, right, you're not only taking care of your adult parent, but you're also taking care of maybe minor children, you kind of need one of those full day programs to support you because you're probably still working as well.
And so finding that program that you feel comfortable with taking care of your loved one, your loved one feels comfortable being there, it might be worth it to drive the little bit extra to get them there if it's going to be a good fit for them. So a lot of it will probably be based off of what your needs are as the care partner and then what the individual is able to tolerate. We do find, though, that for some people, good places will start them off. Okay, let's start, you know, just two days a week at 4 hours. And then as we see them get comfortable, you know, let's bump it up to 6 hours or 8 hours, or are you ready to add another day? So a lot of good places will work with you and understand that you're not going to jump this person into a group of strangers, you know, to a place that they've never been before. If they're dealing with dementia and maybe have a little bit of paranoia and dropping them off someplace for five days a week at 8 hours a day surrounded by strangers.
It is. And so most of them will understand that and let you know what those modifications may be to their programs. Also, when you are kind of looking at an adult day place, if you have a loved one that, you know, maybe has dementia, maybe has congenital heart failure, has diabetes, a good question is to ask regarding what nursing oversight they have.
Some programs will have a registered nurse that's there part time or full time. So it's always kind of good to know if you have somebody that needs that clinical oversight to ask those questions of how long is your nurse on site for? What do they support with maybe what other staff they have there that maybe help with medication management and just kind of ask those questions too, because you want to make sure their needs are fully covered. It also doesn't hurt to ask, you know, especially if you know, your loved ones dealing with dementia, questions on how do you deal with somebody when maybe they're having a challenging time, when some of those behaviors are coming up, what's the protocol? You know, when do you call that care partner to come pick them up? What do you try to do to help them feel comfortable in the space before it gets to that point where they need to leave the program, too? Can ease some of that for the care partner as well.
[00:11:49] Speaker A: And I think that's a really wonderful tip as well because you're right. I mean, you can be in any stage of dementia and going through some behaviors, different behaviors. So you want to know, you know, are these people working at the adult day services dementia trained, really, like, to your point, will they be able to handle if you have an aggressive parent or husband or whatever the case is? So I think that's a really wonderful thing to look for when you are choosing which daycare to go to or, excuse me, day service to go to.
[00:12:20] Speaker B: And also, it doesn't hurt to just randomly pop in too, and see what it looks like day to day. Instead of scheduling a tour, we have people that just randomly stop by and be like, oh, I heard about this place. So I just wanted to see what it was all about or for us, we have doctor's offices right up the street from us, so they'll be like, my doctor said we should come check it out. And so they just stopped by after their appointment. And that can give you a chance to really see what the day to day looks like as well. So that because most places, if you schedule a tour, they're going to probably have you come in when everything is, you know, perfect and you kind of want to catch them at those times where it may not be so perfect to really see how they function.
[00:13:02] Speaker A: Again, I'm again, just going from experience, so you'll have to correct me, but do you have a cap of how many people per day that can come?
[00:13:11] Speaker B: So our cap currently is 30 people a day. But a lot of different adult day programs generally are based off of size, capacity of their actual physical space. So most adult day programs are actually licensed by the Department of Health Services for that state, and they will tell them how many people they can serve by square footage of the facility. And so for us right now, we're capped at 30 people a day. That's just, again, that thing that happened in 2020, Covid kind of created new regulations, so we were making sure to meet those and slowly titrating people back. But we've also noticed that acuity, which is the level of care somebody needs, has also increased because of COVID And so we want to make sure that our services that we provide to our members is able to meet their needs. Where we have a lot of individuals that prior to Covid that might have been with us, were independently walking, and now they need to use an assistive device, or they were maybe diagnosed with a mild cognitive impairment before COVID but because of social isolation and other things that were going on, now they may be in stage three of their dementia, and so they're requiring a little more direction and more one to one support. So we also want to make sure that when you are going to look at places, ask those questions, too. Know, what's your daily capacity? What's your staffing level?
You know, you can ask maybe what acuity of members are. You know, most general information can be provided, like, how many members do you have that have a dementia diagnosis? How many people are using an assistive device? Because that might help you make your decision, too. We are lucky that we are functioning at a very good staff to member ratio, so we can make sure that we can provide the level of care. But that's also because we've adjusted our program to be more specialized to target those individuals that are dealing with dementia. So that's why we also want to maintain a good daily ratio. But there are some places that 60 to 80 people a day are part of the program. Yeah.
