CARE FREE : Day Centers Give Families a Rest From Tending ‘Fragile Elderly’

Every weekday morning at 7:30, before Hans goes to work, he drops Kathie off at her day-care center in Orange.

He is exceedingly gentle with her, holding her hand, guiding her slowly from the car to the two-room facility on the grounds of St. Paul’s Lutheran Church.

The activity room is already set up for the day. The red plastic leis and pictures of Hawaiian seascapes are up on the walls. The morning-snack trays are on the table, next to the large-print magazines, puzzle boxes and doll-making materials. The name tags for each of the 10 participants are arranged in a neat row.

Hans takes Kathie, always the first participant to arrive, to a cushioned chair near the television set. He leans over to hug his wife, who remains silent but smiles back. He kisses her, then leaves.

“It’s hard at times to go. You know, like you were deserting her,” says Hans, 61, who works as an information systems manager in Los Angeles.

“But you have to have time for yourself, some peace of mind, or it becomes too overwhelming. You can’t be there every day, 24 hours a day. You won’t last--I know.”

He turns to catch a glimpse of Kathie watching “Good Morning, America” in the other room, while sipping orange juice and holding a napkin full of crackers on her lap. The sight makes him smile.

“This is a wonderful program for her,” Hans says of his 62-year-old wife, whose speech is still severely impaired from a major stroke. “She’s safe here and cared for. She feels productive and active. She meets a lot of good people here.”

All the participants at this nonprofit community facility, the Orange Adult Day Care Center, are senior citizens living with their children, spouses or other family members.

“You shudder when you think of the alternatives in the other kinds of care out there, and the costs that can break you in two,” says Hans.

“When you think of that, and the people who don’t even know these kinds of elder day centers exist, we consider ourselves very lucky.”

Kathie is hardly the traditional day-care participant.

Nor are the 11 other elderly participants who regularly attend the Orange Adult Day Care Center, which charges participants $22 a day and is one of 13 state-licensed day centers for the elderly in the county.

The ages of the Orange center participants go as high as the mid-80s. Most use walkers; some use wheelchairs. Nearly all suffer from physical and mental degeneration, some from early stages of Parkinson’s disease or Alzheimer’s disease.

All fall under a category that is gaining more nationwide attention: the “fragile elderly” who are still living with their families.

Although they are too infirm to be left alone, such elderly are still capable of taking part in mildly active, closely supervised group activities.

And their physical and mental conditions haven’t declined to the point where they require far costlier, more conventional means of care.

This might be confinement at home under the care of nursing aides, whose fees start at $10 an hour. Or a board-and-care home, which generally costs at least $1,000 a month. Or a nursing home, where round-the-clock care can run well over $2,000 a month.

“The premise (of these centers) is to try and keep the fragile elderly out of institutions as long as we can,” says Marilyn Ditty, executive director of San Clemente Seniors Inc., which operates the Adult Day Health Center of South Orange County.

At the same time, backers say, these centers give families a crucial respite of six to nine hours each weekday.

“These centers help take the tension off the family care-givers,” says Rosalea Wilcox, director of the Orange Adult Day Care Center. “It helps keep these families intact, to maintain the natural bondships from being destroyed.”

To most families in these programs, the adult day-care centers are indeed a saving grace--no matter how temporary.

Until three years ago, all seemed reasonably well for Betty Fogg.

At 81, she was slowing down, of course. Severe arthritis. Minor strokes. Other ailments of advancing age.

Still, she was able to take care of herself, living alone in a Fullerton apartment, visiting her grandchildren and friends whenever she wanted, and taking an occasional job as companion for elderly invalids.

But in 1985, after being hospitalized for a major gallbladder operation, her decline became alarmingly swifter.

“They told us Mother would be bedridden and completely helpless,” remembers her 52-year-old daughter, Marilyn Curtis. Her mother, it seemed, would need round-the-clock care the remainder of her life.

The family ruled out what it dreaded the most--placement in a nursing home.

“I had seen my mother-in-law die in one rest home (five years earlier),” says Curtis, citing her own “horror story.” “It had such a coldness about it. To me, it was demeaning--a place where people were just waiting to die.”

