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Informed Aging
A podcast about health, help, and hard decisions for older adults.
Informed Aging
Episode 92: Adult Day Care Questions and Answers
Jose Santana of the Easterseals Day Break at the Miller Center (Winter Park, FL) helps us understand another option for care, what to expect, and how to shop for it.
Easterseals Day Break at the Miller Center - Winter Park
Phone: (407) 629-4565
[00:00:00] Welcome to Informed Aging, a podcast about health help. And hard decisions for older adults. I'm Robin Rountree a former family caregiver. I've worked in the home care industry and now work for the Alzheimer's and Dementia Resource Center. The thoughts and opinions expressed on this podcast belong to me and my guests, not our wonderful employers and sponsors.
Before making any significant changes in your life or your person's life, please consult your own experts. Today we're gonna talk about. Adult daycare or adult centers. Who's it for? What's it all about and how to shop for it? We'll be back right after this. [00:01:00]
Robin Rountree: Today we are talking adult daycare. What is that we're gonna find out with us is Jose Santana. [00:02:00] He's the center director of Daybreak, which is a local, local to Florida in the Winter Park area.
It is an adult daycare center. So let's first of all answer that question. What is adult daycare?
Jose Santana: Well, adult daycare, I mean it's in the name, it's care during the day. We tell our families it's kind of a day respite for the families who are caregivers. They can drop off their loved ones. at the center and
while they're doing their errands or working, the loved ones can do activities throughout the day.
Robin Rountree: And it's such a nice alternative because home care that we've talked about on this podcast, he's not cheap. Um, right now in central Florida, I'm hearing about 34, 35 dollars an hour. And so it is a less expensive alternative to home care?
Jose Santana: Yes, that is correct. Adult daycares can range from anywhere to low of 65 to about a high of, I would say 80.
Robin Rountree: Per day?
Jose Santana: per day. That is correct. Uh, usually the hours are operation are seven 30 to about 5:00 [00:03:00] PM So Nice. You know, a good 10 hours of a.
care that you can get and receive for that price.
Robin Rountree: That's great. Is there any way to get that covered? Do any insurance plans pay for that?
Jose Santana: Yes, actually, Florida Medicaid does cover that and also, uh, the VA does have some contracts that can cover day services as well.
And there are some other programs that are actually starting to cover more. Um, even Medicare. They're doing a new guide program with, uh, certified doctors and providers that are covering some respite care for caregivers.
Robin Rountree: That's amazing. That's amazing. Now, how did you get into this field?
Jose Santana: Me, personally?
Robin Rountree: Yeah.
Jose Santana: I, I kind of just stumbled into it. I was, uh, asked if I knew how to work a VCR and like old people and, they gave me an opportunity to work kind of a summer job. And that summer job became, oh, 16 years of working with Easterseals. So
Robin Rountree: yeah, no more VCRs.
Jose Santana: No more VCRs.
Robin Rountree: That's great. So. I'm sure the biggest challenge is convincing an adult an, an older adult to go [00:04:00] to quote unquote daycare, because we think of that for three and four and five year olds.
Right. Um, we haven't come up with a better name for it yet. I'm sure you're working on that all the time. But what have some families done to convince their person to, to give it a try?
Jose Santana: We always call it like the center or day program. Um, you know, daycare, it does, it can seem more childish, but a day, program, day center, we don't recommend saying work.
Okay? Some people use volunteer. Um, but any type of like day, um, related to like a day program thing does seem to work.
And it's also trial and error. Sometimes it's a different environment for people that's new. So we can always, you know, blame the doctor. Hey, the doctor said let's try this.
Robin Rountree: Okay.
Alright. That's nice. And then maybe for the more financially minded people, you know, you don't wanna go into quote unquote, the home or assisted living. Um, this is the cost of the home care. Maybe seeing those numbers would [00:05:00] help as well.
Jose Santana: Yes, that is true. Um, we always tell families, you know, it is the best option that you can do for your money as well.
And I think some people who are maybe a little more independent can you know yes, that's a better cost for the family. Let's try this and let's see how it goes.
Robin Rountree: So what sort of older adults are coming in now? It's obviously not gonna be someone who's truly independent, can go drive, can go to bingo, can go to their own activities.
