Day program gets elderly patients out of the house

Center is part of continuum of care

An adult day care program at West Georgia Health Center in La Grange, GA, fills a need for a community in which 13.7% of the population is elderly. The day program is part of the health system’s senior continuum of care, designed to serve the older adults, says Mary Lynn Faress, RN, vice president of the health system.

The program is open to adults who require supervision, increased social opportunities, or assistance with activities of daily living because they are physically impaired or mentally confused. It opened a year ago when staff at the health center realized that a number of elderly patients were not getting the care they needed during the day, Faress says. These senior citizens were unable to stay at home alone but didn’t fit the criteria for long-term care.

Florence Hand Home, the health system’s 150-bed skilled nursing unit, was getting calls from concerned family members looking for day treatment programs or respite care for their elderly relatives. "We have an increasing number of elderly people in our community and saw a need for additional services. We had space at Florence Hand Home and had an activity staff in place," she says.

Staffed for eight patients, the program opened with just one, who came in for treatment one day a week; it now serves about five patients a day. Candidates for the day care program must be ambulatory, although they can use a walker or wheelchair, and must be able to follow simple commands.

Day care patients are involved in some of the same activities, such as recreational therapy, as long-term care residents. (See schedule, below.) Patients may receive physical therapy from a therapist who is assigned to the skilled nursing facility. "The program is more activity-based than health care-based. It’s for someone who otherwise would be at home with little activity or social contact," Faress says.

Typical Participant Schedule

6:30 a.m. Sign in
7:00 a.m. Early arrivals: coffee; soft music
7:30 a.m. Arrivals: reality orientation/validation theory as needed; current events discussion
8:00 a.m. Morning exercises; health screening
8:30 a.m. Morning snack; rest room break; morning stretch
9:30 a.m. Individual games/small-group activities
10:30 a.m. Arts and crafts; game shows
11:00 a.m. Free time
11:30 a.m. Prepare for lunch and eat
12:30 p.m. Rest
1:30 p.m. Afternoon exercise; water/juice; restroom break; individual/small- group activities/games
2:00 p.m. Walk outdoors; pet therapy; speakers; guests such as visiting school groups
3:00 p.m. Afternoon snack; rest room break
3:30 p.m. Individual activities, video
4:30 p.m. Early departures; individual activities
5-5:30 p.m. Departure

The center is open from 6:45 a.m. to 5 p.m. five days a week. Patients check in at the business office of the skilled nursing facility and go to the day treatment room, where they are supervised by a certified nursing assistant, with help from the activity staff of the skilled nursing facility.

Payment ranges from $30 to $42 a day, depending on the level of care the clients need. The hospital charges less for patients who need minimal assistance, such as reminders to use the bathroom or help with cutting their food at lunch. So far, all clients have been private-pay. The center also accepts occasional drop-ins for $45 a day. Like many child care centers, it charges a late fee for participants not picked up by closing time.

Before setting up the program, staff from West Georgia Health System visited other adult day care centers and used some of their ideas. Faress sent marketing letters to local churches and physicians.

The center already has gotten results with some patients. "We have really seen a difference in the way these individuals are able to socialize with other residents and with the long-term care population," Faress says.

One elderly man with depression did little but sit at home and cry before he started coming to the center. Now he’s involved in activities and is animated, she adds.