Laying aside his crutches, Louis Steneman steadied himself on the arm of a chair as he rose to deliver his clue in charades.
By his own reckoning, Steneman last stepped onto a volleyball court 50 years ago. But he delivered an imaginary serve with a force that nearly knocked him off his feet.
"I've tried to keep a photographic memory, because so many places I've seen don't exist anymore except in my mind," said Steneman, 89, whose hearing and eyesight are failing him. "You especially don't forget the good times."
Many of the good times for Steneman lately have been supplied by the Fitzgerald House in Thousand Oaks, one of four Ventura County day-care centers for the frail elderly where charades, group exercise and other activities are part of a daily regimen.
"This place keeps me alert," said Steneman, former owner of a small Bakersfield oil refinery who now lives with a grandnephew in Moorpark. "It's a big question what I'd be doing if I wasn't coming here."
In a county where the senior population is increasing rapidly, it is a question for thousands of people such as Steneman.
According to the Ventura County Area Agency on Aging, the county's 60-and-over population has jumped from 35,000 to 95,000 since 1970. About 27,000 county residents are 75 and older, the fastest-growing age group in the country.
Nursing home beds have become so scarce that nearly half of all Ventura County Medi-Cal recipients are placed in nursing homes in Kern and Riverside counties, isolating them from relatives, said Colleen House, the agency's director.
An alternative in some counties to residential and home health care is day health care at centers staffed by a registered nurse and part-time therapists. Nearly half the counties in the state have opened such centers, which are half as costly as individual home care for shut-ins, according to the California Department of Aging. But Ventura County has not taken the preliminary steps necessary to open a day health-care center.
Elderly people with infirmities that do not need daily medical attention can find day care at four nonprofit centers--the Fitzgerald House, Club Camarillo, Camp Ventura and the Oak Treehouse in Ojai. The centers are licensed to serve fewer than 120 participants a day, out of an estimated 2,000 county residents gerontologists say need such services.
"It's well-established that people who stay out of nursing homes live longer and have better quality lives," said Patty Longo of the Ventura County chapter of the American Assn. of Retired Persons. "You get the budgetary response from government all the time, that we can't afford these alternative programs. But we must face it, the empire of the old will soon be upon us."
For people with elderly relatives, the centers provide respite from the tensions of round-the-clock care that can lead to elderly abuse, said Dr. Rick Zawadski, a researcher with the Institute on Health and Aging at the University of California-San Francisco Medical Center.
"Family members can assume responsibility for a senior's physical well-being, but not their social well-being," said Susan Salguero, director of the Oak Treehouse, which opened three years ago. "This is a place for them to be with their peers, people they know on a first-name basis."
The need for such programs is growing more pronounced as long-term residential care for the elderly contributes to the nation's soaring health-care bill, Longo said.
Zawadski said up to 10% of the country's 65-and-over population suffer infirmities, from minor confusion to physical limitations, that might warrant day-care placement.
However, the four Ventura County centers do not have waiting lists.
Center officials said the reason is that government and private insurers do not cover day care because it is considered a non-medical expense.
Unlike senior centers and child-care facilities, there is no government assistance or tax credit for senior day-care participants.
The cost of senior day-care centers runs $20 to $32 a day, including lunch, with a sliding scale for people unable to pay. Nursing homes charge $60 to $95 a day for 24-hour care.
"We hope our people pay the full amount, but we don't turn them away if they don't," said Jean Schipper, program director for the Fitzgerald House, which receives an average of $18 from participants toward its daily fee of $31.75.
Oak Treehouse, licensed for 20 participants, usually has only eight to 10 participants and has never had a full house since opening three years ago, said Salguero, whose program is run by Help of Ojai.
"There's a very large need for senior day care, but a very small demand," Salguero said. "Maybe it's because day care has a connotation that you're losing your independence, when in fact it's the opposite."