What is Adult Day Care?

What is Adult Day Care?  We are joined by Julie Tombardi, the seasoned administrator of New Day Adult Day Care Center to discuss all of the nitty-gritty details of what Adult Day Care is, what to expect, cost, and why this might be a great solution for your senior and family.

Julie sheds light on the multifaceted benefits of adult daycare, not just for seniors, but also for their families. From offering a cost-effective alternative to home care to providing consistent healthcare monitoring and various engaging activities, adult daycare centers are a lifeline for many. The conversation takes a deep dive into practical advice, from overcoming the reluctance of seniors to participate to the importance of visiting and assessing daycare centers before making a commitment.

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Transcript

Darleen Mahoney [00:00:01]:

And today we welcome Jolie Tombardi. She is the administrator of New Day Adult Care center and has a bachelor's degree in psychology with a minor in gerontology. I'm not even sure I pronounced that right, but we'll just get back into that. She started working in adult daycare in 1991 as an activities director in a small organization in Massachusetts. But since 2007, she has been the administrator of New Day Adult Care center in Florida. She is certified Alzheimer's Level 1 and 2 trainer in the state of Florida and was trained through the Alzheimer's association to lead caregiver support groups. Thank you so much for joining us today, Julie.

Julie Tombardi [00:00:44]:

Thank you so much for having me.

Darleen Mahoney [00:00:46]:

I'm really excited to have you. I've been wanting to talk about this subject for a while, and I know that you currently work with us. And so what a great opportunity for us to connect and chat about this because. Because it's something that. It's a great solution. Adult daycare that a lot of people don't even know it exists.

Julie Tombardi [00:01:05]:

Correct. And it's still surprising to me that people still don't really know of that option.

Darleen Mahoney [00:01:09]:

Yeah. I was actually talking with someone this past weekend who was trying to kind of figure out they don't work in the home, but they wanted their parents to live with them. But the home care for eight to 10 hours a day every day was just not something sustainable. Sustainable. And she was worried about her mom having those social skills and things like that. So I told her about this and she's like, what are you talking about? I've never heard of this before. So we're going to educate some folks today on what is adult daycare.

Julie Tombardi [00:01:43]:

Excellent.

Darleen Mahoney [00:01:44]:

Perfect. So the question is, in a nutshell, what is adult daycare?

Julie Tombardi [00:01:50]:

Well, adult day care is a program that provides supervised daytime care and activities for people with physical and or cognitive impairments. The goal is to keep people in their home as long as possible. So they come to the program during the day. They have their activities, their healthcare, meals, help with personal care if needed, and then they return back to their own home in the evening.

Darleen Mahoney [00:02:19]:

Yeah. That is such a perfect solution if you're trying to keep your loved one at home, but you still have to work. And then you can maybe use those home care services on weekends or things like that when you might have a date night or you have a function that that person cannot attend. So that's a great opportunity to be able to save money and kind of get the best of both worlds.

Julie Tombardi [00:02:42]:

Definitely. And it is a big huge savings. I mean for that person for sure you can, I mean what you can get at adult daycare for 10 hours in a day is huge. As opposed to the home care cost of that 10 hours. It makes a very big difference.

Darleen Mahoney [00:03:01]:

Exactly. And sometimes it's really difficult to get home care for all those extended periods of time. Especially with one person with someone that's familiar, which in my case and in most people cases when they do look at home care that's preferred that you don't have rotating people coming in and out, you have someone fairly consistent.

Julie Tombardi [00:03:18]:

Absolutely. And that's nice at the day program because people really the qualities and the details and everybody knows that. So everybody who works at an adult daycare needs to know how to care for those people specifically. And if someone's absent, there's someone right there to help.

Darleen Mahoney [00:03:36]:

Yeah, exactly. No, I love it. So who benefits from adult daycare? So I feel like there's like a more than just the person that is attending and joining adult daycare. But it extends kind of a little bit about what we talked about. But just be a little bit more specific on what some of those benefits are for those folks.