So what are the conditions and that sort of thing that's bringing a person to a day center.
Jose Santana: So most of the time it's gonna be some type of memory impairment where they cannot be left at home alone. Um, so they can be in a safe environment.
So some of the centers do have, uh, serve adults like 18 and up
Robin Rountree: Oh. With
Jose Santana: different disabilities. Um, but most of the population is gonna be elderly with some form of dementia or memory impairment.
Robin Rountree: Okay. See, that's me. I live in the world of, of older adults, but yes, some adults 18 and up do need some extra help.
So that's wonderful. And everybody gets along, no matter the disability [00:06:00]
Jose Santana: To be honest. Yeah. It just becomes a place that they can come in and make friends and socialize As humans, we tend to be social beings from going to daycare when we're younger to school, to work, to retirement. And then, you know, we have day programs after.
Robin Rountree: Okay. I love that. So when do you know that it's time to look at a, adult daycare or a day center for the person you're caring for?
Jose Santana: I would say the best, my best opinion for it is when you're starting to notice some signs of memory loss. Doesn't mean Oh, they have dementia or
issues, but I do recommend trying to have some type of group activity.
For them, whether it's a senior center or church setting. Um, and then when you start seeing more memory issues, then okay, let's talk to a doctor and see. And most doctors are starting to know more about adult daycare.
Robin Rountree: That's wonderful, 'cause it's a nice alternative that's out there. So some families do, they come after the crisis, like they found out
mom has left, uh, the oven on for a long time.
Jose Santana: Most of the time, yes, it's one of those things that something happened at home. [00:07:00] Um, we do want to be enough time to plan for it. 'cause sometimes when you get into that crisis, sometimes it can be too late or you're, uh, scrumming for the last minute and you know, okay, we got a place, which is not always the answer for that.
There are options out there like adult daycare care.
Robin Rountree: And I'm sure that's, uh, if it's the adult child that's taking care of them, they're like, I still have to work. I still have these commitments. So it is a way to have the parent enjoy their day, right? I mean, you're not just sitting them down in front of a screen.
What kind of things are you doing during the day?
Jose Santana: Yeah, definitely. I'm going back to the adult caregiver. There's that sandwich generation where they're taking care of their kids and their adult and their adult parents. But yeah, so when they're coming, it's pretty much group based activities. Um, exercise.
Mm. We do certain, we do do bingo, but like, low impact activities. Um, we have musical guests that come to visit
Robin Rountree: Musical guests. Yeah,
Jose Santana: Like, Warner Park Playhouse does a quartet for us. A performer out of Maitland also comes, so we have different things that would, [00:08:00] they wouldn't be able to get at home.
. And then also just activities such as, like visual arts, drum circles, singalongs. Nice. Any type of group activity, really any movement, whether it's with the body or mind, is better than no movement. Yeah. Um, we have one TV in our place. It's really never turned on unless it's like an educational program.
Robin Rountree: That's fantastic. Are you in charge of coming up with all of those ideas?
Jose Santana: No, I have an activities team. I, I used to, but I do have an activities team and it does become a challenge 'cause you're taking 30 people with different mindsets and different backgrounds into one room to create, to try to create an activity that they can all enjoy.
So you have to kind of modify it for everybody to, to join in.
Robin Rountree: Right, right. So, and I'm glad you're still doing bingo 'cause I play from time to time. It does keep your brain sharp. 'cause you gotta look fast.
Jose Santana: Yes. That So even something as simple as bingle, I mean there's benefits to, to every activity.
Whether it's the fine motor skills of picking up the bingle chip, the socialization of talking about when you were a kid doing it, or growing up as a family doing it. There's a lot going on in that process of [00:09:00] bingo. So every activity we do does have some type of benefit from it, and I always tell people, even something simple as just picking up a crayon or a pencil or a piece of paper, those are fine motor skills we can lose.
Yeah. So the fact that they're doing it to me, that's a benefit.
Robin Rountree: Yeah. Anything is better than sitting and watching TV if you're not engaging with it. So. Full credit to all the activities directors out there. 'cause that's not an easy job.
Jose Santana: Yes, that is true. And they had to be very creative and and modify for everybody can join in.
