Karen Johnson hid her sadness under a broad smile before calling to her grandmother Lois, who stared straight ahead, oblivious to the noise around her.
"Grandma, come here, I have a surprise for you," she said as she juggled her 1-year-old daughter, a baby bottle and an overflowing purse. Lois Johnson looked at the little girl wriggling in Karen's arms and after a long moment her eyes lit up and she walked toward them.
Like most people with Alzheimer's disease--an incurable and terminal neurological disorder--Lois Snyder, 62, has trouble remembering who and where she is. And like many people who care for Alzheimer's victims, Johnson, 22, must divide her time among her family, her grandmother and herself.
With an estimated 100,000 Alzheimer's victims in Los Angeles County and only 45 adult day-care centers that take them, Johnson is one of the lucky ones who has found a place that cares specifically for Alzheimer's patients five days a week.
The Alzheimer's Family Day Care Program at Long Beach Community Hospital Adult Day Health Care Center was the first such program in Los Angeles County when it began three years ago with 13 patients, a nurse and a secretary. Today there are more than 75 patients and a staff of 10. There are plans to move the center to a larger facility.
When the center moved from the hospital to the basement of a real estate office on Pacific Coast Highway in September, 1983, Lila Maples, director of geriatric programs at the hospital, worried that she would not be able to fill the center.
"We outgrew our space (at the hospital) and when we moved here we thought we could never fill this room," Maples said as she looked around the center's cramped office. "We haven't gotten to the point where we have to turn people away, but we are anxious to move."
Paul Viviano, the hospital's chief executive officer, said plans to move the center and other geriatric programs, including the Alzheimer's Disease Assessment Center, a diagnostic program, into one large facility may be completed in six months.
"I think the center has been very successful but I also think its potential is limited," Viviano said. "It can be more successful if it had more space. I think there is a tremendous need in this town for a service like that."
At 9 a.m. the center is filled with elderly men and women talking and laughing. Some sit in small groups watching television, some work on jigsaw puzzles and others sit alone in silence.
The center also gives the families and companions of Alzheimer's patients the chance to sympathize and help each other. One morning a week, Johnson and a dozen other women who care for Alzheimer's patients participate in a women's support group. The center also offers a weekly men's support group and two monthly evening groups for both men and women.
Ben Marstellar, a counselor who directs the groups, said: "The number of people in the support group has increased dramatically. They are also much more educated about Alzheimer's than they were three years ago. They have definitely been doing some research."
"Education has increased awareness of Alzheimer's dramatically in the past five years," she said. "I think this center taps into a need in the community."
From 7:30 a.m. to 5:30 p.m., patients spend the day under the care of nurses and therapists who take patients to the park, discuss current events, lead exercise classes and serve lunch. Patients arrive in family vehicles or are brought by a van that the center provides for $5 each way. Cost of the program is $27 a day.
Family members "need to know they (the patients) are not home alone and they are not wandering," said Charlene Young, director of the center. "They can feel secure in leaving them here. They are not just sitting in front of a television set, which is a problem in other centers."
As Young spoke, an elderly man quietly wandered into the office.
"It's getting pretty bad," he said softly as he tried to muster a smile. "I know it's not her day today, but I had to bring her in."
Young touched his arm with her hand and assured him that he can bring his wife in whenever he needs time alone.
"He usually brings her in three times a week. . . ." Young explained later. "They need to know they have somewhere to go."
The number of Alzheimer's victims continues to grow, according to Stephanie M. Goor, executive director of the National Alzheimer's Disease and Relative Disorders Assn. in Los Angeles County, but she said there are not enough day-care centers equipped to handle patients with more advanced cases of Alzheimer's who need constant care in a locked facility.
"There are 2.5 million people in this country with Alzheimer's and by the turn of the century one family in three will have someone with the disease," Goor said. "There is a tremendous need for these centers. Every community should have one."