For all anyone knows, Evangeline is thinking of her days as a missionary in Greece when she walks along the sun-dappled portico of an adult day care center in Costa Mesa. Or perhaps it is those early years in New York she is remembering, when she sewed silk linings into fur coats to earn money for Bible college.
After breakfast at the center, graceful as a ballerina, hair swept in a bun, she walks. After lunch, the center staff sees her walk again, up and down, up and down, a faint smile on her lips, eyes fixed on the horizon.
One of about 50 adults with dementia served by the center, Evangeline, 77, is no longer able to speak to the staff members who serve her a hot pizza with a cold glass of milk or help her put on a favorite wool sweater. Once a passionate preacher, her ability to formulate words is gone.
Still, the staff at Adult Day Services in Costa Mesa can see that she seems happy. And they know she is spending her time in a safe, caring environment.
With an aging population that includes 40,000 people with Alzheimer's disease, Orange County's need for such centers is growing daily, says Cordula Dick-Muehlke, executive director of the nonprofit Adult Day Services facility.
"One of the things that happens when someone gets this disease is that they feel isolated. People don't understand what's happening with them. But they still have the desire to get out, be involved in life. These centers help them be part of the community."
The center--in a former grammar school building--not only serves dementia patients but also provides ongoing relief for patient caregivers overwhelmed by the growing helplessness of their loved ones.
Services--from $25 to $60 per day--include recreational outings, crafts, meals and health-care programs for patients with medical conditions such as diabetes. Participants range from age 55 to 100.
"Our primary goal is to affirm [dementia patients] as human beings, give them pleasurable, successful experiences," says Dick-Muehlke, 42, a clinical psychologist. "To have dementia is devastating to the ego. So, to come here, be accepted, have people treat you like a regular human being even though you have some deficits, is a wonderful boost to your self-esteem."
Dick-Muehlke and her staff focus on each participant's "preserved abilities," she says. "Many of them are able to talk about their past for a long time. You learn all of these wonderful things about them, find they had such rich lives."
In November, Day Care Services--in partnership with Hoag Memorial Hospital Presbyterian in Newport Beach--plans to break ground on a $4-million dollar facility in Huntington Beach that will accommodate up to 100 patients.
These days, Dick-Muehlke keeps one eye on her day-care staff and the other on securing the funding that will help make the new facility a reality. "We're working on developing partnerships with Huntington Beach and Fountain Valley," she says. "Then, we'll look toward corporations and our private donor base.
"We're also trying to strengthen our annual giving program. The building will increase our ongoing operating costs."
Securing funds for an adult day-care facility can be a tough sell, she says. "In America, we invest a lot of time, energy and commitment in our young people; we just haven't learned yet the importance of investing in our seniors the same way."
The average cost of caring for a dementia patient through the course of the illness is $175,000, Dick-Muehlke says. "The family actually affected by the disease is having to put their resources into long-term care for the individual.
"They might be the ones who most recognize the importance of this type of facility, [but] they're the ones least able to contribute."
Others find it difficult to face that they, or their loved ones, may someday need such a facility.
Dick-Muehlke attempts to educate the public about dementia, frequently giving community lectures.
During National Adult Day Care week, which begins Sept. 15, Dick-Muehlke will give lectures on Sept. 16 at UCI and Sept. 19 at the Costa Mesa Senior Center and give a seminar on dementia Sept. 20 at St. James Episcopal Church in Newport Beach.
"Spirituality and Dementia" will be the topic of the Sept. 16 lecture. "When we talk about dementia, we usually talk about it from the biomedical perspective, what's happening in the brain," she says.
"Or we talk about it from the psychological perspective, the burden on the caregiver, the stress. We don't think about it from the spiritual perspective.
"Dementia is a spiritual journey where you have to deal with suffering," she says. "The caregiver and the patient both suffer."
Dick-Muehlke says prayer and forgiveness can reduce the stress of dealing with the disease. She offers caregivers information to minister to those with dementia. Whatever the person's beliefs, she says, "it is important to help that person continue their contact with God."
* For information on the center: (714) 548-9331.