Dementia Care - Critical Pathway Forms Help Identify Programming Deficiencies


Lime Green Might be Your Color! The Effects of Color with Alzheimers and Dementia Residents
Visual Stimulation for Alzheimer’s Disease and Dementia
                               Author: M. Celeste Chase, AC-BC, ACC, CDP   

The goal in all communications with a person living with Alzheimer’s should be to connect with him/her in positive, constructive, effective ways. But while most of us have long since experienced the positivity of supportive “words” to communicate; those with progressive Alzheimer’s/dementia will eventual lose the skill of language both receptively and expressively.
Using the Environment to Communicate? – Color My World

Studies have shown that the use of various colors, particularly in the environment can be helpful in restoring some level of independence often lost with the disease progression. Strategic use of colors in the environment also has an uncanny way of improving mood and thereby lessening the occurrence of unwanted behavior incidents.

NOTE: The most effective color preferences for individuals with dementia are red, blue and green.

Red has shown to increases brain wave activity and gives and appearance of a smaller room. This color tends to increase the perceived temperature of the room. The use of red is very effective in getting the attention of an individual with Alzheimer's or dementia. Thus, often used to draw the senior to areas or things you want them to pay attention to.

Blue is a “restful” color with a calming effect.

The use of blue in the physical environment can actually lower blood pressure and rooms painted in this color are cooler than other shades; like red or orange.
Painting walls Blue gives the illusion of increased room size.

Green reduces central nervous system activity and is recognized as being symbolic of growth and life; having the most restful affect of all colors. It is often used to helps individuals remain calm much like blue. Painting walls green gives the appearance of a larger area.

Lime green is particularly effective color to use with individuals with Alzheimer's or dementia for visual attention, i.e., visual cues for bathrooms, bedrooms, walkers, etc.

Blue and red are ideal for a dinner plate and eating utensils colors as it too offers good contrast with food to stimulate appetite.

Studies show that individuals feel happier when wearing colors such as coral, peach and variations of orange. Incorporate these colors in clothing wardrobe, to support happy emotions throughout the day.

NOTE: Those with acutely aggressive unwanted behavior issues tend to act out less when pink is the color of choice. It should be noted that the use of pink, blue and green will often be found in facilities that work with individuals with violent or hostile tendencies.

Contrasting Colors Benefits:
  1. The use of contrast is extremely important for marking edges to delineate the amount of space the item occupies relative to the surrounding environment to help define objects more clearly. It is used to draw attention to furniture or other items that may be tripping hazards to prevent falls.
  2. Contrasting colors are strategically used for dinner plates or finding the toilet seat in a white on white bathroom. It is not uncommon for seniors to completely misjudge the location of the toilet seat or even the bathroom itself. Adding color to seats and bathroom doors can significantly reduce toileting accidents.
  3. Color contrasting is useful in drawing attention to key features on walls. Making it easier to locate switches, railings or handrails.

Color Differentiation:
Research has shown that a person with dementia can be less sensitive to differences in colors – including color contrast such as black or white. The aging process is known to lead to natural thickening of eye lens, affecting distinction between certain colors. It causes a ‘washed out’ affect, making it difficult to differentiate between blues, greens and purples (these colors would then be easily used interchangeably to create the same affect). The distinction between blue and black may also become difficult to identify.

NOTE: Keep in mind that color preferences can change for those seniors living with dementia as they begin to experiences increasing sensitivity to all things, so it is necessary to create a balance throughout the journey of the disease.

Visual Complications:
Difficulties with sight and perception can cause people to misinterpret the world around them, further fueling the confusion and isolation they’re already feeling. The ability to detect movement may be reduced along with problems with double vision, or struggle to change their gaze. Reflections may also be mistaken for other people and shadow areas become a place of overwhelming fear.

Patterns can cause confusion, so keep patterns on the wall and floor to a minimum or eliminate completely where possible. Seniors with Lewy Bodies dementia may view carpets with patterns to be at different heights and levels. Rugs regardless of patterns or solid colors are often seen as holes in the floor and viewed as obstacles to avoid.