It is difficult. Yeah. But it's a fun and very rewarding, uh, occupation.
Robin Rountree: Wonderful. So could somebody start, um, 'cause I, I'm thinking a lot of people are going, oh, I wish my person would do this, but they think, oh, oh, six hours a day can. Could a person start off with just a few hours?
Jose Santana: Yes, we actually recommend that.
So it can be a kind of adjustment period, like, uh, three to four hours. When anyone starts with our program, that's kind of our rule. We don't want the person to feel like they just dropped off into a place, different [00:10:00] environment, a lot of new faces. It can be very overwhelming. We even have people who seemed very independent. Oh, they never had an accident. And the first day they're there, they have an accident. 'cause they're so confused.
Robin Rountree: Oh, there's too
Jose Santana: many people. So we tell families it's an adjustment in the trial period. We'll love adult daycare to be the answer for everybody. And hopefully it is.
But you have to kind of slowly adjust to it. You can't just drop someone in for 10 hours and expect them to be fine.
Robin Rountree: Right, right.
Jose Santana: Even if they did go to another group program, it's, it's a process. You're learning the staff, you're learning the other members, the volunteers. The activities, it's different.
Robin Rountree: Okay. So start off in small steps, try a few hours, see how it goes, and then work up from there is your advice.
Jose Santana: That is my, my advice. Correct. And that's what we work with the families to do.
Robin Rountree: Yeah. And that's where planning ahead is so important instead of waiting for the crisis, easy to say that piece of advice.
Hard to follow it.
Jose Santana: Yes, that is true. It's definitely plan ahead. Um, I recommend just even as an option, a backup, um, to, to have that.
Robin Rountree: Yeah. Because no matter how much [00:11:00] planning goes into things, things happen and does there come a time where a person living with dementia is no longer a good fit for adult daycare?
Jose Santana: At least in our facility, um, when they become very aggressive, we be aggressive behaviors. 'cause we need to think about the safety
Robin Rountree: Yeah. Of the
Jose Santana: other members. And for our location, uh, if they become incontinent bowel movement. Okay. Because we we're, we have a ratio of six to one, uh, which is a state reg.
Right. And if they require two or more people to help than that takes us out of ratio, which becomes a danger to other people in the program. So like I said earlier, we are group based, so keeping in that ratio is very important as well for us.
Robin Rountree: Right? So, uh, urinary incontinence you can probably handle as long as it's not super frequent.
Jose Santana: Correct. Yeah. As long as it's not an issue where, you know, they have their, their wetting through everything,
Robin Rountree: right?
Jose Santana: But we understand this, it's part of the process and Right, even with the bowel movement, if, if it happens once or twice, it's okay, maybe it's medication,
Maybe it's food. Maybe they didn't sleep well, maybe they ate something [00:12:00] wrong.
So we work with each member just to make sure to see what's going on. But if it becomes an issue, then we have to see for, you know, for everyone else that's in the room as well.
Robin Rountree: Okay. So if you're shopping around and you don't live near Winter Park, Florida, how would you start to look for somebody in your area?
Like, let's go to Google. What would you type in? Um,
Jose Santana: you can always search Adult Day Center. Um, the correct name's, adult Day Healthcare. Okay. By any type of day center. They, I believe they do have like regular adult daycares that maybe don't have a nurse on staff.
Robin Rountree: Okay.
Jose Santana: But they do day services for people and.
Can, uh, provide respite for families as well.
Robin Rountree: Okay. Now you have health people on staff?
Jose Santana: Yes. So I have a full-time nurse Wow. On staff. And I have, uh, a medical, two, two medical assistants and a , certified nursing assistant. And then we have an, uh, activities team with two people in it.
Robin Rountree: That's amazing.
Jose Santana: Yeah. I mean, it does help. Yeah. And most of our, most of my staff have personal experience too with dementia or [00:13:00] caregiving, a family member.
Robin Rountree: Oh, that's, that's excellent. So let's say a person is not only living with dementia, but possibly diabetic, maybe on insulin, that adds another layer. So you would definitely need medical people on staff if they had to administer insulin,
Jose Santana: correct?
