Day Care Centre eases dementia care burden

Mrs Durand spent her working life as a registered nurse and was a top class bowls player who also created hundreds of intricate sugar-crafted cakes for special occasions.

Diagnosed with Alzheimer’s last year, she sometimes refers to her daughter Ms Minette van der Merwe as her ‘friend’, but still she draws comfort from Minette’s familiar presence.

Minette and her brother, Mr Dreyer Lotter, are among the many people caring for a loved one who has dementia.

The World Alzheimer Report of 2013 titled Journey of caring : An analysis of long-term care for dementia, reveals that as the world population ages, the traditional system of informal care by family, friends and community will require much greater support. Globally, 13 percent of people aged 60 or over require long-term care.

Between 2010 and 2050, the total number of older people with care needs will nearly treble from 101- to 277-million.

Long-term care is mainly for people with dementia; around half of all older people who need personal care have dementia, and 80 percent of older people in nursing homes are living with dementia.

Mrs Durand’s illness has impacted heavily on Minette and Dreyer. When Mrs Durand, who was living in the Cape at the time, was hospitalised with a chest infection last year, her children realised her health problems ran a lot deeper.

“She was confused and forgetful,” said Minette. A medical diagnosis soon confirmed their fears – their mother was in the early stages of Alzheimer’s. Realising she could no longer live independently, it was arranged that Mrs Durand would move to Alberton North and live with Dreyer and his wife Marlé. A few months later, Minette and her children also moved from the Cape to live with Dreyer and his family and help care for Mrs Durand. Although she is still able to talk and move independently, she needs round-the-clock care. The family has found the support they need at the new day care centre opened at the Ron Smith Care Centre.

The Rand Aid Association-run care centre, which has embraced a people-centred care philosophy, has a wing dedicated to caring for people with dementia, either on a full-time, recuperative or respite basis. The new care centre is equally well-equipped to look after older people with dementia.

Most days, Mrs Durand and Minette spend their mornings at the day care centre, which is situated on the grounds of the Elphin Lodge retirement village. They take part in daily occupational therapy (OT) activities, eat lunch with other residents and watch the geese and ducks on the dam before heading home.

“My mom is more content and typically sleeps better after a morning at the care centre, even though in the evening she cannot remember that she visited. I find that if we are unable to go, her day is long and she gets bored and restless. She sometimes refers to the care centre as ‘the farm’- this must be due to the open space and peaceful gardens surrounding the centre,” said Minette.

It was sister-in-law Marlé who found the Ron Smith Care Centre, after researching a number of similar facilities.

“She was impressed with the homely atmosphere and the structured OT activities,” said Minette.

The family has found comfort in being able to talk to other people whose loved ones have dementia, and in having their mother spend time with people her own age who face similar health challenges.

The OT team at the care centre is also on hand to answer any questions the family may have about the progression of their mother’s disease.

“After my mom’s diagnosis, there was little information forthcoming from the doctor but we have found a support system here at the Ron Smith Care Centre. We now have access to more information,” said Minette.

The family had the foresight to realise they will probably be unable to care for Mrs Durand indefinitely. They believe the day care centre is serving as a bridge between being cared for at home and being placed in full-time care.

“She is getting used to the people, the routine and the environment. Should she come live here full-time, the transition will not be as upsetting. This is like a home away from home and everyone treats us like family members,” said Minette.

Ms Phyllis Phillips, the liaison manager at the Ron Smith Care Centre, said the impact of dementia and Alzheimer’s places a heavy burden on primary caregivers and close family members, particularly a spouse or the responsible adult child or children.

“It is heart wrenching for them to watch a once independent, capable loved one become confused, agitated and eventually unable to perform the basic everyday tasks of daily living. The closer the relationship, the harder it is,” said Ms Phillips. She said the decision to place a loved one permanently in a care facility comes with a great deal of guilt and heartache. Day care for both the affected person and for the caregiver could be a useful bridge or could help extend the decision of permanent placement or possibly render this to be unnecessary.

“A day care programme can help reduce the pressure on the individual who has to bear the strain of being constantly at the beck and call of the affected person. It can be a tremendous relief to have some time away by leaving a loved one in capable, experienced hands. The introduction of a variety of new activities and the re-awakening of old interests can stimulate and even excite a participant, thus helping to fill the long hours of their day,” said Ms Phillips.

She said once they have had a full day with different experiences, they might even sleep better at night.