At Providence Adult Day Health, elders spend the day in a safe, nurturing environment, providing a break for their regular caregivers.
It is the only adult day health center in Spokane. Within 20 years, as the country’s 78 million baby boomers reach their 70s and 80s, will adult centers be as ubiquitous as child care facilities are now?
Kathy Romano, chief executive of Providence Holy Family Hospital, hopes so. She believes adult day health centers will be key to keeping older citizens healthier longer and living in their own homes. This will ease the strain on our health care system and social services infrastructure.
Spend a day at Providence Adult Day Health, and you’ll understand what Romano means when she says: “Strong communities are built on the way we take care of our most vulnerable.”
9 a.m.: Spokane Transit Authority’s paratransit vans begin arriving at the center, located on Spokane’s North Side about a half block northeast of Providence Holy Family Hospital. The drivers gently guide the older people through the center’s double doors. Some are in wheelchairs; some use walkers; some walk under their own power.
About 80 percent of the center’s clients arrive by van from throughout Spokane, Spokane Valley, Cheney and Deer Park.
“The transit system here is so good,” Romano said. “They pick up people right at their homes, and the drivers are all just so nice.”
Staffers greet the clients. Barbara Baehr, a Dominican sister and nurse who specializes in rehab care, looks for Agatha Duffey, 92. When she spots her, Baehr leads Duffey into a medical room to weigh her, because last week Duffey had lost 5 pounds. Sudden weight loss in older people can sometimes signal underlying health problems.
Baehr tells a visitor that Duffey used to be a librarian who took library books around to veterans for many years.
“Twenty-five years!” Duffey adds.
When people grow into old-old age, or get derailed by dementia or disease, younger people can forget that they were once active, too. Here, no one forgets. They respect who their clients once were. And who they have become.
Duffey’s weight has stabilized. She gives Baehr a thumbs up.
9 to 10: Sip and chat time. The elders sit around tables in a room filled with natural sunlight. Staffers and volunteers ask if they’d like coffee, water, juice.
Some of the center’s clients do word puzzles. Some read magazines. Some chat with others at their table. Some of what they say makes no sense, in a dementia phenomenon known as word salad.
“We just go with them where they are at the moment,” explained Megan McCoy, the center’s clinical program manager.
About 75 percent of the center’s clients have dementia. Some of the rest are alert in mind, but their bodies are weakened by Parkinson’s, strokes, multiple sclerosis, falls and traumatic brain injuries.
Some are just very isolated, and social isolation can short-circuit older brains and prematurely age their bodies.
So sip and chat, sip and chat. This hour is a lifesaver.
10:05: Announcements; 47 clients are here today. Sandy Manzo, activity coordinator, announces the date: “Monday, Aug. 13.” The group sings birthday greetings to two people celebrating today.
Opening rituals keep us grounded throughout our lives. In preschool and kindergarten, circle time orients children to the day of the week, the weather, coming activities. Circle time morphs into “announcements over the intercom” in elementary and high schools. Even in workplaces, rituals inaugurate the day. Greetings by the mailboxes; trips together for coffee.
When people retire from their “public” lives, opening rituals disappear, adding to isolation and disorientation. So circle time, elder style, is an essential ritual here.
10:15 to 11: The clients break into small groups and exercise according to ability. Some take a short walk. Others sit in chairs and move their bodies. In one room, a dozen clients listen to big band music, hold onto the back of chairs and hula.
The exercise is not just fun, it preserves the ability for some of these elders to remain in their homes.
“What’s the No. 1 thing to prevent a fall? Making sure people are strong enough, and that means exercise,” explained Diane Pickens, the center’s director.
11 to noon: And now, exercises for the brain. In the main room, several clients shout out answers to a fill-in-the-blank quiz.
“Blind as a…Bat!”
In a smaller room, volunteers play a puzzle-matching game with clients who have memory challenges.
Back to the main room where the clients are now shouting out answers to a name-the-famous-person quiz.
At the end of people’s lives, aging experts say, they often regret not taking more risks. These elders remember best our history’s risk-takers, those who shattered boundaries of race, gender, creed, convention. Joe Louis, boxer. Gypsy Rose Lee, striptease artist.
Noon: Lunchtime. Five men, ranging in age from 56 to 89, sit around one of the lunch tables and dig into today’s offerings: chicken divan over pasta, seasoned peas, wheat roll and cherry cobbler.
“We’re a clique,” they tell a visitor.
The men are veterans. One incurred a head injury in a motorcycle accident. Another has gone blind. Strokes weakened another. The center is their lifeline, they said.
Jim McGinnis said: “I was a loner. Coming here changed my attitude. There’s no better staff than here. When I first came, I couldn’t move without someone touching my shoulder and asking me if I need help.”
The men said they never thought about growing older in their stronger, younger days. They were too busy. And they thought they’d just drop dead of heart attacks in their 50s and 60s.
If they weren’t here during the day, what would they do?
Watch TV or listen to the radio, they say.
1 p.m.: Caregivers gather for a support group.
“The caregiver groups are available to everyone whether or not they are a member here,” Pickens said. “And when caregivers come, they can bring their family members here during their support group.”
On a different Monday, the center offers a male-only caregiver group for the increasing number of men in our culture taking care of spouses and aging parents.
In today’s group, six women and two men settle into chairs rounded into a welcoming circle. Their loved ones are being cared for in the main room. For 90 minutes, these caregivers can exhale.
They have exhausted eyes. Allan Cory, who has been an adult day health staffer for 27 years, begins by reading the caregivers’ bill of rights.
“It’s all right to be angry,” Cory reads. A woman pipes up: “Or yell in the garage!”
These caregivers talk about spouses who have forgotten their names, don’t recognize their children. The ability to run errands and travel with ease? Gone. Their loved ones have wandered off at Costco, in airports. It’s a nightmare.
They understand that as caregivers they are at risk for sickness and even premature death, due to stress. They are out of sync with a society that idolizes the young and the able.
Time moves differently for your loved ones, Cory reminds them. “Minutes could be hours. Hours could be days. Days could be months.”
2:15 to 3: The STA vans return. The clients are tired and anxious for home. The day at the center has provided both the clients, and their caregivers waiting at home, a break from a world where the minutes, hours and days sometimes seem to stretch into eternity.