What are Adult Day Services?

Adult Day Services programs offer daytime care for frail elders and younger adults with disabilities in a group setting. Participants have chronic health conditions and benefit from supervision and socialization. Programs can arrange and often pay for transportation to and from the Center, or family members can transport. Participants spend their day involved in stimulating activities and interacting with their peers. ADS programs provide a wide range of activities that support and promote independence for frail elders and younger disabled adults who are at risk for falls, ongoing physical and cognitive decline, and depression. These programs are an affordable alternative to home care and are more effective in alleviating isolation, encouraging health promotion and exercise, and providing intellectual stimulation. ADS programs help people connect with one another and remain part of their community. For many, the friendships that develop promote a sense of well-being and mean the end to isolation and despair. Programs provide a safe environment in which to spend the day while the caregiver is working or needs respite (time away from caregiving duties).

Who needs Adult Day Services?

Adult Day Services programs provide services to frail elders and younger adults with all types of disabilities including strokes, Parkinson’s Disease, Alzheimer’s Disease/dementia, multiple sclerosis, brain injury, mental illness and developmental disabilities. Many of these individuals wish to remain involved in the community and want to live in their own home or assisted living facility versus living in a nursing home. Potential adult day participants are generally isolated, need help caring for themselves, and/or need supervision to remain safe. A typical participant is an adult with a chronic health condition, living with family members and is unable to care for him- or herself due to physical and/or cognitive decline.

Caregivers need these programs so they can continue to work, take a break from the challenges of caregiving (respite), and take the time to care for themselves and their families. Adult Day Services programs provide caregiver counseling, support, and information and assistance so that the caregiver can maintain their loved ones at home for as long as possible.

What is Adult Day Health Care?

Adult Day Health Care (ADHC) is a licensed health care facilit,y and the quality of care is monitored by the State of California. Anyone can be referred to an ADHC, but the participant’s primary care physician must prescribe services before someone can be evaluated in the program. ADHC's provide health monitoring, (for instance, blood pressure, insulin and medication monitoring), as well as rehabilitation, social services, and therapeutic activities through an individualized treatment plan. ADHC has a prevention focus, provides necessary health monitoring, promotes independence through physical activity, and provides a supportive environment that focuses on the positive aspects of the person’s abilities. The care plan is focused on preventing frequent hospitalizations, ER visits, or premature institutionalization while enhancing the quality of life of the participant through meaningful activities and social support. The treatment plan focuses on the caregiver needs and provides support to reduce the stressors of caregiving.

Adult Day Health Care Services are provided by a team of professional health care providers. The team includes: nurses, medical social workers, physical, occupational and speech therapists, dietitians, certified nursing assistants, psychologists, activity coordinators, and a medical director.

How does Adult Day Services (ADS) differ from the Senior Center?

People who access a senior center are often able to transport themselves and participate in some activities that may be difficult for someone who is frail or has memory impairment. ADSNV is a Health Care Center, prescribed by a participant’s physician, and provides individualized treatment for each participant so that they can be successful in the environment. There is an RN on duty at ADSNV during programming hours and each person’s care plan focuses on maintenance and improvement of overall well -being.

What types of activities are offered at the Adult Day Services (ADS) Program?

Adult day services programs offer a wide variety of individual and group activities. Activities are designed to engage participants, encourage physical activity and mental stimulation and take into consideration the person’s interests, life story, and abilities. Activities may include: yoga, Pilates, reminiscence, music therapy, art therapy, horticultural therapy, current events, cooking, intergenerational programming and pet therapy. Activities are therapeutic and focus on enhancing the participant’s capabilities.

How do I encourage my family member to attend an Adult Day Services (ADS) program?

It is normal for someone to feel apprehensive and nervous when coming to ADS program because it is a new and unfamiliar situation (especially for those who have not been involved in a social group setting for a while). When someone has memory loss it can initially be challenging because the person relies on the caregivers as their touchstone. It generally takes three to four weeks for a new person to feel comfortable. Staff are introduced to each new person by learning about the person’s life story and interests. Greeters are assigned to the new person that have similar interests to help ease the transition.