[00:15:27] Speaker A: Oh, I did not think you're going to say that many.
I'm trying to think what my dad's was, but I will tell you, I will be honest. You brought up another really good point where his happened to be in a memory care facility his day. So it was all people with memory issues. And I don't know because he was so much younger, if that was good or bad at the time, but for me it was reassuring, as, you know, the adult daughter who could see, okay, he's in good hands. All these people are also going through this as well.
[00:15:59] Speaker B: And that's also a really good benefit of adult day programs for the individual themselves is usually they're amongst peers and they're usually around individuals that are experiencing similar issues and that there's almost that kind of camaraderie and that comforability.
For a lot of people with dementia, when they're starting kind of that beginning stages, they know something's going on, right. And so they're really good at picking up social cues and then trying to present really well. And then it can get really frustrating for them because they're realizing maybe they're not presenting as well or they completely forgot a word and they're like, I can't what? Well, they're around people that aren't like, well, what are you trying to say? What are you judging? What's that word? They're not judging because it's happened to them. And so there's almost like this comfortability, and you can kind of see as new members come in and start realizing that they're amongst peers, that these people aren't judging them. They're not expecting them to do things a certain way. They just start to feel more comfortable. And you really get to see a lot more of that personality come out and get to learn a lot more about that individual as well. And it's really amazing to see because I've had the benefit of seeing friendships get started here between our members.
We have actually two gentlemen who are both ex military that have come together. One gentleman, he had a stroke, so he has a little bit of aphasia. The other gentleman is beginning stages of his dementia, and they just started talking and showing pictures of their time in the service and talking about families and just built this really great relationship that actually trickled to their partners. And so, you know, their spouses were connected because they realized this friendship, that they came together, and then they formed a friendship, too. So it also created a support for the care partners as well as the members that were here. So there's just so many great benefits to these types of programs for the individual coming into them as well as for the care partners, because you meet other people that are experiencing things similar to you. Right. Can be a little tricky, especially for adult children who are caring for their parents. And so it gives them an opportunity to meet others to understand where they're coming from and build that connection, too.
[00:18:19] Speaker A: Oh, Leslie, that warms my heart more than you'll ever know. I'm such a proponent of support groups for the caretaker, and I feel like that example alone is their own little support group. It's two women who their husbands now are together every day, and they can have this respite time together. I love that.
One thing, you know, we did talk about, I think it's a very good point to bring up.
People might not know about this service, and we're trying to educate them, but if they wait too long, is there a time in someone's care journey where you're like, this is a good time to start the application process, start touring these centers?
[00:19:00] Speaker B: So I think it can be a bit challenging because first off, with any disease, and especially for older adults, when we start aging, we kind of want to deny it and push it off and not address certain things in the moment and think that, okay, if I admit to this, it's just going to go downhill rapidly.
A lot of people can be avoidant, but I really think when you start to notice those small little things, a big part that I think is a good indicator is when you start to notice that their social engagements are starting to become more withdrawn. Right. They're not wanting to go to their favorite restaurants as much, or they're not wanting to go out to the movies like they used to. They'd rather stay home. There's just those subtle things where they're like, well, I'm too tired today. I don't know if I want to go with you to do this, or, you know, they seem agitated or antsy when you're out. And that's a big for dementia. And, you know, I'm sure lots of people have heard that, you know, that kind of social withdrawal, that's always a good start because you can bring them to a place like this, find those things that they are really interested in, reconnect them with some of the interests that they had, and show them that they can still have that, regardless of what disease or issue they're going through, and bring that joy back to them. But amongst peers, that's where I think it's really important to start realizing that when you're noticing that social withdrawal might be a good time, because the sooner you can get them in these types of programs, the sooner they'll become comfortable with that type of setting and benefit much longer. We've had people that have been a part of our program for ten plus years that are still with us. Yes. And so.
[00:20:54] Speaker A: Wow.
[00:20:54] Speaker B: Yeah, it talks to the benefit of it, you know, and it was helpful too because we've been able to see them age through that process and so we've been able to support their care partner as well. So when we notice progression in disease, we can adjust our program to keep them here and then support that person that's caring for them in their home to adjust as well.
[00:21:16] Speaker A: And I know you can't speak to probably any other day center except for yours, but do you know if you or others have wait lists like, you know, we're talking about when is a good time to start applying and looking?