Overview Summary:
Highlight important elements – prominent color contrast for a backdrop adds clarity to the environment and the objects occupying the space. Things such as floors, skirting boards, walls, and stairs should all clearly contrast with one another so that they’re easily distinguished.
    Example: Chairs should be in contrasting color to the floors, sinks and toilets     should be in contrast to the walls and floors, and table settings must contrast with the table or tablecloth.

Use color to highlight risks – For someone living with dementia, changes in hue values can often be perceived to be changes in floor level. Avoid patterned carpets, especially striped or checkered, which could be perceived as holes in the ground.

Ensure thresholds don’t contrast – If the flooring in one room contrasts with the flooring in the next room it could be perceived as a change in floor level. Try to ensure that the flooring for rooms and areas that lead into each other are the same color so that it is perceived as a continuous level surface.

Reduce unwanted visuals – Clutter can be overwhelming and lead to confusion. As dementia progresses it creates a profound lose of our identity and frequent bewilderment causing ever familiar locations to feel strange. High risk wandering behaviors and attempts to escape the place that no longer feels safe can be colors and patterns advantageously with low contrast to make exit doors recede into the background and become more inconspicuous.

NOTE: Not surprisingly, using colors to paint an exit door or a window image on the wall has been known to distract and camouflage the location of the real exit door and window to redirect attempts to wander.

Many of us are drawn to our favorite colors, and some colors evoke happy memories, but as a general rule of thumb the following colors encourage these reactions:

Blue: Cool colors like blue make a room feel bigger, and have a calming and restful effect, so they’re often used for bedrooms and quiet areas.
Green: This earthy color is associated with growth and life, and is thought to reduce activity in the central nervous system and help people to feel calmer.
Red: This warm color has the opposite effect to blue, making a room feel smaller and often used for rooms that are cool in temperature. It’s also a highly stimulating color which is often used in activity areas to increase brain wave activity and stimulate the production of adrenaline.
Orange: Another warm color with similar properties to red. It is considered an earthy color and is often used in natural environments.
Yellow: This is a stimulating color which is used in activity areas to increase brain wave activity as well. Stimulating colors are good for Alzheimer’s patients as they can trigger fond memories and improved cognitive function.
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Behavioral Health Programming Guide for Skilled Nursing Facilities , written by M. Celeste Chase AC-BC, ACC, CDP

Behavioral Health Programming Guide for Skilled Nursing Facilities
written by  M. Celeste Chase, AC-BC, ACC, CDP,

  • Price: $14.95
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The New Behavioral Health Regulations F740-F744, F758 & F659 have become part of the 2018-2019 Survey Process for Skilled Nursing Facilities. The regulations are facility wide but the Activity Department is right in the middle of things.
This Programming Guide, written by  M. Celeste Chase, AC-BC, ACC, CDP, provides a Step by Step approach to help the Activity Professional and Staff to understand the challenges Behavioral Health presents and how to respond with activities that help redirect and reduce disruptive or unwanted behaviors.
Celeste has deconstructed the most common Behavioral Health issues into a language easy to understand, triggers, strategies, engagement, adaptations, interventions, samples and goals. This Programming Guide will help you and your facility become Behavioral Health Compliant with minimal stress.

Behavioral Health - Behavioral health encompasses a resident’s whole emotional and mental well-being, which include, but is not limited to the prevention and treatment of mental and substance use disorders.
Not surprisingly, federal agencies such as the Centers for Medicare and Medicaid Services (CMS) support behavioral health and psychiatric well-being for individuals in senior care facilities. Specifically, the concern centers on the over-reliance of anti psychotic medication use for residents with disruptive behaviors. Unwanted behaviors must first be treated through behavioral interventions before psychoactive medications can be administered.

