Selected papers from the 1st International Symposium on Therapeutic Recreation

© Curators University of Missouri 1990

Global Therapeutic Recreation I

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Section 18 of 22 | Next Section

An Innovative Solution: The Alzheimer Respite Center at the Parker Jewish Geriatric Institute
Rose Marie Borg
Parker Jewish Geriatric Institute New Hyde Park, NY USA

Edith Shapiro

Parker Jewish Geriatric Institute New Hyde Park, NY USA Willard, NY, USA

In this paper we explore technological advances that can improve the future for the aging members of our society. To design practical and constructive solutions to the problems of the elderly, it is essential to understand their priorities and their needs. The most prevalent, the most feared and the most devastating illness of senior citizens is dementia. It affects 10% of the population over 85. Moreover, it impacts on the lives of their family members and care-givers, reaching several generations in the household. Alzheimer's disease is the most common cause of dementia, accounting for about 66% of all cases. This illness lasts for long periods of time; many patients continue to be cared for by their loved ones for an average of eight years. Despite the burden, two-thirds of them will remain at home. Devoted care-givers provide sole and complete support of the patient in 75% of the cases. Overall, an estimated 40 billion

dollars is spent nationally each year caring for people with Alzheimer's disease at home and in nursing homes. Throughout the country, programs are being developed to respond to the demands of caregivers and to the needs of Alzheimer victims. In 1987, the Robert Wood Johnson Foundation issued a request for a proposal on "Dementia Care and Respite Services." Nineteen projects were funded. The Parker Jewish Geriatric Institute was the recipient of one of those grants. Initially, the Institute, a 527-bed Skilled Nursing Facility located in New Hyde Park, New York, developed an active outpatient geriatric program with Adult Day Care. However, it became clear that Alzheimer patients and their families had different needs: they required individualized, soothing, non-threatening activities in a safe and wander-proof environment which the existing programs could not provide.

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90 Global Therapeutic Recreation I
A new resource, "The Alzheimer Respite Center," was designed specifically for dementia patients. The first step in developing the program was an extensive marketing survey of our community. This survey yielded several interesting findings: eight out of ten patients live with their family. Caregivers' mean age is 55 and their mean household income is $34,000. Half of them are employed. The patients require "constant" supervising in 50% of the cases. Three out of four require companionship and personal care. Almost half of these patient receive no professional care at all. In fact, eight out of ten care-givers have never received any formal Alzheimer's training. For those patients receiving in-home care, the cost averages $50 per day. This care is paid by patient and/or the family in seven out of ten cases. However, nearly half of the caregivers are not satisfied with the current care. Respite care is the most preferred alternative. A respite center would be utilized an average of 3.5 days a week. It is perceived to cost a maximum of about $10 per hour. The Alzheimer Respite Center was designed as a flexible drop-in center, open seven days a week, in order to meet the needs of care-givers and provide respite. It is a psycho-social model where professional recreational therapists were hired who focus on an individualized approach in order to maximize participant's skills in a safe environment. The program provides supervision, enrichment, nutrition and recreation, as well as those varied essential services such as bathing, toileting, hair grooming, shaving and dental hygiene. The environment is designed for safety and comfort. A living room with traditional furniture, a chest for rummaging, a kitchen with dining area, a music lounge and a separate room for quiet time constitute the space. Easy access to an outdoor patio with a gardening area, tables and umbrellas is clearly identified. Labeling, color codes, familiar pictures and a participant security system have all been utilized in order to maximize the environment. Nutrition is an important component of the program. Frequent meals with finger foods are served. Food items are served one at a time to avoid confusion. Assisting devices for silverware, plates, glasses and cups are available as needed. Hygiene is maintained with a two-hour toileting schedule for every participant in a bathroom equipped with grab bars. A bathing program has been developed to provide one-onone safe supervision and assistance while trying to ease the burden of the care-givers. Special training programs and lecture series have been designed for care-givers. The Center has free legal counseling and care management provided through the New York City Department For The Aging and the County of Nassau, Department of Senior Citizen Affairs. A resource library is available to all. Financing the respite care program remains a major issue. Currently there is no reimbursement through Medicare or Medicaid in New York and care-givers essentially pay privately for required services. It is hoped that long-term insurance programs will not ignore this essential and costly service. The key to a successful respite care program is to individualize each plan of treatment. This plan should be based upon the wellness level of the participant, the behavior they mani-

Alzheimer Respite Center 91 fest and their previous life styles. The professional has a potpourri of ideas and resources within them and the participant leads the professional to tap these resources. The goal is to provide opportunities for the participant to have a measure of success without frustration or stress in an environment where each person is treated with dignity and respect.

Global Therapeutic Recreation I

Selected papers from the 1st International Symposium on Therapeutic Recreation
© Curators University of Missouri 1990

Table of Contents

Section 18 of 22 | Next Section

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 show your 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 the distribution of the database by the Leisure Information Network (LIN). http://www.lin.ca

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