Sunday, November 29, 2009

What Exactly is Adult Day Care?

The recent influx of seniors and retirees into the population has nursing homes severely overcrowded and Americans asking themselves in record numbers: "Just what is adult day care and how can it help me?" To answer this we will look at the problem as logically as we can, in a manner that can be easily understood by anyone, regardless of experience in the field or practical life experience.

Considering that the the Baby Boomer population, (the largest single demographic in the nation for many years now) will hit retirement age in force within the next 3 to 5 years, The United States Department of The Census has determined that by the year 2020, the number of US citizens over the age of 65 will surpass the number of US citizens under the age of 5 for the first time in our country's history.

These seniors can best be described in 3 basic need categories:

1. Predominantly Healthy - very active and needing no assistance with life skills such as cooking, grooming, bathing and toileting. These seniors suffer no sign of dementia or cognitive dysfunction.

2. Moderately Healthy - Still very active but requiring some life skill assistance. These seniors are largely alert and lucid and can still actively participate in most normal social activities, and most personal care practices. but may require limited assistance with cooking, grooming, bathing, or toileting.

3. Significantly Impaired - These seniors suffer from severe medical conditions or are in the advanced stages of progressively worsening illnesses such as Alzheimer's, Parkinson's, Lou Gehrig's Diseases, or any other chronic, incurable, or ultimately terminal illness which requires constant or almost constant supervision by medical staff and medically trained personnel. These seniors are not capable of providing for most of their significant daily needs and cannot function in most social settings, even with minimal or periodic assistance.

Traditionally in America, when our grandparents, parents, spouses or siblings begin to become a burden on our personal lives, or develop a dependency on us for any or all of life's basic necessities, we have developed a propensity to deposit them into nursing homes, intermediate care centers, or assisted living repositories.

Leaving moral and ethical issues aside, this fact gets even more significant when we take into account that the resources and facilities which currently exist to serve seniors in America are already inadequate for the existing senior population. Facilities and programs simply do not exist to handle the eminently impending influx of Baby Boomers who are about to retire, most of whom have nothing specifically constructive to do with their time. Those are the exact types of situations and scenarios which adult day care facilities were created to address.

Far less costly than nursing home care, intermediate care, or assisted living participation, adult day care programs are almost always at least partially covered by private insurance and medicare/medicaid, and in many cases, can be provided to qualified registrants absolutely free of out of pocket expenses.

When registered in an adult day care facility, you or your loved ones are picked up directly at your door at a pre-determined time, and transported to an established adult day care facility. Once there, various structured and supervised activities are provided to the registrants to fill their days with purpose and to allow them to mingle amongst their peers. At least one, and often two meals are provided at no additional cost during a typical program day. Since all activities are facilitated by trained staff and take place in a controlled environment, adults fitting either of the first two categories can benefit largely from participation in an adult day care program.

These adult day programs not only provide much needed function and interaction between the registrants, they also provide much needed respite for caregivers and family members who can easily grow exhausted by the increasingly demanding needs of a declining loved one.

Once the daily program is over, the registrants are redelivered directly to their homes, often with a take-home meal or snack for later in the evening sothat they can maintain a sense of self-sufficiency, and not be dependent on someone else at home to prepare an additional meal for them, particularly after returning home fro ma busy day at work or school.

As you can see, there are tremendous benefits to participating in adult day care programs. These programs help keep families together until there is absolutely no other choice, and help to preserve space in Nursing homes and medical care facilities for those people who desperately need that type of elevated care. Many programs have excellent curriculums which allow their participants to remain invigorated and vital in their daily lives and activities, but there is much more work to be done in this field to guarantee our aging loved ones are receiving the very best care and programs they can get. New facilities need to be constructed using state-of-the-art equipment and technology, and curriculums need to be established which can be customized to maximize the experience on an individual basis so that each participant maintains the potential to reap the maximum benefit from their individual adult day care experiences.

Please stay tuned for more on my series of articles pertaining to issues on aging.

Sunday, November 22, 2009

Nursing Homes are NOT the Answer...

Over the past 20 years, more and more Americans have developed into a trend of depositing our elderly into nursing homes, assisted living facilities and the like. Recent studies have shown that over half of these seniors do not require the type of intensive medical supervision nursing homes and intermediate care facilities were designed to provide. These facilities were established for seniors who are in, or are very close to hospice level medical condition, and who require intense, 24 hour medical supervision which can only be properly performed by trained medical staff and support personnel.

Despite this exclusive design purpose, over 50% of the seniors who are registered in nursing homes across the country are there today simply because they have no place else to go, or because there is nobody at home who can assist them with basic life needs such as preparing meals, washing clothes, or bathing. These people are not seriously ill, and many can be expected to live for as long as another 20 years or more.