:::::: Behavior Management mandates requires:


§      Possess appropriate competencies and skill sets to care for residents diagnosed with mental and psycho-social disorders as well as those with a history of trauma and/or post-traumatic stress disorder (PTSD).
§      Provide treatment and services to correct the assessed problem or to attain the highest practicable mental and psycho-social well being for residents that display/diagnosed with;
  •     mental disorder
  •     psycho-social adjustment difficulty         
  •     history of trauma or post-traumatic          
  •     stress disorder (PTSD)
§      Monitor for patterns of behavior difficulties not previously diagnosed, assessed or revealed that decreases social interaction and/or increases withdrawn, angry, or depressive behaviors- unless the clinical condition demonstrates that development of such a pattern was unavoidable.
§      Provide a resident who displays or is diagnosed with dementia with appropriate treatment and services to attain or maintain his or her highest practicable physical, mental, and psycho-social well-being.
§      Provide medically related social services to attain or maintain his or her highest practicable physical, mental, and psycho-social well-being.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ sample ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Big Changes Announced by the NAAPCC Activity Director Credentialing Center

The Credentialing Center is excited to announce that we have now been in 
business for 8 years! Over that time, trends and expectations in the 
field have evolved. The Board met in March to look at how The Center 
could keep up with trends and continue to set and follow high ethical 
certification standards. NAAPCC continues to follow the standards of the 
National Commission for Certifying Agencies, including those related to 
conflicts of interest. No one on this Board or anyone associated with 
the Board benefits financially from any certification criteria. NAAPCC 
is happy to announce that beginning immediately, several changes will 

1. NAAPCC will be offering three certifications. You will be able to 
find the PATHs to reach these certifications on our website by April 15 
2019 or you can request an emailed copy from the office.

Activity Professional -Board Certified: AP-BC
Advanced Activity Professional -Board Certified: AAP-BC
Activity Consultant/Educator- Board Certified: AC-BC

As of now, all current AP-BC’s will be grandfathered to AAP-BC per 
industry grandfathering standards. All new applicants will follow the 
new criteria. Certificates will automatically be mailed for those 
grandfathered to
AAP-BC. This will take some time so thank you for being patient. You 
will continue to meet F Tag 680 with your

All certifications meet F tags 658 and 680 and are national 

2. NAAPCC has made some additions to the Standards required, which you 
will also find on the website by April 15, 2019.

3. NAAPCC has added a PATH under the AP-BC that will accept any 
*recognized basic or advanced activity course that equals 36 hours, 
toward AP-BC .

4. All CE credits from any *recognized basic or advanced activity course 
can now be used toward required CE credits (note that 12 required CE 
credits must be from live, face to face education for all PATHs).

5. The face to face, live education hours requirement for all renewals 
and applications will now be a minimum of 12.

* No specific course is required per NCCA standards, but recognized 
courses, including state courses already recognized by CMS, will be 
accepted toward NAAPCC certification under PATH 2 for AP-BC. The 
definition of a recognized course will be in the standards and on the 
website by April 15, 2019.

Please contact the office at with any questions 
or call (303) 317-5682

The NAAPCC is proud to continue to be the Board Certification choice of 
Activity Professionals across the country.

Men's Activities for Senior Care by Celeste Chase AC-BC,ACC,CDP Activity Directors Network

Activities for Men . . . .
Author M. Celeste Chase, AC-BC, ACC, CDP   Activity Directors Network

While walking through most Long Term Care facilities you will easily take note that the ratio of female versus male residents is significantly tipped towards the female population. Women residents outnumber men at the rate of about 2 to 1 (partly due to the fact women live longer than men). Contributing factors that tip the scale further is that it is not uncommon to find that approximately 80% of the staff is also female and the majority of visitors in general are female as well. Men are simply outnumbered in Long Term Care facilities.

            “this map of America shows the male/female sex ratio for all the states and    
            counties — It's worth noting that, at a glance, the most populous counties in
            America seem to tilt towards female”. 

Upon further glance it may appear that a vast number of activity calendars have more programs geared for women than men. Activity calendars often do reflect a variety of feminine-based domestic activities such as cooking, baking or “unisex” geared activities. One might speculate that Activity Directors focus on meeting the needs of the majority (female) residents but it is more the case of how much more challenging it is to create male oriented programs than it is for the female persuasion.

Consider some of the following factors that contribute to the increased challenge in planning for men’s activities.