Julie Tombardi [00:03:55]:

So for the participant themselves, I would say, I mean the benefits are huge because I mean if somebody provided you purpose in your day, I mean right now, if they're just home, sometimes part of the issue is they just feel like they have nothing for them anymore. They have no purpose. So to have a purpose, to be able to socialize where humans are very social beings. So to have be able to be around people, make friendships, participate in activities and feel joy while you're doing so makes a huge difference in their emotional and even in behavior wise things can settle down a lot. The other thing for the participants is just the health care adult daycares. Most have nurses, not all, but the things that can be caught in adult daycare just by doing monthly blood pressures that you normally wouldn't maybe do and you catch something and then you pursue further and then you find there is something or just those little nuances that change in a day where I've never heard that person ask that question before, that seems a little weird. Wait, why are they having trouble getting up when they usually don't? And just a little bit of a change can be Covid, you know, they can have to go to the doctor and be seen and it can be missed, but can be picked up more easily in a program when you have so many eyes on everybody. So the healthcare I think is huge.

Julie Tombardi [00:05:27]:

But mostly the Socialization and having a purpose and being around people and feeling good every day for the families, for the caregivers. Well, first of all, most lot of day programs do support groups, and if not, they will certainly help connect people to support groups, which is huge. Not feeling alone in this world of caregiving is a big deal for people and to know that other people are struggling as well. But the other thing is they have peace of mind. They know their loved one is being cared for during the day, and they can take a break just because it's hard to be 24 hours a day on as a caregiver. They go to work, they can just do something for themselves because, as you know, if you don't take care of yourself, you can't take care of others. So there's so many benefits for both the caregiver and the participant.

Darleen Mahoney [00:06:20]:

Yeah. I feel like if you are consistently staying at home and you might have home care, you might not. Or even if you're staying in a home where someone's working and they're out of the home and you are taking care of yourself and you maybe shouldn't be, but you might be. But even if that person's working remote, your caregiver's working remote, they don't have time to spend with that person that needs additional care. And what ends up happening is a lot of TV consumption.

Julie Tombardi [00:06:49]:

A lot. Yes. Yep. And just, you know, brain body health, if you don't use it, you lose it. Right. So the more you engage in the multiple different things that can happen at a day program, because, I mean, that's the whole point. There is social activities, there's cognitive activities, there's physical activities, or there's spiritual activities. So you're trying to involve all of the things that they can benefit from during.

Julie Tombardi [00:07:14]:

In the day.

Darleen Mahoney [00:07:16]:

Yeah. And I know that we've talked with so many different dementia experts and talked about dementia in general and brain health and all these different things. And social activity is absolutely huge to keep that noodle healthy and going. And then if you're doing projects, you're. You're going beyond that social. You're doing things that make you think.

Julie Tombardi [00:07:38]:

Absolutely. I can say two things. One is when my father was starting to have. My personal father was starting to have some memory issues. That's the first thing the neurologist told him. I'm not giving you any medication. You need to go get involved. You need to go be around people.

Julie Tombardi [00:07:54]:

Because he was just in his home all day and he was doing okay, but not great. So did he do that? Maybe a little, but it would have been good if he did a lot because it changes things. But the other thing is, you know, they say be social, engage yourself, all that to help maintain as long as possible. And we really saw it during COVID when we had a lot of participants before we needed to close at that time. And when some of them came back when we reopened, those people couldn't even do bingo anymore, which was really like, you read it, you know, it's true, you know, that they need that stimulation. But then we just saw it. I mean, that just kind of sealed it for everybody. It was so clear what two and a half months in your home not engaging in that way did for people.

Darleen Mahoney [00:08:51]:

Yeah, yeah. And some places were even closed significantly longer than that.

Julie Tombardi [00:08:56]:

Yes.

Darleen Mahoney [00:08:57]:

So. And I know that even during that timeframe when we were talking with different medical providers, that the depression that was becoming significantly more. Not relevant, but higher rates in seniors specifically was just apparent. I mean, it was absolutely apparent. The depression rate from being locked in their homes, from being alone, from not having that social engagement just had on them.

Julie Tombardi [00:09:27]:

And from the other side of it, too, we see people coming into the programs that are. Well, for our example, for my program anyway, we have two different sides. We have a regular side, and then we have a cognitively higher functioning that works on trivia and word games and brain games and things like that. So just on the, on the coming inside, we see people, they start in the regular program because they couldn't do it, but over time, now they're socializing, they're doing more, and we're like, you know what? Hey, I'm going to walk you over the other side. I want to see what you're thinking of it over here. And they're doing fine and happy as can be. So just, you know, allowing yourself to be part of something is just so important.

