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April 14, 2011 Volume 32, No. 27

Adult Day Connection is a home away from home

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WINNING PAIR Carolyn Anderson, left, and Jann Klatt are staff members at MU’s Adult Day Connection, which has been serving families for 22 years. The center offers daily assistance and recreation for adults, giving caregivers time for work or a break. Shane Epping photo

A GOOD PLACE TO BE

Staff function as a family

Adult Day Connection at the University of Missouri  is not your grandmother’s care facility. Well, maybe it is, but for adults with dementia and other health challenges this School of Health Professions program functions like a family.

Jan Klatt and Carolyn Anderson are among the staff members offering daily help for adults and giving caregivers time for work or just a break. The center, located in Clark Hall, has assisted families for 22 years.

But for participants, it’s just a good place to be.

Dorothy calls it her exercise group. Stan and his guy friends like their coffee groups, and they lobby for card games at every opportunity. Eli asks to work at the computer. “Miss Edna,” 97, is blind, but she’s ready for most activities.

To many of the 40 enrolled participants, Klatt and Anderson are inseparable from real family.

“I love this place. I love this job. We have enough staff, who all genuinely care. It’s individual attention, and that’s what the participants need most. I need them as much as they need me,” says Klatt, an ADC employee since 1998.

Klatt, who is a licensed practical nurse (LPN), stays alert for physical and mental fragility. She conducts regular screenings of vital signs to update individual care plans and to track details of decline and improvement. She looks for behavior changes and administers medications.

If Klatt spots a problem, she calls a family member or physician. And although it’s out of the health-care protocol, she can converse knowledgeably — by name — about her charges’ children and grandchildren.

As its mission, the state-licensed ADC helps adults delay entry into long-term care. Participants, who range in age from 55 to 97, face a variety of health challenges that include dementia, Down syndrome, developmental disabilities, cerebral palsy, stroke, multiple sclerosis and loss of vision or hearing.

Thanks to the subtle aid of staff members, those health problems aren’t always discernable.

Participants who lose track of a conversation are gently guided back to the topic.

Without making a big deal of it, Klatt and other staff members give tactful reminders that “now would be a good time for a bathroom break.” Help with “toileting” is offered, and bathroom messes are cleaned up with little fuss.

And because the early stages of dementia can be embarrassing, all participants, staff members and volunteers wear nametags.

“For me, Adult Day Connection is a real life saver,” says Marcia Walker, whose mother, Dorothy, attends half days twice a week. “Since my mom quit driving, she gets bored at home. This gives her something to do. She likes all of it.”

Participants arrive as early as 7:30 each morning by car or public transportation for daily activities that start with a wake-up coffee chat.

The outnumbered men often make their own table of five or six to discuss headline news and politics — sometimes boisterously — before moving to a circle of chairs for the exercise session. Health professions student Amber Alexander leads today’s group in stretching.

It’s OK when Charlotte, a former grade-school teacher, decides to skip the exercise to complete a word-search activity. At 95, she wants some private time, and staff members respect her choice. “The people here are very gentle. I enjoy just sitting,” she says.

With exercise class under way, Klatt tends to Ruth, who is partially blind. Ruth arrived with a red bruise on her forehead from a fall at home, so Klatt rubs Ruth’s shoulders and, noticing her hands are cold, brings her a heated muff.

Sometimes the care isn’t essential; it’s just kind.

Mizzou students mix easily with the participants. On a typical day, they help serve lunch and kibitz with a group of card players before joining the sing-along. 

Part of Anderson’s responsibilities involves scheduling the student volunteers. With 14 years of experience at ADC, she graphs work charts for more than 30 nursing students and 40 health-professions students, including those studying physical therapy.

Young people today don’t necessarily grow up with grandparents nearby, so ADC interactions are educational for students planning careers in health professions. But the benefits are reciprocal for students and participants. Since Stan has been working with physical therapy students, his mobility has improved and he no longer uses a cane.

“These students are cream of the crop,” Anderson says. “Our participants always welcome them.”

Last year, student volunteers donated 7,216 hours of time, and for some ADC has provided career-changing experiences leading toward work in geriatric care.

Anderson’s primary challenge is to make each day special, with activities that stimulate cognitive abilities and encourage involvement.

“This is a sharp group. They keep me on my toes. Yesterday I had something planned, but they wanted to play cards,” she says. She offers craft projects, facials, sing-alongs, tea parties, pet visits and interactions with children from the Robert G. Combs Language Preschool, also operated by the School of Health Professions.

Wedding Week, a favorite activity, encouraged participants to recall personal memories when staff members displayed their own gowns. (On the subject of romance, Stan, who has lost two wives, holds hands with Jean every chance he gets.)

Anderson has brought in magicians, master gardeners, artists and travelers for presentations. She has arranged field trips to florists, art galleries, greenhouses and Buck’s ice cream shop.

Even lunch becomes an event. As big-band music from the 1940s plays softly on a stereo, staff and participants set tables for four with placemats and place cards. “The food is always good,” Dave says of the leisurely meal.

Anderson watches the diners and points out that empty plates are best left at each person’s place until all have finished. People with dementia can forget they’ve already eaten if their plates are removed too early.

After lunch, participants pick their own activities during unstructured time. Some socialize or gather for a board game while others take a quick nap in a recliner.

Meanwhile, mascot Willy, a black Scottish terrier, pads around seeking attention and treats. The friendly little dog, owned by staff member Rexene Plagman, joins the group every day. He’s been attending since 2008 and has learned to tread carefully among wheelchairs, walkers and canes. Even if Plagman can’t come in, Willy catches a ride with other staff members.

Like the participants, he enjoys being there.

    — Nancy Moen

       Reprinted with permission of Mizzou Wire