·         Of the less than  30% of male residents in Long Term Care facilities, approximately 1/3 of the population present with less ability to communicate than women due to their respective medical or mental status.
·         Some men suffer from strong fear of failure; particularly relating to starting a new skill in which they may appear incompetent to others.
·         Men of past generations may feel embarrassed or self consciousness relating to their particular disability and how it may cause unsuccessful outcomes.
·         Career responsibilities that have long since pasted may leave a sense of loss or void that may damage self-esteem, and instill feelings of uselessness.

All of the above are useful information when planning for men’s activities but are only a fraction of the possible scenarios that today’s Activity Director needs to consider while planning for a balanced and purposeful activity calendar.

Additionally, there are lifestyle differences that contribute to men’s personal attitudes regarding leisure pursuits between white collars versus blue collar workers. White collar workers engaged in less physical job related labor, shorter work d hours and benefited from higher paying salaries than blue collar laborers.  Thus, white collar workers were more likely to feel more energetic, have additional time in the day for leisure choices and possessed the financial means that allowed him to select from a range of interests and pursuits.

Below are some considerations that may help you to best identify how to plan for men’s activities, specific to Blue Collar Workers.

·         Men put in exhaustive long hours and often were left with little or no time for leisure pursuits thus they tend to be lacking in leisure related skills.
What little available free time in any given day was spent with family members, particularly with their children.

·         Minimal earnings did not allow for financial means to spend on leisure activities.

Starting  Point – the assessment /gender reviewed

Fine tune your Assessment Forms

Most likely you already have a standardized assessment form. Take some time to review your assessment form and activity check sheet and take note of the types of activities that may be more specific to male residents.  You can create a framework of questions that will help you probe for more details regarding his preferences. As you check those areas of interest expressed by your resident make it your mission to elicit and document more information describing what makes his specific selection particularly appealing.

Example - Resident selects Sailing:

Questions to ask:
·         Can you describe what your sailboat looked like?
·         Where is your favorite sailing destination?
·         What time of day do you like go sailing?
·         Who do you like to be with when you go sailing?
·         How often did you go sailing?
·         How do you take care of your sailboat?

Your resident’s answers can be used to engage him in a conversation at a later time about this past time experience and will aide in re-affirming a particularly meaningful memory.  Men of this generation often thoroughly enjoy exchanging stories of past days of glory, sports or children and grandchildren’s accomplishments. Look within your male population to group residents with common denominators that you can foster in friendship and mutual camaraderie.

Once you incorporate your residents’ noted interest in the activity calendar and highlight care plan objectives you are well on your way  to providing for the needs and interests of your resident as a unique individual within the facility community - thereby meeting federal laws for nursing homes.

Men might be the minority in this club but given the opportunity, appropriate resources and a through comprehensive assessment, men may not only be able to participate but contribute greatly by adding to the overall program enrichment through a well balanced activity calendar schedule.
Although the Activity Director professional who will focus on planning these activities keep in mind that the ALL staff members are charged with ensuring that the needs and interests of each individual is met to attain or maintain the highest practical physical, mental, and psychosocial quality of life possible. Such programs are essential to the health and well being of all men and women living in Long Term Care facilities today.