Yes. It's. Def. Yeah. That's why our nurses there and our, our medical professionals are there.
Robin Rountree: And if they have a medication that like they take every day at noon and they're gonna be there, can you handle that?
Jose Santana: Yes, that is correct. They'll go onto a medical sheet and that's actually one of the, part of the audits that we get, is if we're dispensing it correctly,
Robin Rountree: I.
Okay. Alright. So you have to keep that in mind when you are shopping, uh, for a day center. Um, is do you need a medical person on staff? Do they have that? What else should they be looking for?
Jose Santana: I would say, uh, one big thing is transportation.
Robin Rountree: Mm.
Jose Santana: Unfortunately we don't provide it, but there are companies out there that do assist.
And if somebody, for example, has like Medicaid, they do provide transportation. The VA [00:14:00] is starting to provide transportation. But that's, I would say, one of the biggest things to consider is transportation. 'cause it can be overwhelming if you don't have the, the person to take them there and, or you, you know, you're, you find yourself with a busier schedule because you have to come back at a certain time.
So transportation is definitely very important to think of.
Robin Rountree: Okay. So that's not only do they offer it, but can that work into my schedule and do I have a backup?
Jose Santana: Correct. Yes.
Robin Rountree: Oh, this caregiving thing is so tough.
Jose Santana: And you know, I, I give it to the caregivers, um, from the young ones to the older ones we have.
It definitely is something that, I'm happy that they're starting to see more of to provide respite opportunities for them. 'cause they definitely need it.
Robin Rountree: Yeah. Yes they do. Yes they do. So we're shopping for them. We're gonna kind of type in day center day programs for dementia without dementia when you're searching around.
Jose Santana: Yes, you can also search adult daycare day, program day center, any of those keywords should pop up on Google.
Robin Rountree: [00:15:00] Okay. And then staffing, what you, your ratio is one to six?
Jose Santana: Yeah. So one staff to every six members. It doesn't mean that that one staff is gonna take care of those six members, but it's
one staff that's providing direct care. We have to have enough for, uh, every six members.
Robin Rountree: Okay, so you wanna ask about that during your search to find a day center?
Jose Santana: Yes, that is true. Most of 'em are gonna be one to six or one to five. Um, 'cause that's the type of care they're gonna receive. If they need more than that, then it's probably past that care of, um.
Adult daycare.
Robin Rountree: Okay. And in Florida, is it regulated that everybody passes, uh, a background check?
Jose Santana: Yes. Everyone has a level two background check. They have to do a health screening, a tuberculosis screening.
Robin Rountree: Okay.
Jose Santana: Yeah, they're very serious about the, the caregivers that are. The professional caregivers are providing the care.
Robin Rountree: That's amazing. So if you're also searching outside of Florida, ask about background checks, you know, and I would say ask about if an emergency pops up, what's the [00:16:00] procedure like if they can't pick 'em up by five o'clock, are you shutting them down or do you try to work with them?
Jose Santana: We do tell families, you know, we are human, things are gonna happen.
Um, so in, in an emergent situation, you know, we, we will always be there until they come. But we always tell 'em, you know, have a backup plan, like a neighbor, a family member that can be there just in case. Maybe not only for adult daycare, but what if you're,
Robin Rountree: yeah.
Jose Santana: Running errands and somebody you know, have to come back home.
Make sure somebody's there for your backup. So we actually require three people to be emergency backups for our location. Nice. Because we've learned from past experience.
Robin Rountree: Okay. Three emergency contacts per three.
Jose Santana: Yeah, so three in total. So the first main responsible caregiver, and then two more after that.
Robin Rountree: Okay. Very nice. Very nice. What about meals? I. Is that included with the price?
Jose Santana: Yeah, so we actually serve breakfast, lunch, and afternoon refreshment. Everything's approved by the state of Florida and the elder affairs. And, um, they're pretty well balanced meals. I mean, they're, I [00:17:00] always tell families they're approved by two dieticians, the dietician from, we get ours from Meals on Wheels, and then the dietician from the State of Florida double checks to make sure we're, properly serving the right amount of nutrition.
Robin Rountree: Nice, nice. And do you get. Let me go right into my nosy business. Any support from the government to help your program going?
