Adult day services help family stay together under enormous
challenges
Three days a week a bus arrives at a country home off Fairview
Road where Richard Gorsche waits anxiously for his ride to day
care. During long weekends, such as the recent Labor Day holiday,
he gets restless waiting for his time away from home.
Adult day services help family stay together under enormous challenges
Three days a week a bus arrives at a country home off Fairview Road where Richard Gorsche waits anxiously for his ride to day care. During long weekends, such as the recent Labor Day holiday, he gets restless waiting for his time away from home.
“He loves going on the bus. He gets upset on the days he doesn’t go,” said Kathleen Gorsche, 75, Richard’s wife. “He calls it the ‘toot toot.'”
Doctors diagnosed Richard, 78, with dementia more than a year ago. The condition causes the brain to deteriorate and it is eventually fatal. With the support of their five children, Kathleen opted to keep him at home rather than put him in a nursing home.
“Way back, he said he didn’t want to go in a nursing home. I just can’t see putting him in one,” Kathleen said. “He’s still able to dress himself and eat.”
The days Richard spends at the Jovenes de Antaño Alzheimer’s Day Care Resource Center offer a much-needed respite for his wife.
The program is one of only 36 centers funded by the state of California. The program provides support for families that are serving as primary caregivers for a family member with Alzheimer’s or other types of dementia. Its fees are decided on a sliding scale, making it available to those of all income levels.
“The day care has been a God send,” Kathleen said. “I don’t know what I would do without it.”
As with many families, when Richard’s symptoms first started they caused confusion for everyone. A diagnosis of dementia in elderly patients can be hard to come by.
“There is a lot of ageism in the medical profession,” said Nancy Hikoyeda, a gerontology professor at San Jose State University. “Some doctors will say they are just getting old. Any type of dementia is abnormal aging.”
Families, such as the Gorsches, don’t realize it is something beyond normal aging until symptoms are out of control.
Richard became angry and disoriented. He hallucinated that Chinese people were coming over the river, a flashback to his time in the Korean War. He accused his wife of having an affair and asked for a divorce. When he started to wander, she added chain locks to the door. He got out and climbed a fence. He told her he had to prove she couldn’t keep him in.
“He was scared and angry. He was taking it out on me. He didn’t recognize Tim, our son, or our grandchildren,” she said. “I was so angry until I realized what was wrong.”
A Kaiser doctor finally diagnosed Richard with dementia. The doctor prescribed medication to stop the hallucinations and calm him. The medicine slows the progress of dementia.
The adult day services program provides a break for Kathleen and a chance to run errands without worrying about her husband. It allows him a chance to socialize with others.
Like the medicine, the activities at the center are meant to help stimulate the brain and slow the progress of the disease. They play card games that require them to think about the value of numbers. During a memory game, Richard and his classmates share everything they know about a chosen state.
“He always talks about his state,” said Maria Salcedo, an aide in the class. “It’s his favorite thing.”
Richard was born in Des Moines, Iowa. He moved to California while in the service and met his wife in Hollister. He worked as a Spanish teacher at Live Oak High School until he retired at 56. At the center, he enjoys speaking Spanish with Maria or some of his classmates. He has brought plaques or certificates he earned as a teacher to the center. His wife said he sometimes thinks he is teaching at the center.
In addition to her husband’s illness, Kathleen had the stress of taking on the family finances and dealing with legal documents.
“He was in control. He handled all the finances,” she said. “It’s still hard making decisions. I don’t have someone to talk things over.
Her children have helped her make some decisions and since her husband fell ill, she has made sure they know where important documents are kept.
Despite Richard’s dementia being the hardest thing she has had to deal with, Kathleen finds humor in some of the things her husband does now.
One day, her son bought three kinds of ice cream – drumsticks for his mother, something for himself and a no-sugar-added frozen yogurt for his father, who can’t have too much sugar. When the son and wife weren’t looking, Richard snuck out to the freezer. They found him with a spoon, sampling all three kinds of ice cream.
“He’s like a little kid. He loves sweets and ice cream and he sneaks them,” Kathleen said.
But she can see his decline in many small ways. At home, Richard has little energy. He talks less and less. His walk has become more of a shuffle.
“Each day we are losing a little more of him,” she said. “There is sadness in seeing my husband become a little, old man in front of my eyes.”
Understanding dementia
Everyone forgets things from time to time. Forgetting as we get older is expected. But memory loss can sometimes be an early sign of dementia.
“You may forget where you put your keys, but someone with dementia won’t remember how to use a key,” said Nancy Hikoyeda, a professor of gerontology at San Jose State University.
Dementia, an illness in which the brain deteriorates, has different symptoms for each patient. As people are living longer, the rate of dementia is increasing. At least 10 percent of Americans over 65 have dementia and nearly half over 85 are affected by the disease, according to the Alzheimer Association. Family members are usually the first to see early signs of illness and are crucial in helping with a diagnosis.
Here are some common types of dementia and their symptoms.
Alzheimer’s disease is the most common form of dementia, though it is still not well understood by doctors. Symptoms include:
· Memory loss
· Trouble making decisions or using judgment and expressing themselves
· Confusion about time and dates
· Trouble learning or remembering new information
· Get lost in familiar places
· Advanced illness marked by hallucinations, delusions and paranoia
Vascular dementia is caused by a series of strokes that have blocked blood flow to the brain. It is the second most common cause of dementia. Memory and mental function worsens after each stroke, though specific symptoms depend on which part of the brain lost blood flow. They are more common in people with high cholesterol, high blood pressure or diabetes.
Dementia with Lewy Bodies is associated with protein deposits in the brain. Symptoms include:
· Visual hallucinations
· Trouble finding their way in familiar places
· Attention and alertness fluctuates
· Trouble with long-term memory recall
· Prone to falling
Frontotemporal dementia is caused by atrophy of the frontal and temporal lobes. Symptoms include:
· Changes to personality or behavior
· Uncaring toward others
· Personal hygiene neglected
· Says rude things or does sexually inappropriate things in public (such as exposing oneself)
· Obsessed with routines, such as eating the same food
· Difficulty understanding words or naming objects.
Resources:
Alzheimer’s Association, Northern California and Northern Nevada Chapter, www.alznorcal.org or 800-272-3900.
Del Mar Caregivers Resource Center, www.delmarcaregiver.org or 831-637-7303
Jovenes de Antaño Alzheimer’s Day Care Resource Center. Call 831-636-8838 for more information.
Upcoming workshops or lectures:
“Medications for Parkinson’s Disease” meeting with Richard Myers at the First Presbyterian Church, 2066 Cienega Rd., Oct. 3, 1:30 – 3 p.m. Call 831-637-3839 for more information.
“Understanding Memory Loss and Dementia” meeting with Jill Ginghofer at Hollister’s Community Center, 300 West St., Oct. 11, 1:30 – 3 p.m. Call 831-637-7303 or 831-636-8838 for more information.
Latino Caregiver Support Group meets at the Hollister Community Center, 300 West St., Oct. 18, 6 p.m. – 7:30 p.m. For more information, call 831-637-9275.
Medical information provided by Kaiser Permanente’s Health Encyclopedia Healthwise.
– Melissa Flores
