Although dementia has probably been around since humans first appeared on earth, it is only as we live longer that we have begun to see its widespread occurrence in older adults. The most common type of dementia is Alzheimer’s disease, but there are other types and causes of dementia. In fact, new research is suggesting that “pure” pathologies may be rare and most people likely have a mix of more than one type of dementia.
Worldwide more than 50 million people live with dementia and because people are living longer this number is expected to triple by 2050 (ADI, 2019). In Florida, there are more than 500,000 residents currently living with Alzheimer’s disease and by 2025, this number is expected to increase by more than 200,000.
For those of you working in adult daycare, it is very likely you will have contact with clients experiencing cognitive changes. Many will also have chronic conditions and recent hospitalizations. A major goal of adult daycare is to reduce the risk of hospitalizations and readmissions and manage chronic conditions among their participants (Caffrey and Lendon, 2019). Before getting into how the brain works and how it is affected by dementia, let’s learn a little about adult daycare.
There are approximately 4,600 adult day service centers in the United States serving nearly 286,000 people (Caffrey and Lenden, 2019). Adult day service centers provide non-residential coordinated services in a community setting for less than a day. There are three types:
- Medical/health, and
- Specialized (providing programs for people with dementia) (Siegler et al., 2015)
Adult daycare is a program of therapeutic social and health services as well as activities for adults who have functional impairments. Services are provided in a protective, non-institutional environment. Participants may utilize a variety of services offered during any part of a day, but for less than a 24-hour period.
The social model is designed for individuals who need supervision and activities but not extensive personal care and medical monitoring. The medical model provides more extensive personal care, medical monitoring, and rehabilitative services in addition to structured and stimulating activities.
O’Keefe et al., 2014
In Florida, there are approximately 351 adult daycare centers that provide therapeutic programs, social services, health services, and activities for adults in a non-institutional setting (AHCA, 2020). About one-third of adult daycare clients have Alzheimer’s disease or a related disorder (Harris-Kojetin et al., 2016).
In Florida, there are approximately 15 specialized adult daycare centers, which are specifically designated to treat clients with Alzheimer’s Disease and other types of dementia. The specialized centers enroll a higher percentage of clients with dementia than do regular adult day centers and require specialized dementia training for their staff. A specialty license is also required to provide services as a Specialized Alzheimer’s Services Adult Daycare Center (O’Keefe, 2014).
In general, adult daycare clients are younger and more racially and ethnically diverse than users of other long-term care services. More than one-third of adult daycare clients are non-white, about 17% are non-Hispanic black, and about 20% are Hispanic (Harris-Kojetin et al., 2016).
Most (about 2/3) of adult daycare participants attend at least 3 days/week (Siegler et al., 2015) and most clients use transport services provided by the centers.
This course is for those of you who have direct contact with clients in a specialized adult daycare center. It discusses Alzheimer’s disease and other common types of dementia from the perspective of both workers and clients. It includes information on how dementia affects the brain and how Alzheimer’s disease differs from other types of dementia. It describes behaviors you will see in people with mild, moderate, and severe dementia and discusses communication issues at different stages of dementia.
The course includes with activities you can do with your daycare clients and provides information on how to assist with their activities of daily living. We also include information about family issues, caregiver stress, and share some innovative ideas about “therapeutic environments.” We conclude with a discussion of ethical issues you may encounter.