A Home Away from Home

In honour of Therapeutic Recreation Awareness Month, Christina Webster offers a glimpse into her work as a Vancouver-based recreation therapist and co-ordinator by highlighting how adult day programs can support people living with dementia and care partners to live well.

Imagine a place where everyone shouts your name and greets you with a smile when you walk in the door. Imagine a place where the activities are designed with your interests and abilities in mind. Imagine a place where you can be yourself, connect with others and have lots of fun and laughter along the way.

Well, there is such a place — Welcome to the world of adult day programs.

"[The adult day program] gives Sharon a chance to meet friends for a walk, catch up on chores or even take a nap."

– Christina Webster

What is an adult day program?

These community-based programs offer services to members and their families who need care and support outside the home. For people living with dementia, adult day programs can provide a safe and engaging environment.

By using a therapeutic recreation approach, each member is valued for their unique strengths and abilities, as the staff use research evidence to design person-centred leisure programs that encourage independence and choice.

The aim is for everyone to feel successful at the end of the day. And care partners can rest from the stresses of care partnership, while breathing easy knowing they and their loved ones are part of a great community of support.

Care partner support

One such care partner is Sharon. She looks after her husband, Neil, who was diagnosed with Lewy Body dementia in 2017. Sharon and Neil are both in their 80s and caring for him can be quite overwhelming for Sharon. Neil has trouble with everyday tasks and struggles to sleep, waking Sharon every night while looking for things in cupboards and drawers.

Photo courtesy of Canva.

Sharon was at her wits end when her doctor suggested that a day program might provide some respite. Neil was referred to Renfrew Collingwood Seniors Society (RCSS) in East Vancouver and now spends five hours a day, three days a week at the day program, which gives Sharon a chance to meet friends for a walk, catch up on chores or even take a nap. She says the program is a blessing.

When Sharon wanted to connect with other care partners to learn more about how Neil’s disease might progress, the day program staff gave her resources to read and connected her with another family looking for mutual support.

The nurse at the centre calls Sharon each month to check-in and make sure she’s doing alright. Although Neil is attending the program, Sharon is considered because her health is important too.

"One of the primary purposes for day programs is to provide a sense of community, belonging and an opportunity for social interaction."

– Christina Webster

Adult member support

Although each day program is different, most will offer a similar range of activities along with health monitoring and healthy meals for lunch. The therapeutic recreation model is used to make sure all programs meet the diverse health needs of each member through:

Photo courtesy of Canva.

• Physical health

Physical health is addressed through daily exercise programs like gentle stretch, chair exercise or standing/balancing exercise using special equipment.

Most exercise programs focus on fall prevention, as many hospitalizations in people over age 65 are due to falls.

Other popular physical activities offered at some day programs are active games such as bowling, carpet darts or ladder ball. Muscles get a workout while the teams cheer each other on in a friendly competition.

• Cognitive health

Cognitive health is addressed through different types of activities that stimulate the mind and memory. Activities like Scrabble, mahjong, dominoes, or card games are offered to members based on interest or what they enjoyed in the past.

There is always an opportunity to learn new things, but sometimes those with dementia are most successful in activities they have played before. Others enjoy the challenge of bridge or chess in smaller, quieter groups.

Photo courtesy of Canva.

• Emotional health

Emotional health at an adult day program is centred around feelings of confidence, comfort and security. Changes that come with aging or memory loss can have a big impact on how people feel about themselves and their situation.

Programs like music and art can often be mood boosters, as they give members a chance to create things and express their emotions, which leads to a more positive outlook overall.

• Social health

Social health is one of the biggest concerns among day program members and their families. Feelings of loneliness and isolation are very common for people whose social circle becomes smaller over time.

One of the primary purposes for day programs is to provide a sense of community, belonging and an opportunity for social interaction. Chats over coffee, shared mealtimes and celebrating special occasions such as birthdays and cultural events give people a chance to get to know each other and make new friends.

Often, attending the day program may be the only time members get out of the house, so that social connection becomes the highlight of their week.

By focusing on these domains of health, day programs can offer an individualized approach to care. Each member’s needs, interests and abilities drive the program’s design and delivery. And as members change, so does the program. The recreation staff are constantly adapting current programs, creating new programs and asking members what they like and don’t like. In the end, the day program belongs to the members, and everyone is considered in a true inclusive environment.

Photo courtesy of Canva.

Betty’s story

One such member is Betty, who has attended RCSS for more than 10 years. She visits the centre three times a week because her son works during the day and worries about her being home alone. Betty is very fit and has great co-ordination, but she also has Alzheimer’s disease and difficulty remembering things, which sometimes makes her feel anxious.

When the bus drops Betty off at the centre, she walks in with the confidence of a queen. She hangs up her coat, relaxes in a comfy chair and starts chatting with a friend about her cat. It’s a story she tells every day, but no one is tired of listening. Betty is admired for her nimble feet, her helpfulness when someone needs a hand with the scissors, and her absolute joy when she hears Doris Day.

Betty is part of the RCSS family and is one of its many members who create a home away from home – which is what a day program is meant to be.