Not even addressing those facilities, which do exist, that function with less than their clients' best interests in mind, even the noblest of facilities and administrations can't constantly provide a setting where each patron can excel to the level of his or her own abilities. These facilities must still concentrate the bulk of their efforts and resources on providing the intense medical supervision they were designed to provide, to that other 50% of their residents who desperately need those medical services and constant, around the clock supervision.

Many families place their loved ones into these facilities with the belief that the huge monthly cost they or their insurance pays will go to providing their parent or loved one with an elite level of care. They go away believing that the monthly cost of residency, which often exceeds $15,000.00, goes directly to the resident it is being provided on behalf of, but this is simply not true in ANY such nursing facility. Even worse, the facilities do nothing to set the record straight and many even go as far as to encourage and reinforce that misguided belief. Instead, the facility collects the monthly fees from all it's residents and distributes it on an as needed basis to those residents the administrative and medical staffs respectively determine are in greatest need of the resources. This means that your loved one, who's only medical condition might be mild to moderate dementia, will actually benefit very little from the monthly dollars provided to the facility on their behalf.

On the surface, this model seems almost fair and understandable. After all, the day will eventually come when your loved one will need more advanced medical services and at that point, the cost of their care will exceed the monthly monies proved for them by their respective funding source(s). When that happens, funds provided on behalf of other less needy residents will be diverted for their care so it all comes out in the end, right?


The problem with this model is just as easy to see if you make a slight adjustment to your perspective. During those years where your family member was in better overall health and still enjoyed an advanced level of independence, that same roughly $15,000.00 per month could have gone toward providing them with a much greater quality of life than anything provided to anyone in a nursing home setting. Even in our own lives now, imagine your quality of life on a $15,000.00 per month budget. Would you imagine living in anything similar to a nursing home or assisted living type of setting? Surely not.

In fact, the cost of simple companionship and supervision could very easily be provided without even putting a dent in that $15,000.00 per month budget. SO what would you do with the rest of that money? What would you imagine your parents would do? Or your grandparents? Would you or they spend your afternoons watching old movies or playing trivia games in a clean but institutional style multi-purpose room someplace? Hardly. You would want to get your hair and nails done, lounge in a spa, swim in a luxurious indoor pool, play bingo for hours, learn how to prepare amazing bakery delights from accomplished chefs, plant flowers, make bouquets as gifts or decorations, sew, make ceramics, take music lessons, learn how to operate a computer by taking one on one lessons, continue your education through certificate and degree programs, and any number of similar events and activities, NONE of which are continuously available at ANY nursing home or assisted living facility anywhere in America, NOT EVEN IN BEVERLY HILLS!

It is for the these reasons, my hard fought battles with institutions over my mother's care and my amazement at the list of benefits and services my mother receives in her golden years which made me realize the need for, and then helped me develop the concept for The Golden Years Adult Day Services Centers.

Adult Day Services Centers are NOT nursing homes or assisted living facilities by any means. We will provide 100% free door to door transportation to and from our facility each day. This means that your loved one will be home with you, where they belong, each and every night, but will be with a tremendous amount of their peers during the day while you are at work or school.

All 3 meals are provided to our patrons each and every day and we will be open from 7am to 7pm, 7 days per week, 365 days per year. We will pick your loved one up as early as 5:30am under certain circumstances and can provide for them as late as necessary, even as far as keeping them overnight in our warm respite suite. We realize that there are times that caregivers will want to go away for a weekend or even longer and that it would be impractical to bring an elderly parent or grandparent along.

Our prototype facility, currently being constructed to provide a mall-like atmosphere, will provide our patrons with the freedom to move from one segment to another depending on their individual needs or tastes. Do you prefer to play bingo from 9am to noon? No problem. Horticulture from 2pm to 4pm? Anytime. A manicure from 6pm to 7pm? It's entirely up to the patron.

For more information on TGY senior Centers, our program, or when you can expect one of our facilities to open near you, please visit our website at (please forgive the fact that our site is still under construction) or email me personally at and I will be very happy to provide you with as much specific information about our program that you may desire. In the meantime, please stay tuned for more important articles on ArticleBase, our soon to come video podcasts and webinars on YouTube, or check out our blogs at:, and We look forward to receiving any feedback, whether positive or negative, you might care to provide. ALL ideas are ALWAYS welcome at TGY!

Friday, November 20, 2009

The Winter and COPD

Winter and Chronic Obstructive Pulmonary Disease (COPD)

As winter draws near, people with respiratory problems are waiting with bated breath. The winter months often cause an exacerbation or acute worsening of COPD symptoms, often leading to other illnesses and even hospitalizations. I have seen first hand that a large percentage of hospital admissions this time of year are COPD patients. Even my mother suffers from COPD.

Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the United States. It’s believed that by 2010, COPD will move up to third place.

COPD refers to a group of lung diseases such as chronic bronchitis and emphysema that interfere with breathing. These diseases cause lung damage and decrease the lung’s ability to take in oxygen and remove carbon dioxide, resulting in severe breathing difficulties. COPD is progressive, meaning that it grows worse over time. It’s nearly always caused by smoking.

COPD can cause a variety of symptoms, including:

* Chronic, persistent cough
* Increased mucus
* Shortness of breath, especially during physical activity, but can occur at rest
* Wheezing
* A tight feeling in the chest

While there is no cure for COPD, it can be treated. The most important thing to do is to stop smoking. There are several medicines that make breathing easier, including steroids or inhalers. Many people with COPD will eventually need to use supplemental oxygen.

It is important to diagnose COPD as early as possible. Sometimes the subtle symptoms can be dismissed as signs of aging, leaving it undiagnosed until quality of life has rapidly deteriorated and more than 50 percent of lung function has been lost. Unfortunately, many people don’t know they’re at risk, further delaying diagnosis and treatment.

If you or anyone you know is at risk for COPD, see your doctor and learn more about about symptoms and treatment options at the American Lung Association.

Your two cents matters at The Golden Years (TGY), The new benchmark in America's non-residential adult day care industry!

Your two cents matters at The Golden Years (TGY), The new benchmark in America's non-residential adult day care industry!

Thursday, November 19, 2009

If You Could Choose.....

If you could choose which services and amenities would be available to you, your parents, or your loved ones if they were attending and Adult Day Services Center, what would they be?

Would it be okay for them to sit in a multi-purpose room for several hours out of a day in quiet lethargy while listening to an oldies radio station, a scratched up frank Sinatra CD, or the continuous repeats offered by the AMC network(American Movie Classics)?

Would you prefer them to have the ability to sew, practice needlework, plant flowers, learn new recipes, play bingo, or have a choice of movie, game and tv rooms to visit? How about a huge indoor swimming pool? Maybe a beautiful pie shaped Spa? How about a manicure...or even a pedicure? A haircut, frosting or even just a shampoo?

These are all only a few of the many continuously ongoing services which will be available to our patrons once The Golden Years - TGY opens for business in July of 2011.

It will be a tremendous help to us if all of you who have experienced the need for these services in your family would send us your comments, questions, and advice on different amenities you would like to see offered. This input will be invaluable to us and to our investors in assuring that the funds allocated to and for this project are going toward segments that are both desirable and potentially lucrative from business and practical standpoints.

We will always welcome your questions, comments and concerns and look forward to your feedback.

Kurt J Dillon - CEO
The Golden Years - TGY

Friday, November 13, 2009

The Golden Years Prototype Facility..COMING SOON!

Chances are, unless you have a elderly person or persons in your family, you never really gave much thought to senior care or adult day services in America. Most people never really stop to consider the quality of life our grandparents and soon, our parents will have when they begin to become more dependent on the various elder care social services that are available to them in this country.

I am no exception to this. Until my mom got afflicted with COPD and became confined to a wheelchair I never gave much thought to the services that were available to our seniors once their physical health began to diminish. Once they begin to depend on large scale social services, adult day care, and respite facilities to provide general services to them, what quality of life might they expect and just how much assistance was available to their primary caregivers?

Keeping our elders out of assisted living and nursing home facilities as long as possible should be a priority in our country, at least until no other alternative is possible. Too frequently, seniors are institutionalized into such facilities because their spouses and children lack the free time and resources to provide basic companionship style supervision during working hours. sadly, many of these people who require only casual supervision are committed to institutions because nobody is available to just provide that companionship to alleviate boredom, cook a meal, or provide social interaction of any kind.

These are NOT reasons anyone should be institutionalized, but once they are, they are now faced with a life based on a rigid daily schedule. Such scheduling might be needed for dementia and Alzheimer's patients, but to the average mentally alert and competent senior, this type of structured lifestyle is often perceived as a prison sentence.

The Golden Years prototype facility, currently under construction in Woodbury ,Long Island, New York and slated to open in June, 2011, will change all of that. Offering over 15 state of the art continuous and simultaneous activities, TGY will give our patrons who have the capability and the desire to function independently and vitally, the ability to do so.

Whether it's a swim in our 1,500 sq. ft. indoor pool, a dip in our 20' whirlpool spa, a manicure, a pedicure, a massage, a ceramics class, a cooking lesson by a french chef, a planting session in our massive greenhouse, knitting, sewing, some time on the internet in our state of the art computer lab, a movie, a few games of bingo, or just a relaxing nap in our plush quiet room, ALL of these possibilities will be available to each of our patrons all day....every day, from 7am to 7pm, 365 days per year!

