Listening to caregivers and responding to their concerns is an important part of her work, says Judith Davidsohn Nahary, director of senior adult services at the Kaplen JCC on the Palisades in Tenafly. Those concerns often are quite pressing for people who tend to parents, spouses, or other loved ones with dementia.
For example, Ms. Nahary said, caring for someone with dementia over, say, a three-day weekend may be particularly challenging. With that in mind, the JCC recently expanded its four-day program for people with different forms of dementia, including Alzheimer’s disease, to encompass Fridays as well.
“We previously offered four days a week,” Ms. Nahary said, noting that unlike many other organizations, the JCC provides support groups for caregivers as well as for their charges. “Several [caregivers] said they would prefer five days a week, that it would make their lives easier. So we put a budget together, ensured that we [could provide] staff, transportation, and food, and then went back to them to see how many would do it.”
Right now, that number is 11, but Ms. Nahary expects the number of participants to grow as people explore the new option.
“In general, that is how we operate with this program,” she said. “The caregivers tell us what the needs are out there, and we try to offer them a solution. We’ll give them the same services we have currently. We’re not trying any new services yet. But having an extra day will allow us to add more to programming,” employing different types of therapies.
In addition to providing transportation, serving breakfast and lunch, and running support groups for family caregivers and aides, the program offers opportunities for exercise as well as “music, pet, art, and youth therapy,” Ms. Nahary said, adding that scholarships help defray the costs of the program for those who cannot afford it.
Thirty-five people, suffering from varying stages of Alzheimer’s disease and other dementias, come to the adult day care program for seniors living with those conditions. “Initially, they don’t need a caregiver,” Ms. Nahary said. “But once they have additional needs we can’t accommodate” — such as those involving use of the toilet and medication — “they can come with an aide. Most places don’t allow that. We’re unique in that way. The reason is because we want to provide a place for participants to age in place. While their condition may progress, they can still do everything. An aide can help.”
Ms. Nahary said most adult day centers are open five days a week, but they “are medical models. I don’t know of many similar to ours.” What is unique about the JCC, she said, “is that we are not in an isolated environment only for this population. We’re in a vibrant community center, with every age group. Because of that, we can do so much more with our population.”
That includes intergenerational programming and interaction with the performing arts department. “They don’t feel like they’re in a nursing home or day center; they feel like part of the community,” Ms. Nahary said. “They’re threaded into it. The staff knows you, and the security guards and teachers all know you. It’s a very different feeling for them.”
To enhance participants’ feelings of well being, the program strives “to give participants a sense of purpose,” she continued. “They’ve spent their lives caring for other people. This” — dementia — “happens, and now they need help. They may lose their purpose, their independence. This takes a toll on self-esteem and they may become depressed.
“We give them a sense of purpose; they feel like they’re coming to work. It changes their outlook, especially with dementia. We call them volunteers, and they have an opportunity to work with the community.”
For example, they may be asked to help pack weekend snack packs for the Center for Food Action, “and they feel like they’re giving back. Some participants go home and tell their spouses, ‘I’m running the JCC.’ They feel needed and wanted, so they’re more likely to stay engaged and active. We’ve found amazing ways to offer that to them.”
The seniors’ relationship with the JCC early childhood department is especially fulfilling, Ms. Nahary said. “They love the children… and some of the children have cute names for some particular senior, like ‘bubby this’ or ‘papa that.’”
Caregiver Deborah Chiappane O’Prandy of Fort Lee, whose 78-year-old father, Bill, participates in the dementia program, said, “We never even considered another program. We were attracted by its longevity and its reputation. We didn’t look anywhere else.”
And while her father was enjoying the four-day program, “We were so excited that they would add on Friday,” she said. “We’ve been involved with the JCC since September. Dad had been diagnosed with Alzheimers for five years and wasn’t able to drive. This made him homebound, and we wanted to get him involved with some kind of program. This was recommended through the social worker who was dealing with us in the hospital.”
“I just love the program,” Ms. O’Prandy continued. “I can’t say enough good things about it.” She said that the JCC provides transportation “and the bus driver, Shane, comes right to the door. Dad’s like a kid waiting for the bus with his coat on, waving at the driver.” Her father, she said, helps people get on and off. “He’s still able to function in that way.”
Happily, her father met someone in the program that he had known years ago. “Right away they knew each other,” she said. “Talk about six degrees of separation.”
While her dad lives with her now, her sister “does the legwork, the research. Sadly, he doesn’t recognize her.” Her brother, she said, has her dad’s power of attorney.
Since he joined the program at the JCC, “I’ve seen a difference in him,” Ms. O’Prandy said. “He just fully enjoys the interaction with staff and the exercise. He’s more engaging with people, and he very much enjoys the children. He literally gets down on the ground with them.” Perhaps most important, “what helps is knowing he’s safe, being picked up and cared for from 9 to 3. This lets me get to personal appointments or run to the store or to caregivers’ meetings,” where she sees other people encountering a similar challenge.
“It’s weird to have to take care of a father,” she said, but noted that her caretaking duties began in earnest only last year. She said she appreciates the calls from the JCC updating her on her father’s experiences.
“If he’s having a bad day, I get a phone call to say ‘this is what happened,’” she said. “There was a fire drill recently and he had to be outside. He seemed more agitated.’” But in general, she said, “He makes friends there, and remembers people’s names.”