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Published by Glauka

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Published by: Glauka on May 12, 2013
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In this paper we explore technological ad-vances that can improve the future for the agingmembers of our society. To design practical andconstructive solutions to the problems of theelderly, it is essential to understand their priorities and their needs.The most prevalent, the most feared andthe most devastating illness of senior citizens isdementia. It affects 10% of the population over 85. Moreover, it impacts on the lives of their family members and care-givers, reachingseveral generations in the household. Alzheimer's disease is the most commoncause of dementia, accounting for about 66% of all cases. This illness lasts for long periods of time; many patients continue to be cared for bytheir loved ones for an average of eight years.Despite the burden, two-thirds of them willremain at home. Devoted care-givers providesole and complete support of the patient in 75%of the cases. Overall, an estimated 40 billiondollars is spent nationally each year caring for people with Alzheimer's disease at home and innursing homes.Throughout the country, programs are beingdeveloped to respond to the demands of care-givers and to the needs of Alzheimer victims. In1987, the Robert Wood Johnson Foundationissued a request for a proposal on "DementiaCare and Respite Services." Nineteen projectswere funded. The Parker Jewish GeriatricInstitute was the recipient of one of thosegrants. Initially, the Institute, a 527-bed SkilledNursing Facility located in New Hyde Park, NewYork, developed an active outpatient geriatricprogram with Adult Day Care. However, itbecame clear that Alzheimer patients and their families had different needs: they requiredindividualized, soothing, non-threatening activi-ties in a safe and wander-proof environmentwhich the existing programs could not provide.
An Innovative Solution:The Alzheimer Respite Center at the Parker Jewish Geriatric Institute
Rose Marie Borg
Parker Jewish Geriatric InstituteNew Hyde Park, NY USA
Edith Shapiro
Parker Jewish Geriatric InstituteNew Hyde Park, NY USAWillard, NY, USA
 Appropriate Use of Documents: Documents may be downloaded or printed (single copy only).You are free to edit the documents you download and use them for your own projects, but you should showour appreciation by providing credit to the originator of the document. You must not sell the document or make a profit from reproducing it. You must not copy, extract, summarize or distribute downloaded documents outside of your own organization in a manner which competes with or substitutes for thedistribution of the database by the Leisure Information Network (LIN). 
 Global Therapeutic Recreation I
Selected papers from the 1
International Symposium on Therapeutic Recreation
© Curators University of Missouri 1990
Global Therapeutic Recreation
 A new resource, "The Alzheimer RespiteCenter," was designed specifically for dementiapatients.The first step in developing the programwas an extensive marketing surveyof our community. This survey yieldedseveral interesting findings: eight out of ten patients live with their family. Care-givers' mean age is 55 and their meanhousehold income is $34,000. Half of them are employed. The patients require"constant" supervising in 50% of thecases. Three out of four requirecompanionship and personal care. Almost half of these patient receive noprofessional care at all. In fact, eight outof ten care-givers have never receivedany formal Alzheimer's training. For those patients receiving in-home care,the cost averages $50 per day. This careis paid by patient and/or the family inseven out of ten cases. However, nearlyhalf of the caregivers are not satisfiedwith the current care. Respite care is themost preferred alternative. A respitecenter would be utilized an average of 3.5 days a week. It is perceived to cost amaximum of about $10 per hour.The Alzheimer Respite Center wasdesigned as a flexible drop-in center, openseven days a week, in order to meet the needsof care-givers and provide respite. It is apsycho-social model where professionalrecreational therapists were hired who focus onan individualized approach in order to maximizeparticipant's skills in a safe environment. Theprogram provides supervision, enrichment,nutrition and recreation, as well as those variedessential services such as bathing, toileting, hair grooming, shaving and dental hygiene.The environment is designed for safety andcomfort. A living room with traditional furniture, achest for rummaging, a kitchen with dining area,a music lounge and a separate room for quiettime constitute the space. Easy access to anoutdoor patio with a gardening area, tables andumbrellas is clearly identified. Labeling, color codes, familiar pictures and a participantsecurity system have all been utilized in order tomaximize the environment.Nutrition is an important component of theprogram. Frequent meals with finger foods areserved. Food items are served one at a time toavoid confusion. Assisting devices for silver-ware, plates, glasses and cups are available asneeded. Hygiene is maintained with a two-hour toileting schedule for every participant in abathroom equipped with grab bars. A bathingprogram has been developed to provide one-on-one safe supervision and assistance while tryingto ease the burden of the care-givers.Special training programs and lecture serieshave been designed for care-givers. The Center has free legal counseling and care managementprovided through the New York City DepartmentFor The Aging and the County of Nassau,Department of Senior Citizen Affairs. A resourcelibrary is available to all.Financing the respite care program remainsa major issue. Currently there is no reimburse-ment through Medicare or Medicaid in New Yorkand care-givers essentially pay privately for required services. It is hoped that long-terminsurance programs will not ignore this essentialand costly service.The key to a successful respite care pro-gram is to individualize each plan of treatment.This plan should be based upon the wellnesslevel of the participant, the behavior they mani-

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