Jose Santana: We do as long as we, you know, pass all our inspections, serve the right amount of food, um, we do get reimbursed by USDA.
Robin Rountree: Oh, nice. For the food?
Jose Santana: Yeah. A certain amount of, , percentage we get.
Robin Rountree: Okay. Well that's good. That keeps your cost down for the, for the families.
Jose Santana: It definitely does, yes.
Robin Rountree: Alright. And can you give me, um, a success story? I'm sure you've got rooms full of them, but
Jose Santana: everyone that comes into our place is a success story. I mean, I have members that will come in and their family, their spouses tell me, he doesn't say a word, but when he comes here, he's smiling and remembers names.
Mm. And when you think about dementia and Alzheimer's, that short term memory
Robin Rountree: Yeah.
Jose Santana: Goes, but when a member can remember somebody's name that they just met [00:18:00] or new for, like this last few months. Yeah, it does show that, you know, their mind is still going, they're still processing. I mean, just the friendships that build up.
Like I said, our center does serve 18 and up, we see friendships that happen and it's just so beautiful to see a 45-year-old being friends with a 85-year-old at that moment, age is nothing. Uh, disability is nothing. Um, it's just that, that time, the, just having a good time with that friend of theirs.
Robin Rountree: That's awesome. . And then how about for the family members? Are you seeing relief?
Jose Santana: Yes, I would say, I mean, um, you know, there're always gonna be stress. There's always stress going on. But I think during that period of time while they're there, they know their loved ones in a safe environment.
They can do, I mean, we've had people say. I'm embarrassed. I just slept. And so you need that. Yeah. You need that break.
Robin Rountree: Yeah.
Jose Santana: Because if something happens to you, then who's gonna take care of them? So you gotta take care of yourself first. I always tell our families that.
Robin Rountree: Yep.
Jose Santana: Very important.
Robin Rountree: Yeah. You go ahead and you take that nap when you can get it.
Jose Santana: Disney World for a few [00:19:00] hours. The beach, take the nap. I, I tell 'em, you know, I'm not, we're not gonna judge you for what you do. Right. Enjoy. And relax and we'll be here.
Robin Rountree: Yeah. 'cause they've got plenty of work to do once you guys are closed for the day, so. Yes. Yeah. Such a great service. Now if they are interested in being with you, Jose, at Daybreak, um, what's the correct name
Jose Santana: and how do they reach you?
So we are, um, our correct name, is Easter Seals daybreak at the Miller Center. Our phone number is four zero seven, uh 6 2 9 4 5 6 5. You can give a call to schedule a tour. I always tell families it's best to see the facility no matter where it's at, just to check it out, meet the staff, see the members there.
You want a positive environment for your loved one. Yeah. And then, um, after the tour, you know, we're regulated, so there will be a doctor's form that needs to be filled out, so your doctor's part of that process as well.
Robin Rountree: Nice.
Jose Santana: And then we do a nursing assessment just to make sure. And then once the nursing assessment goes, it's pretty much clear to start.
Then they can start our program. So it can [00:20:00] be a good week to two weeks before getting started. It's not a fast process, so it's always good to have that backup plan just in case.
Robin Rountree: Yeah. Yeah. What happens if, uh, the person is at the day center and something goes wrong medically? How, how is that handled?
Jose Santana: On our, in our location, we have a nurse on staff, so the nurse is gonna do their observation.
Um, if, if we do have to call nine one one, we will call 9 1 1 and followed by calling the family. Our hospital is the Winter Park AdventHealth That's Oh, the hospital they're going to. Um, so if, if the paramedics recommend, hospitalization or visiting the hospital then,
Robin Rountree: and that is a quick trip from the location?
Yes. For us it's very
Jose Santana: quick. Um, but we'll always call the families and be communication and then we send a staff to be with a member so they're not alone.
Robin Rountree: Oh, nice. Very nice. Jose, I cannot thank you enough. This is something I needed to learn more about and I'm even more impressed by the service. Let me give out, uh, your phone number once again.
Jose Santana: Yeah, so it's uh, 4 0 7 6 [00:21:00] 2 9 4 5 6 5
Robin Rountree: and that will be in the show notes. If you need to grab that later.
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