Do you know about the waitlist situation?
[00:21:32] Speaker B: So wait lists can be very common. While there's 5000 across the nation, you know, in heavily urban areas, you know, like Phoenix, where you have a lot of, you know, people who are probably in that age group, there's actually not a lot of adult day services available. So even thinking about California, they have quite a few there as well. But they run wait lists too. Generally they're about three months. So that's where if you're starting to notice those small things, reach out and get them at least on the waitlist, you know, and if it maybe is too soon, you can always contact them back and go back on the waitlist. We've had that before where somebody is like, yes, let's bring them in and we start the process and we put them on the waitlist and then we start to come up to them in the waitlist and they're like, I don't know if we're ready for that yet. And it's like, okay, well, we'll keep you on the list. We'll, you know, push you back and we'll reach back out in three months and kind of see where you may be with that because I know it can be a big change for that individual coming into the program and also for the person caring for him. But most places will probably have a wait list. So it's always good to reach out sooner rather than later. Also, each place has different requirements, requirements of functionality for that individual to be able to stay in their program. And so your person maybe be on the waitlist too long and maybe doesn't even qualify. So the sooner you can get in there, the sooner you can let them know your intention and get on the waitlist, the better it will be because then you'll be able to maximize the services provided by the program. But generally every place will probably have a waitlist.
[00:23:17] Speaker A: So I know we've talked about nationwide and Arizona, but can you touch a little bit on your honor health program. You know, you are with honor health, and I'd love to really highlight that.
[00:23:26] Speaker B: Yeah. So we're lucky. We are with Honor Health, which is one of the hospital systems here in Phoenix and Scottsdale. And we're actually desert Mission adult Day healthcare, which is a part of the community services branch of Honor Health. So it's really unique that they provide these services to the community. So as a community based adult day healthcare center, we actually partner with our veterans affair. We partner with the Arizona long term care system. We partner with Mercy Care, which is the state funded healthcare program for older adults, especially those at risk. We partner with the area agency on aging here to be able to provide these services. So we're able to serve everybody, regardless of what their socioeconomic background is. There are. There is funding available for them to come into our program, which I think is really great that we can bring in people from so many diverse backgrounds into our program and important.
[00:24:22] Speaker A: So that's wonderful.
[00:24:24] Speaker B: Yeah. And I think what makes us really unique is, like I said earlier, we notice the need to be more specialized and working with individuals that have experienced dementia. And so we actually have. All of our staff members are certified dementia practitioners through the National Council of Certified Dementia practitioners, because my staff actually, when I came on board, said, you know, we're noticing more of these challenging behaviors and issues associated with people with dementia, and we want to be able to support them better. How do we do that? So we actually looked to see what programs might be available for training, and through that process, we came across the certified dementia practitioner designation. And last December, all of the staff received that certification, which is great. Yeah. Because it really shows their dedication to work with this population and provide the best services and level of care and understanding, and it really shines through, which is great, because we hear that back from a lot of the families. Right. The care partners. And, you know, when we first walked in, you could feel the energy of the place, and it was really great and bright. And your staff are so good with them, and we try to problem solve with them, and so they feel that support as well, which I think is key. You know, it should be. We are focused on the wraparound services, so, you know, we have a full time registered nurse to oversee their clinical needs. We have a one to five caregiver ratio to our members, so we can make sure they get best quality services. We have a full time social worker, so she's not only here to kind of assess the needs of the members, but she works with those care partners and providing them resources. And she runs our support group for the caregivers as well. So we do offer a caregiver support group.
[00:26:18] Speaker A: Your program is incredible. I mean, truly, this is a gift you are giving people.
[00:26:24] Speaker B: Yeah. And, you know, we also try to just make sure that we're touched. We're creating dynamic experiences. Right. Because that's at the heart of it for the member. You know, we want dynamic experiences. We want them to feel enriched, and we want them to feel welcomed and having fun, because that's really what it is. At the end of the day, you know, they may not be able to tell you, oh, yeah, I did this really awesome art project, or, you know, tell you that they had a vibraphone player come in and play music from the 1940s or that the Phoenix Art museum docents came in and did a presentation on the impressionist era, but they can tell you they had fun. And so that's kind of where a lot of this is, too, is understanding that there's. They're getting something from this program. And I think that's what makes us unique is that we also try to challenge. Right. Like, what the expectation is of an adult day program. You know, a lot of people, if they. You tell them an adult day program or adult day care, they're like, oh, just bingo. Right. And it's so much more than just.
