Dusk to dawn adult care, is first in state


By Brian Goslow



Most evenings, participants in the ElderServe on the Palisades at Night program listen to music that for many, spark memories of years ago. If she knows the tune, Isabel Quevedo, 79, sings along. “Otherwise, I just look at the people dancing,” she said. “I don’t dance, I’m too old for that.”

ElderServe is the country’s first adult overnight care program for seniors with Alzheimer’s and other forms of dementia based at the Hebrew Home at Riverdale, it began in 1998. It operates year-round, holidays included, from 7 p.m. to 7 a.m. for Bronx, Manhattan and lower Westchester County residents.

This fall, Dodge Park Rest Home in Worcester introduced From Dusk to Dawn at Dodge Park, a program based on the New York model and only the second such program in the country designed to give caregivers a break during the overnight hours.

Quevedo joined the New York program over a year ago. “So far, so good,” she said in a telephone conversation during a recent night’s stay at ElderServe. With excitement evident in her voice, she added that she was looking forward to the evening’s bingo game. “We play bingo a lot. I win at bingo.” During the day, Quevedo lives with her granddaughter, her granddaughter’s husband and their three kids. “That’s enough,” she declared, showing a sharp sense of humor. “Don’t bring me any more.”

Families who look after their loved ones turn to ElderServe to get a break from the 24/7 pace of tending to a parent or relative whose conduct is unpredictable. “If you’re taking care of mom and dad, you want a break and they want a break from you,” said Deborah M. Messina, director of the Adult Day and Evening Services programs at the Hebrew Home.

“The benefit here is two-fold because we serve the caregivers and the client. It’s rewarding to hear the caregiver call and say, ‘I actually had a good night’s sleep’ while knowing their mom or dad was being well-taken care of.” Not getting a good night’s sleep puts a heavy strain on caregivers and can lead to premature placement of their loved one in a nursing home, Messina said. She estimated nursing home placement for ElderServe participants could be delayed by one to five years.

The idea of adult overnight care is so revolutionary that ElderServe on the Palisades at Night program was recently featured on ABC’s Good Morning America and in The New York Times. That’s led to a huge increase in inquiries from interested families. Though Dodge Park began offering its Dusk to Dawn program on Sept. 1, the program is still waiting for its first client. “We have all the staff and equipment ready,” said Executive Director Micha Shalev. Because the concept is so new, few are likely to understand how it works. To that end, Shalev’s experience is similar to ElderServe’s beginnings, which started with only two clients during its first couple of months.

Night nurse supervisor Mabel Hernandez, 48, has been with ElderServe since its inception; she has worked at the Hebrew Home since 1993. The program is staffed by three Certified Nursing Assistants (CNAs), recreational, occupational and physical therapists, a social worker and depending on the need, a nutritionist. Upon a participant’s arrival, the staff at ElderServe takes the person’s blood sugar levels. Then the seniors are separated into two groups — one for dementia sufferers who need special care and another group is comprised of individuals with less severe dementia and who have better communication skills.

Then it’s off to dinner. The meal is followed by a rotating series of activities including aromatherapy and hand massages for those in wheelchairs and those who are non-verbal. The more active group enjoys exercises, arts and crafts, table games and talking with one another. “They talk a lot about forgetting things or about their kids,” Messina said. “There’s lots of reminiscing. They say, ‘I remember when …’ When we do cooking activities, they remember meals their families used to have.”

Snack time, as you’d expect, is hugely popular. By 10 or 11 p.m., most participants go to bed. “Those who don’t, we give something to do,” Hernandez said. “Some listen to music, some watch movies, others pace back and forth. We talk to them and give them a massage.” During late night hours, CNAs are available to sit and talk with those who are having trouble sleeping. “You like to talk to somebody, to have somebody to listen to what you’re saying,” Hernandez said, adding that the talking relaxes the participants, who eventually drift off to sleep.

As the sun rises, participants are awakened for breakfast before being prepared for their ride home. Two-way communication is key to the program’s success. From the beginning, families are encouraged to call to check on how their loved one is doing. “The very first weeks are very crucial ones,” Hernandez said. “They — both the families and participants — start to adjust.” It’s important to make sure the participants know why they’re there — to give their relatives a break and let them know that they haven’t been left there. “Once they get used to it, things are fine.”

Dodge Park’s Dusk to Dawn program mirrors its social adult day care model. “We want to keep participants in a social environment and provide nutritious meals,” Shalev said. Along with supper and breakfast, snacks are provided throughout the evening. Participants can be kept busy, if they so desire, with music and art-related activities and reminiscence groups. They’ll be kept relaxed through massage, meditation, Reiki and aromatherapy. Exercise regimens will include yoga and morning stretch exercises.

For those who just want to nap or sleep, a new recliner awaits. Many adult children of parents suffering from dementia live with the fear their parent will run away in the middle of the night, which can severely affect the caretakers’ ability to sleep and make it impossible to continue to care for them, Shalev said. “If I can delay someone going to a nursing home for a year or two, through our program, that’s a huge financial contribution to the family.” Those family members can then live a somewhat more normal life. “It can give caregivers the knowledge they can go to a movie with a friend or sleep at night without the anxiety of worrying about their loved one,” Shalev said.

Peace of mind for a caregiver can also come from knowing their parent is enjoying lots of peer socialization and interaction with people their own age and with problems they can relate to, Messina said. “They’re experiencing things they wouldn’t naturally experience at this age, whether it’s doing arts and crafts or going to a restaurant a caregiver or relative couldn’t bring them to,” she said.

Meanwhile, before going off to her bingo game, Hernandez wraps up her thoughts on staying at ElderServe. “I’ve got no complaints,” she said, laughing. “I’m quite happy here.” The Dusk to Dawn program is available for long-term use 365 days a year from two to seven days a week; or on an as-needed basis with a two-night minimum requirement. Handicapped-accessible round trip transportation is available to residents of Worcester and surrounding towns.

For more information: Dusk to Dawn at Dodge Park, call Micha Shalev or Ben Herlinger at 508-853-8180 or visit www. dodgepark.com