Right At Home Day-Care Program For Adults Allows Elderly People To Remain In Their Private Residences And Preserve Their Independent Lifestyles

Anna Goldsmith was born to a Spokane County pioneer farm family in 1905.

A neighbor boy courted her in the apple orchard. She went away to college, and later married him. They settled on a farm.

Now at 92, her husband is gone, she’s crippled from age and her eyesight is failing. But Anna Goldsmith is happy.

“I think I’m very fortunate,” she said.

Goldsmith lives at home.

She does so with the help of family members and a unique day-care program that allows elderly people to stay independent by providing them with health services they need.

Holy Family Adult Day Centers is widely regarded as a growing trend in elder care because the non-profit program offers a lower-cost alternative to nursing homes and it gives seniors what they most often want.

“I like my home. I like my independence,” said Goldsmith during one of her twice-a-week visits to Holy Family’s day-care site at Bethlehem Lutheran Church, 27th and Ray.

She is among the 45 enrollees at the South Hill program, which opened two years ago.

Here, seniors get a range of professional services including nursing care, recreational therapy, physical therapy and monitoring of medications. The idea is to keep them healthier longer so they can stay out of nursing homes.

In addition, family members or in-home caregivers get a break, which helps them avoid burnout. Older caregivers can develop health problems of their own if they don’t get away occasionally from the stress of caring for a loved one.

Studies show that elderly people who remain in their communities with the help of professional care have a higher quality of life than those who are institutionalized.

This has benefits for taxpayers because it reduces the drain on Medicaid funds, which often end up paying nursing home bills.

Experts say the demand for adult day care will grow as the population ages and families try to find gentler alternatives to institutional settings.

Spokane County currently has more than 50,000 people age 65 or older, a 25 percent increase from 1980.

Holy Family’s program, the only one of its kind in the area, is feeling that growth. In 1993, it helped 198 enrollees at three sites in the Spokane area. Last year, the number was 295.

The South Side program occupies leased space in the basement of Bethlehem Lutheran Church, but its directors are hoping to find a permanent home for the center in that part of the city.

“I think adult day care is the wave of the future,” said Director Marie Raschko.

“A lot of seniors fear getting old and being forced into a patient facility,” she said. “One of our goals is to slow down the deterioration process.”

Goldsmith regularly sees a licensed nurse and an occupational therapist. The staff is helping her maintain physical mobility because that is critical to her staying at home.

Her bones and joints have been ravaged by osteoporosis and arthritis. She has broken both shoulders and one hip, and both her knees were replaced surgically.

Goldsmith lives in the Lincoln Heights home she and her husband, Ralph Goldsmith, bought in 1964 when he retired. Her husband died 10 years ago.

She still sparkles with the quick mind that helped her earn a degree from Cheney Normal School (now Eastern Washington University) and become a school teacher. She left teaching when she got married.

Goldsmith uses a walker to get around now, and her 29-year-old grandson lives with her to keep an eye on her and help with the house.

“She’s a tough one,” said her daughter, Donna Anderson, of Spokane. “I don’t think mom would be happy in an assisted-living center.”

“They’ve been so good to her,” she said of the day center staff.

The Holy Family program provides far more than physical needs. It offers a social environment for people who may be isolated at home and need the emotional boost that companionship offers.

“There’s a lot of comradeship here,” Goldsmith said. “Before I was just at home and waiting for the family to come over. I was lonely.”

Mabel Beyer, 91, suffered a stroke four years ago and now lives in an adult family home. A retired hospital clerk, Beyer lost her ability to speak clearly, but is regaining her speech with the help of therapy at the day center.

“The people I live with are the kind who sit and do nothing,” she said. “I like to get out and do something. I like to be with people.”

Beyond socializing, one of the things staff members try to do is help the seniors adapt to their limitations.

For instance, occupational therapist Roberta Choma teaches seniors to cook for themselves with one hand when the other hand is immobilized. She mounted a cup holder on a wheelchair for one patient so she could carry her morning coffee without spilling it.

In one of her exercises, Choma uses a bowl of rice filled with small objects. She has her patients dig into the bowl to retrieve the items. It helps increase dexterity, she said.

Another exercise involves putting together pieces of plastic tubing to increase a person’s reach.

During the day, the seniors get a hot lunch and, occasionally, the staff prepares breakfast.

After breakfast earlier this month, recreational therapist Mary Anderson led the group in a discussion to help them exercise their minds. A number of the enrollees suffer from cognitive impairments such as Alzheimer’s Disease.

The discussion involved simple things like the day of the week and names of historical figures, but it provided social interaction and got them to think.

One of the men in the group, a retired lawyer, was dressed in a coat and tie. He shows up like that all the time. He suffers from dementia but hasn’t lost his charm.

“Why are you so nice?” he asked repeatedly in a cheery voice.

Of course, the staffers told him he’s nice, too.

Staff members say they are satisfied if they can make the seniors’ lives better one day at a time because they know it’s not easy coping with age and the burden of physical and mental impairments.

Finances are a concern as well. A lot of these seniors have retired without a large savings. Holy Family Adult Day Centers offers financing options to help them get into the $40-a-day program. Most enrollees attend a few days a week.

The cost is low compared with the $3,000 a month nursing homes charge.

Out of the 45 people signed up at the Bethlehem site, about 15 show up each weekday morning. Many of them get rides on subsidized transit vans.

Only those who have exhausted their financial resources are eligible for Medicaid to pay the tuition at the center.

Others pay at least a portion of the cost on a sliding scale based on how much money they have. State grants and charitable scholarships are available to reduce the amount each client might have to pay.

The center works with the agency of Aging and Long-term Care of Eastern Washington to tap into state money available for seniors. Charitable contributions are collected from foundations and individuals in the community.

Holy Family’s program is one of about 30 adult day health care programs statewide, said Sharen Schermer, an administrator with the long-term care agency.

Among those programs, Spokane’s is probably one of the top three, she said, adding, “People are getting a quality product here in Spokane, and we should be proud of it.”

The staff at Bethlehem thinks so, too. They believe the patients are happier in day care than a nursing home.

As assistant director Becky Tiller put it: “We’re kind of a well kept secret.”

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