Darleen Mahoney [00:10:15]:

I mean, I feel like your quality of life shouldn't be discounted just because you're starting to have cognitive issues or you're getting older. You still need to look for those ways for your quality of life to be the best that it can be. And I think this is a great opportunity for some of those folks that are just watching television or they're not paying attention to things that are going on because they're just not being engaged the way that is healthy.

Julie Tombardi [00:10:39]:

Absolutely. Yes.

Darleen Mahoney [00:10:40]:

Yeah. So one of the things you mentioned is cost, so that it's less expensive to do adult daycare versus, you know, home care for eight to 10 hours a day, which can be Completely unfeasible. Unfeasible. Especially if you're, you're paying for it and you're working and I mean your salary. It's almost like daycare for children that we are seeing now. The cost can sometimes outweigh what you actually are bringing in.

Julie Tombardi [00:11:08]:

Absolutely.

Darleen Mahoney [00:11:09]:

So what are the expectations? I know they're probably different in all different parts of the country, but what is the average? What does that typically look like?

Julie Tombardi [00:11:16]:

So, you know, because I knew this was all over the country, I was trying to think about that a little bit. So I have seen as low as 50 and as high as $125 day. And I think there are a lot of programs in many different places that can help assist with that. First of all, long term care insurance, if anyone happened to buy into that. Absolutely. Pays for adult day care. The va, if the person's a veteran themselves, has a program nationally that will help, that can help pay for, for adult daycare. There are, in different counties, there's always, there's always these little programs that can also assist and it's different across the country.

Julie Tombardi [00:12:08]:

And but so for us, for my program, we are right in there with like the Palm beach county, the general norm. But I would say in our area it's probably 75 to $100 a day for a full day. But many programs also have half day rates and some programs even do hourly. So there are ways to combine it in ways that work for you.

Darleen Mahoney [00:12:38]:

Yeah. So check, check into it. So Yeah. So check, check into it. So one of the, and the other thing that I wanted to ask, so there's what are things that are provided with adult daycare? I know that I believe that one around here that's located in my area actually provides transportation. So they'll come and get your sen. And then also bring that person back at specifically designated times. Is that something that's normal or is that. Because to me that is bonus.

Julie Tombardi [00:13:03]:

That is a bonus. I don't, I'm not sure if it's normal or not normal, but it's definitely, I'm going to say it's probably 50, 50 for. Who doesn't, who doesn't do that. So some places have public transportation. Not public, public, but like I know in Massachusetts they have like the ride or in Palm beach county we have Palm Beach Connect. So that is a very, very discounted rate for a person to person pickup and drop off service. So it's like $3.50 here, let's say. So there are some of those even if you don't have your own vehicles.

Julie Tombardi [00:13:46]:

But Many, I would say there's many across the country that have their own vehicles. And it is a great, great service. It is. I had it when I was an adult day. When I was a day program administrator in another state for a period of time. And it's stressful. It is a stressful thing to be driving around with people. And I give them a lot of credit for doing that 100%.

Darleen Mahoney [00:14:13]:

I even know that driving with my dad who had dementia, we'd be in the car five minutes and you'd think we'd been in it for five hours because he just. Why is it taking so long? I don't understand. Why are we, what are we doing? And it was just. I would literally have him watch the GPS for me to take him and go up to Publix because he needed to see how long it was going to take to get there. Because time is completely different for a lot of people with cognitive impairment, their relation to time. So for me, I was just like going, I can't imagine doing a long road trip with him. I don't think he could have handled it. So.

Darleen Mahoney [00:14:50]:

Yeah, yeah.

Julie Tombardi [00:14:51]:

So transportation is a good bonus. Some programs, you're asking about services. So some programs have nurses and some do not. The ones that have nurses, they can do medication administration. They can, they do health monitoring. There's physical therapy, occupational therapy, speech therapy, cognitive therapy. Some places do flu vaccines at their facilities. Some places.

