VI. THE NEED FOR ALTERNATIVE SETTINGS OR ADDITIONAL SUPPORT

The adult day care center can offer needed respite to the caregiver as well as providing the demented person with structured recreation and mental stimulation within the capabilities of a confused person. There is great variability among day care centers regarding their hours, fees, type of staff, services offered and clients accepted.

Some centers are not equipped for clients who are incontinent or wander, while other programs are designed and geared specifically to the needs of the person with dementia. A professional (e.g., doctor, nurse, social worker) may be able to help locate a center that will accept a person with Alzheimer's Disease.

There are many professional agencies that can provide respite care by sending a trained helper into the home for a prescribed period of time. Often friends may know of someone who would be appropriate. The helper should understand the nature of the illness and have emergency information supplied by the caregiver.

Support groups provide an opportunity for caregivers to meet together and exchange advice and provide emotional support to one another. They can also be an excellent source of information. The Alzheimer's Disease and Related Disorders Association (ADRDA), social service agencies and adult care programs have all been active in organizing family support groups. They meet regularly and offer the caregiver or family an opportunity to give as well as receive support from others coming with similar difficulties. When a family can no longer care for the person at home even with respite services, other living arrangements should then be considered. While it is very difficult to place a family member in an institutional setting, it may become necessary at some stage of the disease. Alternative settings include residential facilities, intermediate care facilities, skilled nursing homes and psychiatric-locked facilities

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