Below are a number of ideas for your consideration but remember, that you’re objective is to find a “match” between your resident’s needs and interests to the many potential ideas you come across. 
Train Hobby Club – The collection for the train hobbyist is numerous, everything from the train itself to the landscape and surrounding villages will keep your resident busy. Look for a location in the facility where you can leave the train convoy permanently set up for residents to watch throughout the day.
Men’s Choral Group – Rehearse all time men’s favorite songs to musical accompaniment or acapella style.  Let your residents listen to past male entertainment groups (Miracles, The Four Tops, The Platters, etc.) 
Car Talk – Collect car magazines and new car brochures and solicit a discussion about new cars vs. the old cars, foreign vs. domestic, manual vs. automatic transmission, 2-door, 4-door, convertibles, etc.
Car Wash – A simple hose, bucket, soap, sponges, and towels is all that’s needed. Solicit facility staff members to volunteer their car for washing. Each resident may choose whether to wash, rinse, dry, or just watch the scrubbing and polishing busy work.
Rope Tying – Former professionals and wanna-be ship mates will enjoy trying and re-trying various rope techniques to get it right - while sharing sea worthy tales. If there is no sea captain in the crowd just purchase the many rope tying teaching books out there and dawn your sailor hat to get the ship moving.
Santas Workshop – Doll houses, airplanes, train kits, bird house, mailboxes etc., make for a super great Santa Shop assembly line. Finished product can be donated to non-profit organizations such as Toys for Tots during the holidays. Your men will love knowing how meaningful their labor of love will be to a child.
Sports Time – Watching a live or a pre-recorded horse race, ballgame, boxing match on a big-screen will get the crowd in the mood. Set out peanuts, popcorn, and pretzels. Serve non-alcoholic beer and soda.  NOTE: keep in mind any issue with potential chocking risk/consult with nursing.
Competitors Club – Horseshoes, bean bag tosses, badminton, and bocce ball, balloon toss are fun games that involve a lot of movement while encouraging interaction, socialization, and teamwork.
At the Movies – Ask the residents to select a film (a western, war movie, or mystery). Schedule a matinee or an evening showing. Supply hot-buttered popcorn, movie-style candy, and soda (if permissible- relating to potential chocking/consult with nursing). NOTE: War movies may be triggering for some residents. Be sure to vet your residents for potential behavior relating to aggression that may be triggered from viewing war movies.
Honoring Veterans – Military veterans are often eager to exchange stories about the war days as a way to bond and honor veterans and the past memories. Create a list of “military positions” held by your resident and post in an easily visible location to honor their service.
Casino Night – Organize a game of dominoes, checkers, chess, or a card game (poker or Blackjack). Be sure to decorate with all the ambiance and glitz and glamour to set the tone. Arches ranging from roulette wheel to gleaming gold circle to let the residents make an entrance.
Tool Bits – Provide a variety of different sized nuts, bolts, and washers and a few empty containers. Either direct the person to sort the items or assemble the items and start up a conversation and provide pictures about what each item might be used to make. NOTE: Be aware if there is any evidence whereas you believe that your resident may want to ingest non-consumable items.
Trade Show – Journey out to a local hardware store, such as Home Depot or Lowe’s. Make a project list and ask the men to find the supplies to complete the job. Many men enjoy discovering new tools and many will spend countless hours at a hardware or home-improvement center.
Shoe Shine – Contac a local shoe shop to enlist the tradesman to come to the facility to show off his craft to the men of the house. Your residents can wear their Sunday best shoes for this shoe renovation. Offer newspapers, magazines, books for reading while resident shoes get a new lease on life.  The smell of shoe polish may evoke memories and provide opportunities to reminisce.
Card or Coin Collection Club – Many men collected and traded baseball cards or coins when they were young. Gather a collection of baseball cards or coins and set up a sorting/organizing station. Obtain detailed information about the items to share with the residents. Encourage the men to talk about their baseball or coin favorites and share how they acquired their treasures.
Career Day – Gather a collection of photographs with a focus on jobs, occupations, and careers. (Also consider: colleges, military service, sports activities, clubs or organizations, hobbies or leisure activities.) Encourage the person to discuss the photographs and their past employment. Pass around various hats representing different careers and ask residents to talk about which occupation they think the hat belongs to. Share information about each career such as, educational requirements and potential earnings.

M. Celeste Chase, AC-BC, ACC, CDP

How do you Avoid Job Burnout? Internal Validation ... have a look

How do you Avoid Job Burnout?

Many of us, admittedly most of us, look for some level of external feedback in the form of recognition to measure the importance of what we do. Feedback from our family, friends, business associates or coworkers helps us to develop a sense of personal and professional contribution. But all too frequently we give away our power to others to rate how successful we are while working to achieve our goals. The success of our own internal ability to self-motivate will increase or decrease greatly when those external sources say yah or nah to what we do often leading to a maker or breaker attitude.
 We can always count on our loved ones to give us what we need to succeed but that is not the expected scenario out there in the working world. It is neither rewarding nor any fun to toil away at a job where your efforts go unnoticed. You are especially prone to those influences when the elements of your work are demanding both physically and emotionally.