Days of attendance are usually chosen based on therapies and activities that match the participant’s interests, and when visiting the program it can be best to come on a day of a favorite activity. Many participants feel more comfortable attending if they have an identified volunteering role in the program such as helping with lunch or watering plants. If someone is uncomfortable in large groups, activities can be adapted to a smaller group setting and participant’s are allowed quiet time when they need it.

Although anyone can refer to ADS, a doctor’s referral is needed so it is often helpful to let the participant know that the doctor has recommended the program. People should be encouraged to give it a try. It is not uncommon for someone to have one reaction with the caregiver, but attend the program and have a good day. Staff is available at all times to support the participant’s transition and help the caregiver get the much needed break from caregiving that they need. Ultimately, the program benefits both the participant and the caregiver.

Describe a typical day at Adult Day Services (ADS)

A typical day begins by participants arriving by Vine Go (public paratransit services) or with their family members. They are greeted by staff and start the morning off having coffee and conversation with their friends and staff. After that, formal activities begin in larger and smaller groups based on people’s interests. See list of activities above. At the same time, participants also receive the services according to their care plan which may include physical therapy, occupational therapy, speech therapy, a nursing visit, social services 1:1 visit or a small support group. Throughout the day participants are assisted with personal care given by the program aides. A hot lunch is served at noon and then activities resume until participants go home at around 2:30-3:00pm.

Can a participant with a walker or wheelchair attend?

Yes. We have Program aides who assist with walking and transferring as well as help with personal care. In addition, each participant is evaluated by our Physical Therapist and Occupational Therapist who develop an individualized treatment plan and inform staff of safety needs and techniques to maximize the participants independence.

How do I get started?

To get started you can call our Intake Coordinator, Ruby Uran, email us, or fax ADS your contact information or the contact information of your client or patient. Once we have a name and number we will call to set up a program visit and provide the prospective participant and caregiver with the necessary paperwork to initiate the assessment process and enrollment.

How much does it cost?

In many cases Adult Day Health Care is covered by Medi-Cal, VA healthcare, and some long term care insurances. For those not covered by these programs, we offer a sliding fee scale based on income through our scholarship program. Adult Day Services provides a daily rate for those who pay privately. This rate is significantly less than private home care. Please call to inquire.

What are your hours?

Our program hours are 9:30am-3:00pm, Monday through Friday.
Extended care hours are available from 8:30am – 4:30pm.

How many people do you serve?

Our facility is licensed to serve 100 participants a day; on average we serve 50 participants a day. In addition, we serve caregivers and people through our support groups, community outreach program, and MindBoosters.

How do I get more information on caregiving?

You can call ADS at anytime and speak to one of our social workers who can provide you with more information and resources regarding caregiving. Our social workers are also available for free family consultations. ADS has a free lending library that has many resources on Alzheimer’s disease and caregiving. We also provide caregiver support groups on site during the day and evening.

What qualifications does your staff have?

Our staff consists of licensed and experienced health care professionals that have extensive training working with frail elders, younger disabled, and persons with Alzheimer’s disease and related dementias. Staff attends monthly inservices and trainings for ongoing professional development.

What is the staffing ratio?

We have a 1:8 staff ratio for our Adult Day Health Care program and maintain a 1:5 staff ratio for our Alzheimer’s program.

Do you help with personal issues, such as tolieting and/or incontinence?

Yes, as part of the participant’s care plan, the nurse evaluates what each participant needs. Physical therapy and occupational therapy make recommendations in terms of safety and independence. Based on the care plan, the program aides provide assistance for those who need reminders to use the restroom and provide the hands-on care necessary for those who need assistance. We ask that the family provides incontinence products to be stored at the center. Because personal care is personal, staff are sensitive in working with participants to promote their dignity.

How do you deal with difficult behaviors?