If you had a wish list of what you would like to see offered in a facility of this type, what would it be? TELL US! And if we can, we will provide it in this prototype facility, or at least consider it for addition on one of the next generation facilities coming soon to a location near you!

Monday, November 9, 2009

What does $40,000 per year actually get for you in the world of adult day care?

Ever consider how much it actually costs, per person, to house 95 or 100 adults, in what is usually a cramped adult day services center, for an afternoon of card playing, radio listening, television watching, or just general sleeping and meandering?

Ever wonder just where that $40k per year that you, your insurance company, or medicaid pays to provide adult day care to you or our loved one actually goes?

If you or your loved one doesn't attend The Golden Years, the answer is most likely that it does not go directly toward the care of intended registrants.

The overwhelming majority of adult day service centers in America will provide our seniors and other developmentally disabled adults with a clean, generic, institutional-like atmosphere where they can participate in several rigidly structured daily events. Until now, the simple fact that anyone was available to provide ANY services to this large and oft ignored population demographic was considered by those who required them, for themselves or for a loved one, to be a Godsend - and they were!

Nobody can ever really understand the life of a caregiver until life happens and places you in the never expected and truly unfortunate situation to be one. Once there, the idea of a respite, even an extremely brief one, might seem the only thing standing between you and insanity. For these caregivers, the idea of a clean place where their loved ones might go for a few hours a day to be safe and in proximity to others who are similarly afflicted seemed too good to be true.

Today, adult day service centers (or adult day care centers as they are frequently referred) are relatively common in most parts of the country and most people have either had a family member who has attended one, or known someone who has. Traditionally, such centers have done an admirable job of providing quality care, supervision, and companionship to seniors and the developmentally disabled adults they were designed to accommodate. As such, I want to go on record right now as saying that I would never, for even a minute, try to suggest that the majority of such establishments don't truly care for the registrants that attend their facilities and work admirably and diligently to provide a very high level of care and supervision. What I am saying, however, is that good intentions and basic supervision simply shouldn't be enough anymore.

When I envisioned The Golden Years prototype, I didn't envision building a new mousetrap, just building a much better one.

After coping with my mother's increasingly debilitating illnesses for over ten years, and enrolling her in one of the better adult day care centers on Long Island, I had occasion to visit my mother while she was at the complex. What I found was a very antiseptic environment. The multi-purpose rooms I saw were clean and efficient in the extreme, but devoid of emotion, laughter or good nature. Supervision and attentiveness of staff were in high abundance, but completely missing were joy, autonomy or independence of any kind. My mother had come to enjoy her time there and even to look forward to going each day, while it was all I could do to keep from bursting out in tears at the sight of the place as my mind's eye could see the 50 or so registrants I observed that day, and in the days that followed, visually wasting away before my eyes and in real-time.

Once I got home, I began to look through my mother's medicaid billing records to see just how much such an endeavor was costing the taxpayers of America, and I was appalled to discover that it cost just under $40k per year ($39,644 to be exact) for my mother to attend this facility 6 days per week, from 9:00am to 2:30pm, 6 days per week. Yes, this amount did also include the cost of her transportation to and from the facility, but she was certainly not the only passenger on the route either. The gravity of what I had seen that day was then immediately compounded by the incredible amount of money this seemed to me to be. While this amount might seem plausible to you when considering an individual, the actual costs get far more watered down when you consider a registration and attendance base of about 100 people per day.

If this facility was earning just under $40k per year, per registrant, I wanted to know what that equated per day, per registrant, so that I could calculate the approximate daily, weekly, monthly, and annual gross revenue of the facility as a whole. I will spare you the calculations since they are easy enough to do on your own, but as you can see if you did the math, the complex earns approximately $128.00 per registrant, per day. When multiplied by 100 registrants, this totals $12,800 per day (5.5 hours); $76,800 per week (6 days); $332,800 per month (26 days); and a whopping $3,993,600 per year (305 days since you also have to account for the facility being closed on Sundays and the 8 major bank and federal holidays).

Could I possibly conceive of a way to accommodate at least 100 senior or afflicted people in a way that would give them a significantly greater amount of freedom, and independence in how they spent their days while at my facility?

What could I do with a $4,000,000.00 per year budget that this place, and places like it weren't already doing? Could I really provide more choices, more autonomy in the daily schedules of those non-dementia patrons who still enjoyed active lifestyles but just sought some companionship and camaraderie?

I could.... and The Golden Years concept was born.