Getting a loved on living with Alzheimer's disease to try new experiences can be a difficult task. Especially if that new task involves an Adult Day Care program! ASCC recently polled local Directors of Adult Day Care Centers on what they tell families to ease the transition. The first group focuses on dealing with the resistance of the caregiver, the rest work with the person living with Alzheimer's disease. As Allison Freeman, Director of the ACE program at the Jewish Community Center (JCC) says, "Of course there is no magical way to make it happen and not every approach works for every one. We must acknowledge that it really can be scary to try at first and that resistance is a normal reaction. As always, knowing your relative as you do, you will know what works best, but here are some things to try."

1. Convince yourself. Our ambivalence about the whole process of entrusting your relative to someone else's care can sometimes be conveyed to your relative who also knows you very well. Do your best to convince yourself that it is a good thing for you, certainly, but also beneficial for your relative.

2. Ask where the person thinks they're going. Often they think they're going to a nursing home, permanently.

3. Relate the benefits. "It's important for all of us to get out each day, to have some structure in life, to have something to do of our own, to be with other people.

4. Stress the health benefits. Whether you speak of this generally or specifically in regards to Alzheimer's stress that it is good for his or her health to interact with people. That stimulation helps keep us involved and engaged, exercise is necessary for good health, etc.

5. Use the doctor's authority. "The doctor said this is what you need to do, that it is critical to your good health." Ask the doctor to write a prescription for you.

6. You might want to tell them they're going to 'rehab' because the doctor wants them to go to rehab.

7. Encourage their participation as a way to help others. They can be enlisted as a volunteer.

8. Highlight a certain activity they might enjoy. One participant comes to our group for the exercise. Though we do many things, this is his reason for coming each day.

9. The participant may feel more comfortable attending a 'club,' 'gym,' 'class' or "therapy."

10. One of the things I do is not to call the program "Day Care." Most of our members call this their club so they are going to the club meeting. Since they have a good time here, there aren't many negative feelings to contend with.

11. The other thing we do before someone becomes bonded with us, is to recommend families don't tell them exactly where they are going. We suggest to say they are going to get coffee and donuts, which is true since that is how we start each day. The day care program has to establish a bond with each client and greet them with enthusiasm for either of these suggestions to work.

12. Do not tell them that they are going to attend "day care.' Take the words "day care" out of your vocabulary. Instead use words like "social club." Try to find a way to tap into their hobbies and interests. If someone was a volunteer in the past, tell him or her that they're going to volunteer. Day care sounds demeaning and child-like. Would you want to attend "day care" when you're retired or would you rather spend your days at an exclusive, Uptown social club?

13. Telling someone in advance that they are going to day care is a bad idea. This only leads to anxiety and sleepless nights. Instead, go about their normal routine and surprise them by telling them you are going to have lunch. Bring them to the center around lunchtime and tell them that you have an appointment, but that you'll be back soon. When you pick them up bring them to get ice cream or anything that they enjoy doing. Continue this routine until they become comfortable with the center and then start to extend their day at the center.

14. Use other members in the group. "John is expecting to see you today." I have called certain participants the morning of the group requesting their presence and highlighted something that I will need their help with that day.

15. Very often, one of the more welcoming participants can serve as the new participant's "buddy." The new participant can be engaged by a seasoned participant. This often has a positive synergistic effect.

16. The staff can "implore" help from the participant by prefacing with "I'm so glad you're here, would you help me with …" Ladies often enjoy "teaching" the staff how to fold clothes, cook, take care of the kitchen, etc. Gentlemen can be asked to move some small empty boxes that are kept on hand.

17. Use yourself. "I need you to do this for me." Here you play to their need to contribute to the relationship.

18. The old stand by, "I need you to help me …" when getting ready to attend the adult day care. Before or as soon as the participant arrives, it helps for caregivers to advise the staff to engage the participant immediately.

19. Family members have come with their relative and stayed until he or she is acclimated to the group. Then they gradually reduce the time they stay at the program, a gradual weaning process.

20. Make explanations brief and timely. Often caregivers go to lengths to "over-explain" and plan too far in advance of the event. This is usually more confusing and anxiety-provoking to the participant.

21. Keep trying! Don't give up or in to their initial resistance. You the family member, has to be committed to working through the initial 2-3 days until the person with Alzheimer's gets used to the new routine.

22. For some families, it becomes an impossible task, and that is why in-home respite is so critical. For others their mighty efforts succeed.

Our contributors are: Kathleen Leach of East Jefferson General Hospital, Genie May of Alzheimer Angel the Alzheimer's day care center at Aldersgate Presbyterian Church in Slidell, Linda Greenwalt of the Greenwalt Center part of Catholic Charities, Robin Noel, MT-BC, Touro Senior Day Center, Daphne Dominguez, Program Director of Hunter House and their PHASE program (Poydras Home Activity Services for the Elderly) and Allison Freeman, Director of the ACE program at the Jewish Community Center in New Orleans.