Staff is highly skilled in dealing with difficult behaviors. Staff are trained in communication techniques to reduce agitation. Staff use redirection, David Troxel’s and Virginia Bell’s “Best Friends Approach,”, Naomi Feil’s Validation Therapy, and person- centered care. Difficult behaviors are often a participant’s way of communicating an unmet need and staff try to anticipate and meet those needs.

What is your service area?

We serve all of Napa County and the City of Vallejo.

How does transportation work?

Once a participant is enrolled in the program, we use the Napa County Paratransit Bus Service (Vine Go) for transporting eligible participants who live within the City limits in Napa County, and we use the Alta Bus Services for participants living in the City of Vallejo. These are door-to-door services. Staff assists the participant in completing a transportation plan prior to enrollment. Vine Go and Alta Bus Services does a property check to ascertain that the location is accessible to the bus, and that the property is within their service area. Upon enrollment, when the days of attendance have been determined, the staff schedules the participant with the appropriate transportation services. Caregivers also have the option of transporting their family members to and from the center; typically this option is used when caregivers request extended care hours.

How many days should I or can I attend?

Participants attend anywhere from 1 day per week up to 5 days per week, based on medical necessity and the participant’s and/or the family’s needs. The number of days a participant attends is determined during the 2 days of evaluation, prior to enrollment, when the participant meets 1:1 with each of the disciplines, i.e., Nurse, Social Worker, Physical Therapist, Occupational Therapist, Activity Coordinator, Speech Therapist and Dietician. An Individual Plan of Care, which includes the frequency a participant attends, is created based on the participant’s individual needs. The care plan and recommendations for number of days attended is reviewed at the team meeting with the participant and caregiver present.

Does the Veteran's Administration cover Adult Day Health Care services?

Adult Day Health Care Services are covered through the V.A. for those participants that meet the V.A.’s eligibility criteria.

How do I get Veteran's Administration services?

First a participant must determine if they are eligible for services through the V.A. There is a Member Services Department phone number (877) 222- 8387 that can determine if a participant is currently eligible for services. Napa County also has a local Veteran’s Service Officer who can assist with this process.

Contact Patrick Jolly at 707-253-3818. Once eligibility has been determined, it is necessary for the participant to be referred to the program by the V.A. Social Worker and Physician.

Do I have to come everyday?

No participants come anywhere from one to five times a week. We recommend a minimum of two days a week so the participant can get a routine established and get maximum benefit from the program.

What kinds of people come to your program?

All sorts of people come to an adult day services program: Retired doctors, nurses, contractors, teachers, electricians, mothers and fathers from all over the country and from different cultural backgrounds. People who have no cognitive impairment, but are physically frail attend, and people who are in great physical shape, but are living with memory loss attend. The age range of participants is eighteen years and older which provides a rich intergenerational environment at the program.

Are there any younger people there?

Yes, though the majority of our participants are elderly, we have a number of younger participants who are living with physical or mental impairments.

Why Adult Day Health Center then Home Care?

ADHC is an affordable alternative to home care and is more effective in alleviating isolation, encouraging health promotion and exercise, and providing intellectual stimulation through the wide range of activities offered at the center by health care professionals.

Do you serve people who do not speak English?

Yes. We have staff that speak Spanish and Tagalog. Approximately 20% of our participants are monolingual Spanish speakers. At this time we have participants who speak Spanish, Tagalog, German, and French.

Do you provide programming in languages other then English?

Yes, we conduct some programming in Spanish and have a Spanish Activities Coordinator. Our staff also speaks Spanish and Tagalog.

Does your program take drop-ins or someone who is just visiting for a few days?

Although this is definitely a need for many caregivers who have emergencies or a family member visiting from out of town, ADS programs are licensed and are required to have a physician history and physical form on file. In addition, a tuberculosis screening is needed. When someone attends the program, days are scheduled on a regular basis. With prior notice, and based on availability, days can be changed and added as needed.

Will I lose my In Home Support House (IHSS) if I attend the program?

Not necessarily. The Adult Day Health Care program somtimes can actually extend the amount of care the participant and provides the caregiver additional support. The ADS social worker coordinates with IHSS and often will advocate for additional hours when the participant’s condition declines.