Give yourself permission to find reward and value in what you do. When we are waiting for those external sources to find time during that busy work day to give us praise for work well done, we stand in pause, a momentary state of waiting for validation and responses to unanswered questions. Are we valued, are we not valued for our work? Did we do as well as we thought we did – did we do as well as we wanted to?
Permit yourself to self-reflect and self-rate what you do first and then proceed to include the input from those outside sources. Establishing a sense of a job well done is the best way to prevent burnout. Ask yourself if your still leaving work at the end of the day feeling satisfaction and excitement upon the thought of returning back to work the next day.

Before evaluation date, pursue a dialogue with your work supervisor to ask how you are doing. Your approach should not be defensive but rather should be to seek better understanding of what is expected and whether you are on the right track. Ask for clarification if need be so you can make clear plan of action to meet your job requirements. You will ensure that you remain on target to be in line to move into another position of more responsibility if you have aspirations to do so. You are looking to partner with your supervisor in a way that supports the overall mission & goals of your department. Your supervisor will remember & appreciate this meeting when your actual performance rating is scheduled.

There is never a time when we have learned it all; regardless of what position of professional status one may achieved. Continued education is not only consistently required to maintain certifications but continues to provide one of the largely single greatest source of renewed interest in any given career path. Learning sparks introspective thought that provokes one to look for better and more current strategies to improve delivery and discover more effective ways to offer the services provided.
Job burnout is often seen to take hold when work tasks become mundane in nature or otherwise automatic and lack the need for individualized thought process, thus, mind stimulation through continued education provides a pathway that may prevent that “same old same old” mind set.

Protect yourself from that it’s me and me alone feeling. No one success story in any profession, business or leadership role, was ever accomplished by just one individual alone. Plans are devised policies & procedures are written but it takes the entire team to create a synergy – whereas; combined effect of the sum of all is greater than individual efforts. Remember … “IT TAKES A VILLAGE”

Here are a few qualities that a successful team possess.

  • Group focus on goals and mutual support of each other’s achievements
  • Everyone contributes their fair share – jointly collaborating towards a common action plan
  • The team offers each other support & develops natural synergy amongst the group
  • Unity of individualized members creates a collaboration of diversity that creates success
  • Good leadership is balanced by each individuals unique leadership style

Look around for Validation
Look for those rewards that which is not spoken; those quiet subtle nuances that speak volumes. You will see that in the smiles, it will present in the body language, it will be reflected in the positive behaviors and in the active engagement of those you serve. Take time at the end of each day or week to reflect on what went well and what didn’t go as well. This task helps you to recall both what you’re good at and why you do what you do. Concentrate on the positive to nourish your self esteem and self-validate your achievements. Those external sources charged with rating you in the work world will also see that you have that special quality – that capacity to improve the quality of life of others in a meaningful way.

Look to move away from the desire to obtain external validation; fulfillment, job burnout prevention and real validation will come from within and will always lead to a proven success story.”

Internal Validation to Prevent Job Burnout …. 
Author : M. Celeste Chase AC-BC, ACC, CDP
Activity Directors Network -

What’s The Difference . . . between Adult Day Centers?

Author:  M. Celeste Chase, ACC, CDP
               Activity Directors Network

-Medical, therapy and socialization centers
-Socialization and safety centers
-Alzheimer’s and dementia care facilities

Adult Day Centers are either social or medical in nature with specifically trained and compassionate staff that creates programs to meet the needs, preferences and cultural differences of those they serve. These facilities offer supportive assistance by way of physical activities and cognitive stimulation and/ or medical care during the day-time hours (no overnight stays).

 Family members can plan for daily “predictable respite” for which they might use to relax or go to work or run necessary errands (without the added burden taking their senior loved ones with them). When participants go home to be with their families after a day at the center, families will find their loved ones happy, stimulated, alert and often more ready to sleep soundly through the night. Giving the entire family a most welcomed nighttime benefit which is often desperately needed. Without a doubt adult day health programming leads to improved well-being and increased socialization within a safe, nurturing and comfortable community setting.