Julie Tombardi [00:15:19]:

So there's a lot in the healthcare world that can be taken care of at one stop or podiatrists come in, things like that. So there is a lot that can be done in that realm. Many programs, programs vary on what level they'll handle in terms of cognitive impairment and in terms of physical impairment. Some people will do a two person assist for helping somebody in the bathroom. Some people will only do a one person. Some places will only do one person assist and some places don't do any hands on, where they just have to be able to, they can walk them in, but then they have to be able to do their personal care on their own. So there, there's a big difference in that. So this, there's just so many.

Julie Tombardi [00:16:07]:

I think it's comparable to assisted livings where there's just so many nuances of each individual place of what, where they're at and what they're capable of doing. The activities is. That's what we do. If there is no activities, there is nobody coming to us. So they come for the programs, they come for the joy, they come for the parties, you know, the things that you try to make special for them and they have to be all day long. There's no beds to go to, there's no place to lay down. Well, there's recliners to lay down if you need it. But you know, there's no private areas to just go back to your room.

Julie Tombardi [00:16:44]:

So if you're not doing activities every minute of the day, then people are okay, ready to go. Where's my driver going? So keeping people engaged all day long.

Darleen Mahoney [00:16:58]:

Yeah. Oh my gosh, that's incredible. And you know, one of the things that, you know, price point wise, if you're getting all those added health benefits from, you know, like a podiatrist that's coming in and getting your blood pressure checked and actually the second pair of eyes. Because I sometimes think that, you know, when you're living with someone, you might not see a digression or anything like that. Whereas if you've got someone else, especially someone that's a professional, working with people every day, they're going to notice that more and that's going to be helpful in getting extended care or getting, you know, any additional help that person might need.

Julie Tombardi [00:17:32]:

Yeah, I agree. I think it's just, it's natural if somebody is declining or changing, you're slowly compensating for them. When you live with them and unknowingly and you don't even realize where they're really at. And it does. It is good to have that other perspective. And it's hard to see. It's not like you can just take them to the doctor or nurse's office and sometimes, you know, they can hold it together for a little bit and you don't. They don't see the true person as they are at home.

Darleen Mahoney [00:18:02]:

Yeah, it can be. And I love the way that you put that. I've never heard it termed that way that you will compensate and not realize that you're doing it.

Julie Tombardi [00:18:11]:

Yeah, I think it's just a natural thing. It happens a lot. Most people, it happens with. They know something's different but you know, they're just slowly. Oh, slowly I'm going to start taking this over or start doing this. And it's hard to see where they're really at.

Darleen Mahoney [00:18:26]:

It is. And I definitely did with that with my dad before I got a proper diagnosis in actuality, kind of trying to make excuses for some of the things that were going on because I didn't want to like wrap my head around that this is actually could be happening.

Julie Tombardi [00:18:40]:

Absolutely.

Darleen Mahoney [00:18:41]:

Yeah, yeah, yeah, absolutely. So I know the question, the answer to this, but you can expand on it. Should you visit an adult daycare before committing to one?

Julie Tombardi [00:18:54]:

Yes, absolutely.

Darleen Mahoney [00:18:56]:

Good answer, good answer.

Julie Tombardi [00:18:58]:

So I think you can listen. I can describe over the phone all day long what my program does, but until you see it and feel it, you don't really get it. So, yeah, you definitely have to see it. But also I think you want to see. You want to see people that are well cared for. You want to see a place that feels comfortable. You want to see staff that look happy in their job and. And want to hear about the longevity of the staff that are there and what type of programs.

Julie Tombardi [00:19:26]:

In fact, I used to give tours at any time of the day, whatever was convenient for you, and I still will. But I really try to do it during the times of the most people are there with the most activities, because that's where you're going to know, would my father do this? Would my mother participate in this? Are they going to be comfortable here? That's how you know you have to see it and see that people are well cared for and hear how the staff interacts. And you can't do that from a phone call.

Darleen Mahoney [00:19:57]:

No, absolutely. And I think to go in and even see the. They're not residents, because that's senior living. Participants. Participants. Okay, so we'll do this. Participants. See who your mother or father or loved one or whatever the case may be is going to be interacting with while they're there.

Darleen Mahoney [00:20:16]:

Is this a potential for a new friendship? Because there's some really great ladies there that maybe enjoy some of the same things or chatting. And I think it can help you kind of imagine that your, your parent is able to make some of those connections for a better quality of life as well.

