Luz Co slowly pedaled on a stationary bicycle one morning recently at the South Orange County Adult Day Health Care Center in San Clemente. Her face showed a grim determination.
A year ago, the 73-year-old Laguna Hills woman lost the use of her arms and legs following a stroke. When Co began coming to this San Clemente facility for the frail elderly earlier this year, she recalls that she was confined most of the time to a wheelchair.
Today, after 1 1/2 hours of daily therapy at the center over the past five months, Co can walk with the aid of a four-prong cane and feels she is on the road to recovery from other effects of her stroke.
Co is among the growing number of Orange County residents, usually age 60 or older, who are participating in so-called "adult day-care centers."
The county's 14 facilities are designed for less active elderly people who cannot be left unsupervised during the day; they are functionally impaired because of strokes, heart disease, hearing loss, poor sight and Alzheimer's disease, according to South Orange County Center program director Julie Doyle.
Adult day-care center participants are not ill enough to join the county's estimated 5,500 elderly in nursing homes. Their spouses or children leave them at these centers during the day and then take them home at night.
"Contrary to myth, surveys show that over 80% of the elderly turn to their families for help when they become sick or disabled," said Marilyn Ditty, executive director of San Clemente Seniors, the nonprofit organization which operates South Orange County Adult Day Health Care Center.
Unable to Live Alone
"Frail elderly people generally are unable to live alone," continued Ditty, immediate past president of the California Assn. for Adult Day Services, which lobbies on behalf of 70 adult day-care centers in the state.
"Often these seniors are placed in nursing homes simply because their children work and aren't available to supervise them during the day; or their spouses aren't able to provide the 24-hour-a-day care they frequently require.
"Adult day-care centers prevent this premature, medically unnecessary placement of seniors in nursing homes because they're places where the elderly can receive supervised social and health care."
Attesting to the benefits of adult day care, Jessie Lebowitz, who attends the South Orange County Adult Day Care Center, said, "I come here every day, and I love it."
"The people are nice, and we do things that make us happy," said the 81-year-old Mission Viejo resident. "I live with my daughter, who works. If it wasn't for this place, I'd be spending my time alone at home. It'd drive me up the wall. I'd be talking to myself and counting things--and it wouldn't be money."
Co and Lebowitz are among the 20,000, or 11%, of Orange County's frail residents over age 65 needing help with daily activities such as personal or home care, according to a study by St. Joseph Hospital in Orange, the most recent and comprehensive study available on adult day-care centers in Orange County.
There are two types of facilities: "health" and "social" day-care centers.
The so-called health or medical model, like the South Orange County Adult Day Care Health Center in San Clemente, offers medical assistance to clients, in addition to the services provided by social centers. There are four health centers in the county.
In the so-called social day-care centers, participants typically are provided with meals, transportation, entertainment, education and counseling. The majority of adult day-care centers in Orange County--10--are based on this social model.
Participants in health day-care centers like South Orange County, program director Doyle said, tend to be in their late 70s and have various mental or physical impairments. To treat these problems, health centers provide physical, occupational and speech therapy, in addition to social and recreational services for seniors.
Although the participant's personal physician remains responsible for his patient, Doyle said, he provides the center's consulting doctor with information necessary to ensure proper medical care.
A registered nurse monitors such general health factors as the participant's blood pressure. The nurse also dispenses medication, changes dressings and instructs participants in the principles of self-care, Doyle added.
Psychiatric and psychological counseling is available not only for participants but also for their families. A resident social worker will alert the seniors and their families to services and community agencies available for resolving personal or social problems in such areas as finance, law, shopping and housing.
A mid-morning snack and hot lunch are provided, taking into account special diets. Recreational activities include crafts, singing, group outings and armchair exercises.
(The professional staff is supplemented by volunteers.)