It’s not just sitting around
at adult day care centers
Growing number of adult day care sites offer
variety of services
FARRAH MAFFAI Michael Gastomelsky sets up a billiards shot on a recent morning at Just Home Adult Medical Day Care, Edgeboro Road, East Brunswick.
EAST BRUNSWICK — Three elderly men watch carefully over a pool table as one of their cronies shoots a ball into the corner pocket.
Across the room, a white-haired drummer accompanies a keyboard as it weaves a lively Russian melody.
Next door, three gray-haired women sit together on easy chairs and talk about the day’s news while others gather around a bulletin board, on which photos of their recent New Year’s party are displayed.
Welcome to Just Home, a privately owned adult medical day care center that recently opened on Edgeboro Road. Owned by Peter Bekkerman and Zhanna Basima, Just Home is part of a growing trend in health care for senior citizens, offering a lifestyle alternative to medically fragile adults who might otherwise require home-based care or a nursing home.
FARRAH MAFFAI Lydia Tabachnik teaches the citizenship class, one of many courses offered at Just Home Adult Medical Day Care in East Brunswick.
"We put sparkle in their lives," Bekkerman said. "It’s like they are born again."
The idea of medical day care is nothing new in New Jersey, but it has become more popular in recent years as the number of senior citizens increases and families struggle to find ways to care for them, said Nancy Day, director of the Office of Community Programs at the New Jersey Department of Health and Senior Services Division of Senior Affairs.
Medical day care centers have traditionally been affiliated with larger organizations such as hospitals, nursing homes and assisted living facilities — offering a less-expensive alternative to staying in an institution full time. In the past five years, there has been a rise in the number of free-standing, privately owned medical day care centers, according to Jane Harkey, president of the New Jersey Adult Day Care Services Association.
So far, Just Home is one of six free-standing proprietary day care centers in Middlesex County. There is also a center in Old Bridge, as well as in four other townships, according to Day. And it looks like other centers may crop up in the near future. Melyssa Lewis, supervisory project development specialist for the Middlesex County Office on Aging, said her agency has been getting more and more inquiries from people who are interested in opening adult day care centers.
Why the increase?
According to Eleanor Colston, public health consultant for the state Department of Health and Senior Services, the fastest growing segment of the senior population is made up of those age 85 and up. Within this segment, 50 percent develop dementia or are otherwise unable to care for themselves. Despite these disabilities, these seniors want a way to "age in place, if not at home, then in the community," Colston said. This has created an increased demand for day care close to home.
While many families are familiar with social day care centers, the concept of medical day care is unfamiliar to them, according to Day, who said families often make decisions about health care once they are in a crisis situation rather than while their elder family member is still healthy. As a result, they don’t thoroughly research their options.
"Families, especially caregivers, are in a situation in which this is new to them," Day said.
Medical day care centers are different from social centers in that they offer nursing services in addition to recreational and social activities. In New Jersey, they must also meet strict licensing standards and guidelines, Day said.
Still, the specific services offered vary from center to center.
At Just Home, for example, while clients are busy enjoying board games, exercising or attending computer class, the full-time nursing staff monitors their health and administers insulin and other medications. A dietitian plans low-salt and low-fat meals. Social workers circulate throughout the building, talking informally to clients and even organizing group discussions.
Doctors are not on site full time, but they visit patients at the center, Bekkerman said.
Just Home also offers transportation to and from the center and gives trips to local shopping centers. Clients also have use of a laundry room, receive therapeutic massages and eat two meals per day (either breakfast and lunch or lunch and dinner, depending on whether the client is on a morning or afternoon schedule).
While not available at Just Home, other services offered by adult medical day care centers may include physical therapy, speech therapy, care for Alzheimer’s patients and a variety of other options.
Recreational activities may also vary, depending on clients’ needs, abilities and interests.
At Just Home, where many clients are retired professionals who immigrated to the United States from Russia, some of the most popular activities are English as a second language classes and computer instruction.
"We don’t sit like old people," said Just Home client Riva Ferdman, a former corporate executive who has diabetes. "We need for our soul, for our heart something else."
Most of the clients at Just Home pay for the care through Medicaid. In general, the services are covered by Medicaid, Harkey said, but some life insurance companies will also pay for adult day services, especially the long-term care policies. Also, some HMOs pay for it, as well as the Veterans Administration.
When looking for medical day care for a family member, it is very important to find a center where your elder will feel comfortable, according to Harkey, of the state adult day care association.
"It’s just like child day care," Harkey said. "This is a vulnerable population."
Besides activities and services, some other factors to consider when choosing a medical day care center include the physical layout of the facility; the level of training received by the staff; the staff-to-client ratio; the level of caring and compassion displayed by the staff; and the overall mood of the clients.
"Each center has its own little personality," Harkey said.
To get a complete listing of medical day care centers, call the Middlesex County Office on Aging at (732) 745-3295.