So Curtis brought her mother to her home in Orange. Since Curtis and her husband, Bob, worked, and daughter Kelly, still living at home, was going to college, a daytime nursing aide was hired for Fogg.

Fogg’s physical comeback was dramatic. In four months, she was able to get around with a walker. “We were lucky because (the aide) was a close relative,” says her daughter, “and because we kept Mother with us, it was the family that was caring for her, not some strangers.”

But a new fear surfaced. “Mother hardly left the house. She was so depressed,” recalls Curtis. “We were afraid she was slipping away again--this time, because she lacked contact with the outside community.”

The regular senior centers, explains Curtis, weren’t the answer. Such programs were aimed at far more active and independent senior citizens.

In mid-1986, Curtis learned of the day-care centers for “fragile elderly” by sheer accident. “My daughter Julie just happened to pass by (St. Paul’s) church and saw the sign. Just like that. We had never heard of it.”

A few weeks later, Fogg was enrolled in the Orange Adult Day Care Center.

“Yes, it’s a good place to be,” says Fogg, now 84 and recently confined to a wheelchair. “I keep busy. I get tired, too. But the people--I like them.”

The days are much the same at Orange center. Slow-paced. Low-key. Very gentle.

On a recent Thursday morning, the 10 participants, including Fogg, were silently sipping fruit juice or coffee, waiting for the start of the “I Love Lucy” rerun at 9.

The mood always warms up with Lucy, whose slapstick turns draw murmurs of recognition, then chuckles, from the elderly watchers.

When the center’s assistant director, Rosa Martinez, leads the group in the morning armchair exercises, the sense of camaraderie takes hold. At first, they wave arms, wiggle shoulders and try to lift legs--all done with straight-faced solemnity.

Then, laughing and clapping, Martinez plays catch with them.

The game, however, is very difficult for Fogg. She fails to catch the ball several times. Egged on by the others, she keeps trying until she finally makes the catch and wins a round of applause.

Smiling, she settles back in her wheelchair, pleased by the little triumph.

But later, after the roast-turkey lunch and a session of cutting out doll patterns, Fogg’s mood again changes. She is working on a puzzle depicting a shaggy dog--one that she has completed many times before. This time she doesn’t seem to remember where to fit the remaining pieces.

“I’m so mad,” she says, glaring at the unfinished puzzle, “because of something I can’t seem to do.”

Her good spirits return quickly when the children from the St. Paul’s preschool day-care center arrive for their daily visit.

Giggling and waving, the children bound up to the elderly like puppies--the bold ones climbing into laps, the shy ones waiting to be asked.

One of the bashful girls slowly approaches Fogg. They trade smiles. And Fogg reaches out and gives the girl the warmest of hugs.

Whip Whipple, 71, is considered a model participant at the Adult Day Health Center of South Orange County.

The one-time aerospace planning executive is one of 32 regular participants at the San Clemente-based, $40-a-day facility, one of four adult day-care centers in the county that provide medical and therapy services and extensive counseling, as well as social activities.

Every weekday at the center, Whipple--who has had to use a wheelchair since suffering a spinal injury eight years ago--works out on every physical therapy equipment at the center, from the bicycle and portable steps to the hand weights and grip exercisers.

“I can walk around the whole center now (with a walker),” says Whipple, who has been with the San Clemente program six years. “No sir, I don’t give up. This kind of center doesn’t let you.

“If I didn’t have this center, I probably would be languishing at home, never getting out of bed.” He laughs. “How can I quit? I’ve already promised (my wife) Gertrude that we’re going to go square-dancing again.”

Many participants, however, have had to drop out of these programs.

“Some find it too hard to come out of the shell,” says Carol Quintana, director of the San Clemente facility. “So they don’t want to come back, no matter how much the family tries to change their minds.”

Others just become too much to handle. “They are too abusive or disruptive,” says Rosalea Wilcox, the Orange Adult Day Care Center director. “Or they are too lost mentally, and keep wandering off the premises.”

Still others, whose conditions have declined dramatically--because of illness or injury--are placed in nursing homes.

For many other families, such institutional placement is the most chilling fear.

“You hope that (Kathie) will keep recovering,” says Hans. So far, she has.