Nominated for National Award
This stroke victim gets a helping hand
with the finishing touches on his floral project.
Story and Photos By Judy Lee –
What do a Vietnam veteran who is blind and suffers the symptoms of shell shock; a hospice patient heavily sedated on morphine; a grandfather who cannot dress or feed himself; and a woman who “just can’t remember” have in common? Each one found purpose and renewed vitality at The Salvation Army Adult Day Center (ADC).
The ADC is a community-based adult day health program that provides meaningful daytime experiences for elderly and medically frail adults in need of supervision, physical/whole body movement activities, socialization and health-related services.
The ADC is conveniently located in downtown Honolulu at the Kauluwela Mission Corps. A familiar site to local residents, the corps has been a haven to thousands of islanders over the last 94 years.
Need for quality day care
Corps Officers Majors Edward and Dorothy Covert and Lieutenant David Pierce offer comfort and cheer, and maintain the Army’s spiritual involvement at a significant level. Pierce provides a weekly chapel service to the participants and their caregivers, and the Coverts offer counseling and program services.
“As America continues to get grayer,” stated Covert, “the obvious need for quality adult day care to sustain the quality of life for our seniors gets more demanding. The Salvation Army makes major contributions to this area and is proud at Kauluwela to be on the cutting edge of adult day services.” Covert earned a Certificate in Gerontology while studying for his bachelor’s degree at Rhode Island College.
The center began in 1970 and was the first free-standing adult care facility in Hawaii. It is now the only free-standing day health facility in the state. It is a shining example of alternative care for adults needing supervision, and serves as a leader in supporting and promoting alternative care in Hawaii.
In 1990, the ADC implemented a day health component for the medically frail adult. Adults with a wider variety of disabilities, from blindness to Alzheimer’s disease, are served, including those in need of skilled nursing procedures, such as colostomy care, catheter maintenance and tracheotomy care. The ADC serves as a model for other adult day centers desiring to upgrade their service delivery systems or the quality of their services.
Quality hospice care
The ADC can even provide quality care for the hospice patient. “In August of 1994, my mother was referred to The Salvation Army Adult Day Center. She was in the terminal stages of her illness, with less than six months to live, and heavily sedated on morphine,” said her daughter, Juliette. That was a year and a half ago. Since then, Eleanor hasn’t missed a day at the center and participates in all activities, including excursions. “She comes and forgets her pain,” states Juliette. “I truly believe my mother is alive today because of the Adult Day Center.”
As a member and leader in the association of Adult Day Centers Hawaii, Inc., the ADC provides leadership in the development and care of the elderly and medically frail, and assists other day care centers in their efforts to increase program effectiveness.
Helen Myers is the Adult Day Care administrator, and has played a major role in the broadening of community-based long term care to Hawaii’s disabled and frail older adults. She is a strong advocate for the disabled adult, and sponsored legislation to include Medicaid reimbursement for Adult Day Services. With 25 years of experience, she is well known and respected in the health care community and currently serves as president of the Adult Day Centers of Hawaii, Inc.
“The need for community-based services for elderly and medically frail adults in Hawaii is critical,” stated the divisional commander, Major Chris Buchanan. “In 1993, Hawaii had a nursing home bed ratio of 14.4 beds for every 1,000 persons 65 and older. That compared to the national average of 52.5 beds.” In 1993, there were only 3,490 nursing home beds in the whole state of Hawaii. One result of this situation is that the households are overcrowded, with approximately 22 percent of Hawaiian households in which each room is occupied by one or more persons. This compares to the mainland, where only 5 percent of households have one or more persons per room. Buchanan went on to explain that Hawaii has the highest life expectancy in the United States: 80.9 years for women and 75.4 years for men. The population is changing and more of Hawaii’s seniors are single, female and aged 75 or older, all of which are correlated with risk of poverty.” These figures represent a growing, critical need,” said Buchanan, “not only for the seniors who will need care, but for the caregivers as well. The ADC provides this care, and the priceless gift of respite to the caregiver.”
ADVOCATE-Helen Myers, a strong advocate for the disabled adult, sponsored legislation to include medicaid reimbursement for Adult Day Services. She gives State Representative Dennis Arikaki a tour of the facility.
Excellence in planning
Plans for an Alzheimer’s Center to be built on the same site as the ADC are currently being discussed. The center would have a capacity of 65 and would serve as a model both locally and nationally. The building will be constructed by the Pacific Thomas Corporation, whose founder has recently been diagnosed with Alzheimer’s disease.
The ADC has achieved excellence in the provision of adult day care/health programming and is recognized in the community for the quality of services, and, equally importantly, for the leadership it has provided. In 1992 the Governor of the State of Hawaii, John Waihee, awarded the ADC a Certificate of Acknowledgment for contributing to the community’s welfare by rendering community-based health services. The State Legislature, in recognition of the program’s excellence, awarded the ADC $116.000 to renovate its facilities and expand its capability to serve medically frail adults.
The ADC is fiscally solvent. This is particularly noteworthy because it operates on a fee-for-service basis and no longer contracts with the state. It obtains grants to upgrade its facilities and is able to meet operational costs through its fee for service arrangements.
State and city government, along with the University of Hawaii, work directly with the ADC in developing day care services for adults with a wide variety of disabilities. “Carlton is a veteran and had his entire frontal lobe blown away while serving in Vietnam,” said Myers. “He is blind and suffers the symptoms of shell shock. Before the ADC he spent his days alone in his room at the nursing home with only a radio. Here at the center he listens to ‘talking books’ that the library provides. He can take a walk with a staff member, and has other clients to interact with.”
Respite for caregivers
The ADC program offers a viable option to the premature, unnecessary and costly institutional placement of the disabled or frail elderly in care homes or other long-term care facilities. Additionally, caring for these adults in a day program provides respite for the at-home caregivers, enabling them to keep their loved ones with the family.
The ADC provides a friendly, safe environment, daily exercise and physical therapy. Arts and crafts classes are offered, and clients especially enjoy these because they can make gifts for their loved ones on special occasions and holidays.
“Pet therapy can elicit and elevate the spirit in participants,” said Patty Riva, program coordinator, “particularly the severely depressed and withdrawn. The Hawaiian Humane Society provides the animals on a weekly basis, producing smiles and even laughter where human contact has sometimes failed.”
Hot meals and snacks are served, with provisions made for special and restricted diets. Personal care such as showering, manicures and haircuts are given. Myers explained that many elderly accept assistance in these services from a nurse, but are embarrassed if, for instance, they need help from a family member to shower.
Henry had taken care of his mother for many years, but when her forgetfulness became a risk to her safety, he knew he had to make some changes. Rebecca was diagnosed with a form of dementia; she could no longer remain at home unsupervised. Nursing homes were very expensive, with long waiting lists, and Rebecca really didn’t need that kind of care. What she needed was day care for an adult.
“The Adult Day Center has not only been her lifesaver,” said Henry, “but it’s been my lifesaver as well. I would have had to make a lot of adjustments in my career to care for her, since I am the only child she has.”
“When she first had her ailment she was very depressed-she wouldn’t talk-she didn’t want to do a lot of things,” explained Henry. “Now, she gets up in the morning and she wants to have her breakfast, and she wants to go. She looks forward to something to do. In fact, she prefers coming here to staying at home, because she has a variety of things to do and she is challenged by it and really wants to go. We say ‘school’…she really wants to go to school.” When Henry was asked if he would like to say something about the Army, he said, “Thank you very much, Salvation Army-you are a lifesaving and life-giving organization, and the beautiful part about it is, it’s all done with a lot of Christian understanding and love.”