Julie Tombardi [00:20:34]:

Yes. I equate it to like picking out a college. I'm in the process with my son doing that. And I keep saying as we visit, do you see your people? Like, you have to see your people, you have to see yourself. What they're doing is exciting to you from what you see. You have to be able to feel that. And if you don't, then it might not be the right fit. And I even encourage people, I usually encourage families to try to come once with the first time without the person because they know them best, so that they'll be able to.

Julie Tombardi [00:21:06]:

I'll be able to explain it without being careful exactly what they're seeing so that they can really understand what we do and then bring it to them in a way that's going to help them Say yes. And then they can come back with the person for sure. And they can come back and observe and stay for two hours and figure out if it really is for them, you know. But I just think it's really good for families to see it first.

Darleen Mahoney [00:21:33]:

Yeah. I did have another question. So talking about, you know, your loved one being there in security and things like that, do you typically have cameras or anything like that that's keeping an eye where. I mean. And you may not know the answer to this because this is just completely out of left field, because it just popped into my brain, which happens on occasion. If those folks are able to kind of look and see, you know, check in on their parent, if they're leaving them for the day to kind of see the activities that they're doing, is that something that's normal or is that something that.

Julie Tombardi [00:22:06]:

I am not really sure. We don't do that. I don't. I don't know if there are other day programs that do. I haven't heard anybody really talk about that. I know they do that in childcare and it's kind of getting more and more regular. Yeah. So.

Julie Tombardi [00:22:21]:

But I'm really not sure if they do it in adult daycare.

Darleen Mahoney [00:22:25]:

We do not.

Julie Tombardi [00:22:26]:

But, you know, we tell people, if you're nervous, call. Call a thousand times a day. If you feel like you need to come peek in through the wind, don't let them see you, but peek in and see what's going on. Whatever you need unannounced is fine. You just have to feel comfortable when you're leaving your loved one.

Darleen Mahoney [00:22:43]:

Yeah. And that's a lot of it as well. Even in, like, assisted living, it's. If you leave your loved one there, you have to have the trust in those employees that are taking care of your loved one every day to have that commitment. And I will say that if you build a rapport with them, you'll definitely get a better idea. Really get to know that person that's working with your loved one. I think it's really important to have that. It builds that trust.

Darleen Mahoney [00:23:11]:

And then also that camaraderie when you go to pick that person up, where you have a good, frank conversation as well.

Julie Tombardi [00:23:17]:

Absolutely. Communication, I feel like, is the. For me, is the biggest thing, is I will tell everything that's happened. And when I see them, they're going to know what's good, what hasn't been good, that I don't like. I don't want them to have any surprises because as a parent, I don't want any Surprises. I don't want me think my kids doing fine at school and then one day find out that was completely not the truth. You know, I didn't want to know what's going on. So.

Darleen Mahoney [00:23:45]:

Yeah. Yeah. So one of the things that you kind of hinted at is when you're taking someone, like when you're visiting, when you're taking your senior or your loved one to visit, to want them to want to go and encourage them to go. So if my dad was very stubborn and I don't think that's typically highly unusual. No. So how do you. What are some things that can benefit someone that may think that their. Their loved one is not going to go or not going to want to go? What.

Darleen Mahoney [00:24:20]:

How can they kind of move them in that direction, encourage them to participate in adult daycare?

Julie Tombardi [00:24:26]:

It's a hard question because this. Everyone's so individual and you don't know what's going to resonate to that person. But they're. So we have suggested have the doctor say it, you know, and give a timeline. We want you to do this for one month because of. We think this is going to help you maintain as long as possible. Whatever the doctor says, I want you to do this for one month. When people feel like they have an out, they're willing to try.

Julie Tombardi [00:24:54]:

And time, like you said, they don't really remember time as well as they used to. So it's not like they're like, all right, one month is up, I'm out. And even if they were feeling that way, usually within a couple days, they're good. They just have to get them in the door. So the doctor telling them, unless they hate their doctor, usually works. Sometimes I say get that favorite son from California to ask him to do it, you know, just for them. Sometimes it's, you know, it depends on the husband, wife dynamic, whether many people will say, you know, just do it for me, I just need one day. And usually it turns into a lot more.

