An adult day program is a place a person goes during daytime hours, with staff, activity, and sometimes a meal. For a family keeping a parent at home on hospice, it can be one way to gain a few hours away from the bedside. It is not a replacement for the hospice team, and it does not change what the hospice team is responsible for. Before you enroll, compare programs on the points below, and write the answers down.
Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.
Start with the hours
Ask for the exact hours the program is open, the days it is closed, and the latest time it will accept a pickup. Then lay those hours against the hospice visits already scheduled. Nurse and aide visits happen on the hospice's schedule, and a program that opens at a fixed time can collide with them. Ask the program how it handles a hospice visit on a program day, and whether you need to call them or the hospice team first. Ask the hospice team to note the program days in the care plan so the team knows when the house will be empty.
Ask about the ride
Find out whether pickup and drop-off are included, what the pickup window is, and how far the vehicle travels. Ask how your parent will be moved into and out of the vehicle, whether a second person rides along, and what the driver does if your parent is unwell at pickup. The answers tell you more about the program than the brochure does.
Ask what staff will and will not do with medicines
Put this question in writing: what staff will do with medicines during the day, and what they will not do. Medicines stay with the family, the doctor, and the pharmacist. A program that offers to keep or give medicines during the day should explain who signs for each one, how it is recorded, and how the hospice nurse learns about it. Bring the program's answer to the hospice team before the first day.
Check the staffing and the license
Ask for the staff-to-participant plan for the hours you need. Ask what happens on a day when staff are out, and whether your parent will see the same few people each week. Ask the program to show you how it handles toileting and moving from a chair, rather than describing it. If the program says it is licensed, ask which state agency issued the license and what the license covers, then check that agency's listing yourself instead of relying on a framed certificate on the wall.
Plan a short trial
Ask for a short first day rather than a full week. When your parent comes home, note how the evening goes without deciding what it means, and bring those notes to the hospice nurse at the next visit. Compare each program against the same list: three things you need it to do, and three things you need it not to do. If you are still building the list of places to ask, Local Help for Hospice Families is a place to start.