Medical vs. Social  - There are two types of adult day care:
Both provide a comfortable, secure place for a senior to reside during the day, enabling them to socialize, stay active, remain productive and enjoy an improved quality of life, Typically, the center provides one or two meals a day. Some centers provide transportation for pick up and/or drop off, which may or may not be included in the cost.
The main difference between medical and social day care is that the medical model also provides an array of medical professionals, which may include on-site registered nurses, speech therapists, occupational therapists, physical therapists, social workers and registered dietitians.
Keeping it simple; the easiest way to identify the difference between these two centers is to take a look at the name. An “adult day care” facility, without the word - “health” in the title are not required to adhere to the same standards and regulations and do not offer the availability of on-site health care professionals from a range of disciplines to provide clinical oversight.

Adult Day Centers and Offerings
Socialization and safety centers – Adult Day Care

Adult Day Care Many centers have well-trained activity specialists who lead dynamic activities programs.  These programs might include arts and crafts, intergenerational programs, music, cooking classes, exercise sessions, movies, discussion groups, live entertainment and trips into the community.  Some care centers offer programs that are especially designed for physically frail individuals with special medical needs such as diabetes, hypertension and post-stroke disabilities, and those with mental health challenges such as dementia, confusion and Alzheimer's disease.  The goal is to be an extension of the home environment with caring, personalized service. These centers rely on private pay reimbursement for services provided.
Medical, therapy and socialization centers – Adult Day Health

Adult Day Health centers offer all of the same services you would find in Adult Day Care centers mentioned above, in addition; they provide ” certified” amenities via trained health care professionals such as physical, occupational and speech therapies, nursing services, personal care, social services and much more depending on the individuals acuity level assessment. These centers are prepared and well equipped to enroll not only very independent individuals but also those with chronic physical illness and/or cognitively challenging needs.
Most states have specific governing bodies that work to establish procedures for licensing and regulation standards to oversee the business of Adult Day Health “medical” care centers. These regulations are mandated and centers are required to adhere to guidelines and protocols to be given licensing privileges. These standards are not only specific to medical record guidelines but are also required for the centers to qualify to submit billing to Medicaid and/or Medicare for reimbursement of services on behalf of those participants pre-approved to receive these benefits.

Alzheimer’s and Dementia Care centers – may be found in either social or medical model centers (medical facilities usually provide for more advanced stages of the disease).
Many dementia patients are at risk for safety and cannot be left unsupervised. Progressive memory and cognitive decline may lead to potential for wandering, risk for self harm from misuse of everyday regular household items. This puts family caregivers in a difficult position, especially if outside help is scarce and/or family members are still working. Dementia programs at adult day centers typically utilize security features to prevent wandering as well as improved staffing ratios to ensure seniors are safe and their needs are met in a timely manner. This provides invaluable free time and peace of mind for the dementia caregivers. Skilled Adult day centers that specialize in the care of those with dementia are becoming more and more in demand in light of the increased numbers of seniors diagnosed with this disease over the past few years. Many states require centers to have staff members obtain specific dementia  training to care for this population.  Trained professionals are able to recognize those seniors that prefer quiet, solitude like environment while others are in desperate need of more stimulation. This expertise proactively minimizes potential disruptive behavior by addressing each     individual’s unique needs. State regulations have been written to target this topic requiring medication management to modify behavior to be used only as the last option after it is documented that all non-pharmaceutical interventions have been implemented without success through the individualized care plan.

Adult Day centers provide an array of activities for attendees to participate in; adapted to each person’s unique abilities to maximize enjoyment and minimize frustration.  Many centers also offer flexible scheduling choices from attending just a few hours each day to attending the entire day for one or more days per week.  The affordable cost of care for Adult Day allows these centers to be more accessible to a wide range of families for senior care options. Clearly, Adult Day Centers are the go to choice for those looking find support that fits into their family values and needs while allowing them to keep their loved one at home.

Author : M. Celeste Chase, ACC, CDP
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