[00:27:27] Speaker A: So much more bingo.
[00:27:28] Speaker B: So much more. There's so much enrichment. And what's really great is that since it is specialized on creating activities, we get feedback from the members and their family, and so what are they interested in? And we incorporate it into our program. We have, like, a needlepoint group. You should see these women, like, they crochet, they knit, they do these amazing things. And two of them had never done it before, and now they're making, like, bags and baskets. And so that's a great way to make it person centered. Right. Because that's also what you want to look at. And I think that's what we're really good at doing here at desert Mission is really being that person centered and creative, creating that dynamic experience for the members when they come in, and then also providing those wrap around services to their care partners, because we know it's a relationship. Right. That's why I like to call them care partners, because it is a partnership of care, not just for the individual, but also for the person that may be providing it to them. So we also want to support them and help them, too. So that's where a lot of day programs are great. But I think what makes us really unique is we are on that more specialized side of focusing on people with dementia and that we are trying to push the envelope. Right. And try new things with people that are experiencing dementia or maybe have, you know, a physical health condition that they may see as limiting, but we're challenging them and being like, it's not as limiting as you think it is.
[00:28:53] Speaker A: They'll do it in their own time and way.
[00:28:55] Speaker B: Yep. Maybe a little more encouragement. But I can tell you I was very surprised we tried axe throwing with our members.
Not, like the sharp, like, metal ones.
[00:29:06] Speaker A: Yeah. Yeah.
[00:29:06] Speaker B: You know, the actual Costco, I think, is selling them right now, the plastic ones, and, oh, my gosh, they were so competitive, and they were all really good at it and to the point where they're like, when can we do that again?
[00:29:18] Speaker A: Oh, my gosh. I love hearing all this. It's remarkable what you're doing. And I know there are others around the country and in Arizona, just thank you, Leslie. Thank you for the work you're putting in. It really makes a difference, like you, like you said. And, you know, I agree, not only for the person, but for the career member or caretaker as well.
[00:29:36] Speaker B: Yeah.
[00:29:37] Speaker A: Anything before we wrap up that we may have forgotten to touch on.
[00:29:41] Speaker B: Yeah. Something also to look at. And I know we do it here at Desert mission adult day healthcare and other adult day programs may offer it, too. But when looking as well, look for a program that maybe has an intergenerational program, we are lucky. Here at Desert mission adult day health, we actually have a five star accredited childcare center right next door, the Lincoln Learning center. And we actually have a weekly intergenerational program. And that's where, really, you get to see a lot of the older adults come out of their shell and really connect with our little friends, as we like to call them. So that's always a great program to look at and another piece of what kind of makes us unique as well and just adds that extra layer of interaction for our members.
[00:30:25] Speaker A: I might come down and watch that. I love that concept. That's amazing.
[00:30:30] Speaker B: Yep. And, you know, if you're in town, feel free to stop by. Like I said, the best way to check out a place is just randomly stop in.
[00:30:38] Speaker A: So that's amazing. Well, truly, truly, thank you for bringing light to this subject. I really, obviously, as everyone has been listening, knows, I am a true believer. You. You really believe in it and are just an advocate for it as well. So thank you. And anywhere that people can find you.
[00:30:56] Speaker B: So you can actually learn about us at the desertmission.com website where you can learn about the adult day services program that we have there. And like I said, you know, our address is listed there and if you're ever interested, you just want to stop on in and kind of see what we're about and learn a little bit more about us. We're always pleased to have somebody just pop on in and see what amazing things are going on here for our members.
[00:31:22] Speaker A: Amazing. Well, thank you again, Leslie, and thank you for sharing your time, talents, and treasures with us.
[00:31:28] Speaker B: Thank you so much, Meena.
[00:31:34] Speaker C: Well, that's it for the team this week, and thanks for joining us. If you've enjoyed the content, remember to subscribe and share this episode on the app that you're using right now. Your reviews and your comments, they really help us expand our reach as well as our perspectives. So if you have time, also drop a us a note. Let us know how we're doing for tips and tools to clarify your parent project, simplify communication with your stakeholders, and verify the professionals that you choose. You can find us on YouTube, follow us on Instagram and Facebook. Thanks again for trusting us until our next episode. Behold and be home.
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