Along the dementia journey, you might start to think about adult day programs (ADPs) for your loved one with dementia. This might be a difficult decision to make and many individuals think of ADPs in a negative light, as you might not think your loved one belongs in an ADP or might not understand why they are attending. On the blog, we discuss the pros and cons for seeking ADPs and how we can help eliminate the stigma associated with ADPs.
Not sure of what an ADP involves?
ADPs offer a partial or full day of programming that takes place in the community for adults who might have a disability, condition, or illness and require a safe environment with care staff available to help support them if needed. ADPs can be specific to persons living with dementia, but do not have to be. That being said, 47% of individuals who attend ADPs are individuals with dementia1. Care that is typically offered in ADPs include assisting with activities of daily living, any medical needs, such as reminders to take medications, and meals are often provided for participants2. Participants often engage in discussions, cognitive, social, and physical activities, form relationships, and are in a safe environment. Some ADPs also offer support groups for care partners who are interested in gaining support from other community members who might be experiencing a similar situation.
Let's start with the positives of ADPs and how they can assist you and your loved one along the dementia journey.
1. Do you find that your loved one with dementia is no longer participating in social activities?
Many individuals with dementia experience a loss of friends after their dementia diagnosis as people don't always know how to react to dementia and stigma still exists. This results in feelings of isolation and loneliness. Persons diagnosed with dementia should be engaging in both social and physical activities as they have many benefits for them, such as improved mood, a reduction in cognitive decline, improved communication skills, and helps persons with dementia to gain confidence and feel a sense of belonging and accomplishment. ADPs provide both social and physical activities in their programming, which is important for persons living with dementia based on the aforementioned benefits. While individuals are diagnosed with dementia, this does not mean their preferences change, they are still themselves and should still seek out opportunities to remain engaged in their communities, whether that be through an ADP or not.
2. Are you feeling burnt out and in need of a break?
Care partners often enroll their loved one with dementia in an ADP to take some time for themselves and have a break. ADPs typically run during the day, with programming starting around 9:30 and ending around 4:30. This provides care partners with the day to relax, run errands, do house chores, visit with friends, or engage in their own recreational activities. ADPs are a great opportunity for care partners to have a respite period and can be beneficial for the relationship as the person with dementia and care partner get a break from one another.
3. Is your loved one with dementia not sleeping as well or maybe napping too much during the day?
Maybe they are missing that cognitive stimulation of being in a routine, engaging with others, and participating in recreational activities. Physical activity and socializing are cognitively stimulating activities that help to improve sleeping. Individuals who attend ADPs typically have a routine, waking up, getting ready for the program, attending the program, and coming home in the later afternoon. This helps individuals get into a routine which might also help their sleeping routine. Sleep is important, but napping too much during the day might be due to a lack of cognitively stimulating activities and boredom. While napping is beneficial, sleeping for most of the day might affect their nightly sleep schedule. Engaging in an ADP will help them maintain a routine, be cognitively stimulated during the day resulting in feelings of tiredness, and reduce the time spent napping during the day.
4. My loved one with dementia is in the early stages of their journey and it might not be the best fit.
ADPs are often offered for individuals along any stage of their journey. Finding the right match for you and your loved one with dementia is essential. If you're interested in enrolling your loved one, visit some ADPs in your community and see what stage individuals are at and if your loved one would feel comfortable in the space. Speaking with your local Alzheimer Society will allow you to get to know each ADP in your community and gain insight on which one might be best for you and your loved one. Speaking with friends or neighbours who are also on their dementia journey will also help you gain insight on ADPs. If your loved one knows someone who already attends an ADP, this sense of familiarity will make them feel more comfortable attending.
5. Losing relationships and seeking a connection to the community?
ADPs are a great place to meet community members in a similar situation as you and your loved one. ADPs are a great opportunity for your loved one with dementia to engage with others who are similar to them and connect over their diagnosis. They can gain friends and support along their dementia journey. For care partners, you can connect with one another and remain integrated in your community with others who are in a similar situation.
6. Needing support as a care partner?
ADPs that offer support groups can help with this. Many ADPs offer separate support group sessions either during the time your loved one is at the program or after the ADP. This is a great opportunity to meet new people who are also along the dementia journey and gain support from others. It's important to talk to other people as a care partner and gain support from those around you.
7. ADPs help to track the dementia journey
Noticing any changes in your loved one with dementia? ADPs can help to track these changes while your loved one attends the program. There are many support staff who are directly interacting with persons with dementia and can make notes of any changes they might see. If you, as a care partner, might notice some changes you can always talk to staff members at the ADP and they can direct you to more resources and next steps.
Next, we'll take a look at some of the challenges to ADPs and why they might not be the right fit for you and your loved one with dementia.
1. Waitlists
Many ADPs have waitlists and this might take a while for your loved one to be accepted as a participant. While this can be a drawback, it is important if you might be interested in an ADP in the future to put your names on the list. Whether or not you are ready for it when they do call, this way this gives you the opportunity to say yes or no when the time comes.
2. Referral
Some ADPs require a referral in order to attend. Contact your local LHIN or doctor on how to receive a referral and the process involved.
3. Cost
Many ADPs cost money to attend. While looking, take this into consideration and determine whether or not you can afford ADPs or not. Reach out to resources in your community if seeking other alternatives.
4. Lack of Understanding from your Loved One
Your loved one with dementia might not understand why they're attending an ADP. Treat an ADP as a positive experience and inform them of why they're going to avoid frustrations and confusion. Other participants might have more advanced dementia than your loved one, and prior to enrolling your loved one with dementia, it is important to have an open and honest conversation with them and make sure they are comfortable attending a new place. Many ADPs ease you into their spaces with trial runs to ensure this is the best fit for them.
5. Location
Ensure the location of the ADP is the right fit for you and your loved one. This is something to consider if you have to be responsible for picking and dropping them off or if you would like to stay close in case anything might happen.
We hope this discussion helps you make the right choice for you and your loved one with dementia. It is important to talk about it with your loved one, family, and friends to ensure ADPs are right for you.
References
1. Anderson KA, Dabelko-Schoeny H, Johnson TD. The state of adult day services: findings and implications from the Metlife national study of adult day services. J Appl Gerontol. 2013;32(6):729Y748.
2. Fields NL, Anderson KA, Dabelko-Schoeny H. The effectiveness of adult day services for older adults: a review of the literature from 2000 to 2011. J Appl Gerontol. 2014;33(2):130Y163.
Thanks for the kind words Diana. It’s a difficult choice to make, but the most important thing is that everyone’s physical and mental health is kept at the forefront. We work with a lot of ADPs where persons with dementia thrive while their care partners can also receive respite at the same time. I hope he enjoys it and feels welcomed and comfortable! Maintaining that sense of connection to the community provides people with a sense of confidence and accomplishment. Best of luck on your journey!
This was a beautiful article. Thank you for writing. I am attempting to place my husband in an ADP for the first time tomorrow for 1 day a week and even though its a lovely place and the people there are so nice I’m completely stressed and overwhelmed over this next step and how it will be preceived by him. However this article gave me a sense of relief and affirmed I am making the right decision in what may be difficult for me initially emotionally but better for my husband’s mental, physical and emotional health.