Adult day care helps keep senior citizens active

Harford seniors keep active, interested at adult day care

Ninety-something-year-old Bill Herr typically needs two people to help him walk – with a walker, but he was cutting up a rug last week during Zumba class – a seated Zumba class – dancing across the room.

Theresa DiVenti and Charles Fox sat next to each other kicking their feet and raising their arms, following the lead of their Zumba instructor.

Earlier, across the room and during lunch, Dennis Forman and Peg Burgard were bantering back and forth about what each likes to do.

"She likes flirting with the boys," Forman said about Burgard.

"I don't have to flirt, they flirt with me," Burgard responded.

It was a typical day at the Family and Children's Services Medical Adult Day Care on the Harford Community College campus, where clients were participating in their first Zumba lesson.

As he danced with nursing assistant Christine Story, Herr's smile lit up the room. A nurse was nearby, just in case Herr got a little wobbly, but he had no trouble whirling Story around. It wasn't until the song ended that Herr finally took his seat. And he was pleased as punch.

"That was so great," Tracey Meise, a registered nurse and medical program manager at the adult day care, said. "It just warms my heart. This is what I am here for. It makes all the difference in the world to him, and us. It's why we want to grow and be vibrant."

While it sounds like a government program, the Medical Adult Day Care is part of the non-profit organization Family and Children's Services, which provides assistance to family, children and elders in the Baltimore area. The organization has been at HCC for three decades.

The Medical Adult Day Care gives older residents, most of whom live with family or caregivers, a place to go to participate in activities and continue with their lives.

"The program really supports the notion of aging in place, older adults who don't want to be institutionalized, don't want nursing homes or assisted living. They want to remain in their homes. They do have options as older adults, they don't have to grow older and go into a nursing home," Director of Elder Services Katie Cashman said. "We're here as much for the caregiver as the clients. It's respite care for the caregivers, so they're able to go to work, get a break, run errands. They have to have a break, have time for yourself. If not, you're not a huge help to that person."

The facility at HCC opened 30 years ago with 10 to 12 clients a day. Today the average is 24 clients a day, though it has a capacity of 45. The center is open five days a week, but not all clients attend beyond the minimum two days.

Most people in Harford County don't know about Medical Adult Day Care, unless they're referred by a community partner, but Family and Children's Services is trying to change that.

"Our goal is to increase our capacity to serve as many folks as possible that need us," Cashman said.

Adult day care clients

Traditionally, clients at Medical Adult Day Care can no longer attend typical senior centers because they need more help with activities of daily living, whether it be walking, using the restroom, eating, taking medicine or other such necessities.

The majority – 67 percent – are low-income, earning $15,000 or less a year, Cashman said. The program costs $85 a day, and clients are required to attend at least two days a week, but most clients can't pay the full price, so Family and Children's Services tries to find ways to subsidize the cost.

A state grant of $12,000 a year "doesn't go very far," Cashman said, and it provides a subsidy to the lowest-income clients. Two years ago, 32 clients were getting help with their tuition, but that number has dropped to four.

The program's subsidies have gone from about 3,000 days a year to about 400, she said.

To be able to continue providing those subsidies for its clients, Family and Children's Services has kicked off its 1,000-day Campaign, an effort to raise $75,000 so that no client will be turned away.

Family and Children's Services is also reaching out to help local veterans with an open house at the day care center and through the Harford County Comrade Project.

Thirty percent of the Medical Adult Day Care's clients are veterans, most of whom can't get help through the Veterans Administration because the waiting list is so long, Cashman said. They wait six to seven months for services.

Medical Adult Day Care provides an alternative to the VA, and is hosting an open house Nov. 17 from 10 a.m. to 1 p.m. to give veterans the chance to see what opportunities there are.

Veterans with VA benefits can attend the Medical Adult Day Care two days a week; the Harford County Comrade Project is a scholarship that would allow veterans to extend the number of days they attend.

"The whole objective is to support older adults living in Harford County. But we can't do it alone, we have to have local support," Cashman said. "If it's not monetary, it's understanding the service we're providing, increasing visibility and awareness so people know we're here."

To contribute to the Harford County Comrade Project or to the 1,000 Day Campaign, donations, specified for Harford County Adult Day Care, can be sent to Chris Merriken, Family and Children's Services, Development Office, 4623 Falls Road, Baltimore, MD 21209.

Medical oversight

On staff at Medical Adult Day Care are two registered nurses, one full-time and one part-time, as well as two certified nursing assistants.

On a daily basis, they can provide diabetic management (finger sticks, insulin), pain management, tube feedings, physical therapy, diet modifications and flu shots, according to Tracey Meise, the medical program manager at Medical Adult Day Care.

Long-term, the nurses coordinate with their clients' primary care providers to go over possible changes in the clients' conditions or diagnoses, any illnesses or hospitalizations or changes in medications. They also coordinate with psychiatrists to do care planning with the clients' families.

"Some really rely on the nurses here. They don't get it at home," Meise said. "We facilitate issues with the client the caregiver might not necessarily pick up on."

The average age of the Medical Adult Day Care's clients is in the mid-70s, with some as young as 50 and others as old as 98.

"They're here as long as they need to be. Most stay here until they need assisted living," program coordinator Danielle Schocket said. "Some stay here until the end of their lives, some until we can't provide care for them."

Many are senior center drop-outs – they will want to do things and be active, but they need supervision for their safety.

Structured program

The days at Medical Adult Day Care are structured, which helps senior citizens, like children, thrive. They'll alternate between mentally and physically stimulating activities to keep their minds and their bodies sharp, Schocket said.

They'll play trivia, reminisce and discuss current events and how they relate to today. Activities include visits with Pets on Wheels and entertainers, including local musicians (like Schocket's father, Dennis Schocket, who has played locally for years) who play songs from years ago.

"We're taking them back to when they were younger and we see their personalities shine," Danielle Schocket said. "The older population – everyone has an interesting story to tell and we let them share."

The hardest part of her job is trying to find activities for all the clients, whose abilities vary.

"Some are really, really with it, you wouldn't know they have dementia or Alzheimer's, and some who can't really speak to me," Schocket said. "I try to find something they all can participate in one way or another. I try to find a balance."

Danielle Schocket has been at Medical Adult Day Care for about 18 months.

"I love that I am able to help them stay independent, letting them stay with their families, but still being able to interact with the community," Schocket said.

What they like

Diventi, who loves to dance, thoroughly enjoyed the Zumba class last week, and hopes it comes back.

"I like the Zumba. I like anything that keeps me moving. When I don't move, that's bad," DiVenti said. "I used to go dancing all the time. Us girls used to go dance with the servicemen. It was nice to entertain during time of war."

DiVenti, who said she attends Medical Adult Day Care four days a week, lives with her daughter and son-in-law. She has her own room, and when she wants something to eat, "I go down and raid the refrigerator."

She enjoys attending the adult day care "because we do things. I like to do stuff. I love meeting people, I don't like to be lonely."

Fox likes to go on the field trips.

His favorite thing to do?

"Eat," he said. "At least I'm honest about it."

Patty Muirhead is new to the program. She's been attending five days a week for the last five weeks.

"It's better than sitting at home," Muirhead said.

She's been enjoying meeting all the different people.

"I find it interesting. Most of the people they bring in here have something to offer," Muirhead said.

During last week's Zumba session, she was more animated than she'd been in the previous weeks, staff said.

"She's still adjusting. It really helps in getting to know people," Meise, the medical program manager, said. "It's great to see their adjustment."

Eria Crawford likes to keep herself moving, too.

"I'll be wore out when I come home," she joked. "Whatever they like to do, I join in with them."

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