Julie Tombardi [00:25:42]:

No matter however they start, we have people come in as volunteers. Sometimes they feel as though they're helping us. So that is a way to get people in because they feel like they're helping others or helping the program in some way. So there are a lot of little things, but you got to kind of figure out what's the catch for that person. The. Sometimes we have a program called the Integrated Memory Enhancement Program. And with that program, it tends to attract your father because they don't want to come, but it isn't. It's geared towards cognitive programming to help them maintain.

Julie Tombardi [00:26:32]:

So it tends to get professionals in that aren't going to play bingo, aren't going to sing along. I'm going to, you know, some of the things that you do in the regular day program, and they feel like it's a more professional setting, they can see themselves with those people. So sometimes you have to, like, kind of just switch some of the programming to make it fit the people, and then you can get enough people to kind of switch around a little bit. But there's no perfect answer to that question.

Darleen Mahoney [00:27:04]:

No, there is not. And I will tell you, you have to kind of figure out with your loved one what works. I know that with my dad, he never went to adult day care. He passed away years ago, right before COVID But one of the things with him is when I realized I had to take his car keys away, that was not going to go well coming for me, I can absolutely tell you. He would have thrown himself a fit. So I told him that the police had told me that they needed him, his keys, and he was fine with that. Because a lot of seniors, they have a lot of respect for authority, which is, you know, not what we're always seeing these days with some of the younger folks. But that is one of the things that I found that my dad really respected.

Darleen Mahoney [00:27:47]:

Things that the police. The police would say to him or his doctor would say to him. And if that was something they recommended or told him, he was on board with it because it was coming from a place of authority. So you're right on that. Having the doctor mention that, I think that's a great idea.

Julie Tombardi [00:28:03]:

And I've even had husbands or wives tell their husbands that, you know, there's. When you're really at the end of your rope and nothing else is working. People of that generation fear the home going to the home because their parents or grandparents had to go to the home. So they're not going to do that. So, you know, some of some people just go to that point where they say to them, listen, you're doing this for two days a week so I can get a break or you're going to the home. And not that I'm recommending that threat, but people do do that sometimes, and it is a reality. They are going to have to put them somewhere if they can't get a break somehow.

Darleen Mahoney [00:28:46]:

So, yeah, and I will say this. The fact that you have activities and all these different things, it does make their day, I would imagine, fly by a little bit more. That along with the fact, and give them something to look forward to, to go to. Especially once they get into a routine. I think that that's a big deal too, getting into that routine. If you're going, then you have that expectation. You get up and you make it happen. So.

Julie Tombardi [00:29:07]:

Right.

Darleen Mahoney [00:29:08]:

Yeah.

Julie Tombardi [00:29:08]:

I think, you know, for some people, you can't. Most people, you can't say adult daycare or anything like that because that just feels. That's not for me. Some people, we. Sometimes it's good not to even have a conversation. Just come, just show up in the morning, hey, let's go get a cup of coffee. Should have the coffee with us. Somebody walks up, they write a little note, hey, I love you.

Julie Tombardi [00:29:30]:

I have an appointment, I'll see you at 4:00. And they kind of walk out. And then we deal with trying to figure out how to keep them happy and entertained. And sometimes it completely works and sometimes. Okay, that didn't work. We're going to try something else next week.

Darleen Mahoney [00:29:47]:

Right, Right, exactly. Well, that's so much great information. Do you have anything else you want to add before we sign off on this podcast episode?

Julie Tombardi [00:29:58]:

I don't think so. I think we covered a lot.

Darleen Mahoney [00:30:01]:

Yeah, I think we covered quite a bit. I really appreciate your time, your expertise, and your willingness to share information with our listeners. You know, hopefully to build a better quality of life for everyone involved and give them different options. Because I think there's no, you know, one stop solution for everything. I think you have to really figure out what works best for you and your family.

Julie Tombardi [00:30:23]:

Yes, definitely.

Darleen Mahoney [00:30:24]:

Yeah. And that caregiver for sure.

Julie Tombardi [00:30:26]:

Yes. Because without the caregiver, there is definitely not staying at home at that point.

Darleen Mahoney [00:30:31]:

No, exactly. Exactly. Well, thank you so much for joining us. I think we're going to go ahead and sign off on this podcast episode. If you enjoyed this episode, we are available anywhere you enjoy podcasts or music such as Spotify, Apple, Good pods. We're on baby boomer.org check us out there. And until then, thank you for listening.