To most people, "day care" means a place where parents can drop off preschool children during working hours. But to the Leriget family of Monterey Park and thousands of others with ailing, elderly relatives, the term has a different meaning entirely.
Rosie Leriget, then 76, was diagnosed in January, 1985, as suffering from the severe memory problems of Alzheimer's disease. Formerly a meticulous woman, she had stopped grooming herself or even changing her clothes.
Her deteriorating condition threatened to overwhelm her 81-year-old husband, Peter Frank Leriget. Her daughter, Alice Leriget Pena, lived only six blocks away but she had her own household and job as a school secretary to consider, and she did not know where to turn. "Between my doctor and my church, I could get no answers," she said.
Nurse Supplied Answer
Finally she got an answer from her own daughter, a nurse, who told her about a day-care program run by El Centro Human Services in East Los Angeles for aged people with mental problems. Shortly after the Alzheimer's diagnosis, Peter Leriget began dropping off his wife of 58 years at the center three times a week.
Such adult day-care programs are a new feature on the landscape of an aging society. The first one opened in about 1970, and already there are perhaps 1,200 to 1,400 of them nationwide, according to Betty Ransom of the National Council on the Aging. Not only do they offer a variety of services for those who attend them, but they provide a second and equally important benefit--respite for relatives from the grinding, round-the-clock responsibility of caring for their loved ones.
But day care for the elderly remains a well-kept secret. Programs are rare in rural areas and smaller cities, and the Lerigets had trouble finding out about them even in Los Angeles, despite the fact that there are about 25 programs in the county. "Your average person on the street wouldn't know what the heck adult day care is," Ransom said.
Discussing the Past
At El Centro, adult day care meant that Rosie Leriget spent four hours in activities varying from counseling to making Easter baskets to discussing the past in the brightly decorated cuarto de recuerdos , or "memory room." Sometimes Peter Leriget accompanied his wife on field trips to such places as Disneyland and Universal Studios. Other times he used the hours to relax and pursue his own activities.
"We're giving them (relatives) four hours a day to do whatever the things are that they need to do," explained George Caballero, coordinator of geriatric services at El Centro.
El Centro staffers also pitched in with suggestions for lightening Peter Leriget's burden even when his wife was at home. They suggested that other relatives could prepare meals and help with household chores, and they educated the family about the inexorable course of Alzheimer's disease.
"Poppa thinks that if Mamma starts to eat she's going to be well--but we know differently," Alice Pena said.
'Respite for the Family'
Adult day care helps the frail elderly live at home as long as possible without overwhelming the relatives who must care for them. "If you can provide respite for the family, they can last longer giving care," said Laurie Zahner, who runs a day-care program for Westside Independent Services to the Elderly in Santa Monica.
The nature of adult day care varies greatly. While El Centro takes only those with mental and emotional problems and includes psychiatric treatment among its services, other programs stick entirely to group recreation and other social activities and mingle the mentally able with Alzheimer's disease victims.
About 27 states provide at least limited financial support for day care, and 39 states impose standards that Ransom said vary from "wishy-washy to comprehensive." Rates are as varied as the programs, with many operating on sliding scales that range from no charge to $25 a day or more for those who can afford it.
Ro Mayer, director of a day-care center operated by the Older Persons' Information and Counseling Associates in West Los Angeles, believes that demand will inevitably increase. "The aim . . . is to keep people in their homes as long as possible, to have them living these years with some dignity, some self-respect, some self-esteem," she said.
But most centers are run by nonprofit groups with tight budgets. Federal support will remain limited for the foreseeable future and private industry has largely remained out of the business because profits are so hard to turn.
In the case of Rosie Leriget, day care worked successfully for almost a full year, until a stroke last November left her incontinent and out of touch with reality. Family members finally decided that she would be better off in a nursing home.
But her daughter is convinced that the assistance from El Centro helped make the best of a sad situation. "I wish she could have come five days a week," she said, "if anything, for Poppa, not just for her."