Respite Care

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ASK DR. MINDY

MINDY KIM-MILLER, MD, PhD
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Question:

What’s the difference between adult day care and respite care services? I don’t really know anything about this disease and these places and I am taking care of a patient with a severe Alzheimer’s. I cannot afford assisted living; he is not on Medicare and Medicaid yet and very hard to look for a cheaper place with memory care unit. Please help me. I am on my own for right now and I don’t know how long I can handle this situation. I am getting tired. I can’t even enjoy my life. What’s the best thing for me to do?

–M.Y.

Answer:

It sounds like you are feeling overwhelmed by trying to provide care to your person by yourself. Caregiving is very stressful and challenging, and you need to find help and take care of yourself and your needs in order to provide good care to your care receiver. You should start by finding ways to reduce your stress level. LightBridge offers some tips on how to manage caregiver stress at http://www.lightbridgehealthcare.com/2048.xml.

You need to get help with the caregiving responsibilities. Contact your local chapter of the Alzheimer’s Association to find out about resources and support networks in your area. Find out about local services and programs that can help lessen the burden of caregiving for elders or those with dementia. For example, Meals on Wheels offers assistance with meal services. Look for volunteer programs, such as Senior Companions, that can offer support.
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Respite care is also a good way to get some help. Respite care is the provision of short-term relief to those who are caring for family members. It essentially provides a short break from caregiving. Adult day care is one form of respite care.

There are five models for providing respite care:
• In-home respite
• Specialized facility
• Sitter-companion services
• Emergency respite
• Adult day care

In-home respite care is popular, because the temporary caregiver comes to the home and gets to know the person, the family, and the person’s regular routines. In-home respite care can be provided by friends, relatives and paid professionals. Depending on the state, Medicaid or Medicare may be used to help cover some of the costs.

Specialized facilities that offer respite care will take the care recipient for a few days to a few weeks. This option is nice for caregivers who need a vacation or time to take care of personal needs.

Sitter-companion services are sometimes provided by local civic groups, the religious communities, and other community organizations. Make sure the sitter-companion is trained in what to do during emergencies if the regular caregiver is away from the home.

With emergency respite care, caregivers set up an agreement with a provider or facility to care for their person in case of an emergency. Many homecare agencies, adult day care, health centers, and residential care facilities provide emergency respite care.

Adult day care provides respite care at a center during the day. There are over 4,000 adult day care centers nationwide. They can provide health services, therapeutic services, nutritious meals, and social activities for people with dementia, chronic illness, or disabilities. Generally, the programs are available several hours a day to a full day, five days a week. Most programs do not offer weekend services, although some may offer half-day services on Saturdays.

There are three types of adult day care:
• Alzheimer’s specific adult day care, which provides social and health services only to those with Alzheimer’s or a related dementia.
• Adult day social care, which provides social activities, meals, recreation, and some health-related services.
• Adult day health care, which offers more intensive health, therapeutic, and social services for individuals with severe medical problems.

The Alzheimer’s Association offers a topic sheet on issues to consider when selecting an adult day care program at http://www.alz.org/national/documents/topicsheet_adultday.pdf. Your local chapter of the Alzheimer’s Association may also have a list of programs near you. The Better Business Bureau may have information on for-profit adult day care centers. Another place to begin searching for a program is in a phone directory, which will list possible options under “Day Care-Adult.”

Here are some additional resources for you to consider:
• Area Agencies on Aging (AAAs) can direct you to adult day care centers in your area. A list of local AAAs can be found at http://www.n4a.org/about-n4a/?fa=aaa-title-VI.
• The National Aging Information Center offers the Eldercare Locator, which helps to find community assistance for seniors at http://www.aoa.gov/naic/elderloc.html.
• The National Council on Aging (NCOA), National Adult Day Services Association (NADSA) offers a set of guidelines for adult day service programs at www.ncoa.org or call (202) 479-6682 or e-mail nadsa@ncoa.org.
• ARCH National Respite Network provides a free search service to help caregivers find respite care in their local community at http://chtop.org/ARCH.html.
• The National Family Caregivers Association educates, supports, empowers and speaks up for family caregivers: http://www.nfcacares.org.
• Lotsa Helping Hands provides an interactive calendar and other functions that will enable you to organize your friends, relatives and neighbors into an effective support group: http://archrespite.lotsahelpinghands.com/eldercare/home.
• Meals on Wheels delivers meal services to people in need: http://www.mowaa.org/Page.aspx?pid=183.

I hope some of this is helpful.

Sincerely,

Mindy Kim-Miller, MD, PhD

Dr. Mindy Kim-Miller is a trained medical physician who provides useful, but general answers to questions provided by online visitors. While Dr. Mindy can not provide specific medical advice or services, we hope you find her responses useful in your personal education. All information is provided for informational and educational purposes only and is not meant to be a substitute for professional medical advice, diagnosis or treatment. If you suspect you have an illness or disease, or a health related condition of any kind, seek professional medical care with an appropriate health care professional immediately. Do not postpone or delay seeking treatment or disregard professional advice based upon the general answers provided by Dr. Mindy. Dr. Mindy’s advice is not intended to substitute for a visit to your personal physician or other qualified health provider. Any specific medical concerns or questions you may have should be directed to your personal physician or other qualified health provider.

References:
KaganJ. Respite Care. (2006). Wikipedia. Retrieved on March 17, 2009, from http://en.wikipedia.org/wiki/Respite_careARCH National Respite Coalition.
Whirrett T. Adult Day Care: One Form of Respite for Older Adults. (2002). ARCH Factsheet Number 54. Retrieved on March 17, 2009, from http://www.archrespite.org/archfs54.pdf.

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