The Embers Special Care Center

24/7 Caregiver Support Center

PILOT PROGRAM-EMBERS MODEL

The Embers Special Care Center ( 24/7 Caregiver Support Center) will be a 42,218 square foot, one story facility, built to withstand hurricane winds up to 150mph, and each wing will have their own tornado bunker shelter. With the capacity to care for 80-Special Care (Adult Day Care) and 80 Sundowners participants, 12- 24-hour respite beds, 12- (Extended Congregate Care) rehabilitation beds. 12- (Hospice beds) all expandable to 19 beds, in a non-institutional environment.

In our society, this disease has been regarded as having no cure, no help, and no hope. This statement is a false proposition, as we strive to maintain as long as possible one’s quality of life, and reducing the levels of strain from the caregiver thus maintaining family dignity the key is, early intervention and education. We care for both the Caregiver and Care Recipient from the initial onset of this disease to the final moments, under the same roof and personal, this program is from cradle to grave. Our Holistic approach to this model will able us to accomplish all this. We will have a high quality care facility with a cost effective model that will keep the family at home together and not in a nursing home.

With such a large percentage of those being cared for at home, there is an increased risk of caregiver burden. This burden or stress can create an environment where elder abuse, neglect or exploitation is more likely to occur. Caregivers need to be given proper respite and support to deter the onset of an abusive situation. In Brevard County, elder abuse has increased by 68% between 1998 and 2003 (Florida Department of Elder Affairs). These statistics show that strong support networks have to be built within the community to relieve caregivers of burden and stress associated with their role.

The reality of Alzheimer’s is that it is a slowly progressing disease that leads to breakdowns in remembering loved ones, the ability to perform daily tasks such as how to eat and dress, and how to talk. On a day-to-day basis, caregivers experience the frustration and sadness that accompanies this disease knowing their loved one is trapped in a body it cannot escape. The current interventions that exist in our society have been more concerned with the care recipients’ needs, with little emphasis on the caregiver. Caregivers are an under-served segment of the Alzheimer’s population, a group that deserves the opportunity to be offered appropriate educational support and intervention. Our goal is to not only serve those afflicted with Alzheimer’s but to give special attention to caregiver burden with the goal of preserving the family unit and the quality of life of the patient.

To establish a collaborative relationship to facilitate and provide outreach, referral, information , education on coping with this dreadful disease and direct services through professionals and trained staff over the totality of the disease for both the Caregiver and care recipient.

Our Inner Core is our Adult Day Care

The following activities to support the Care Recipient and for support of the Caregiver:

• Multi-Therapeutic Intervention Program

• Mental Stimulation: mental stimulation therapies to challenge the mind, as reminiscing to exercise their short and long term memory. Trivia games and therapies designed for low, medium and high functioning clients. Example of these therapies is making a rag doll where each person has a task in the production of the item to meet their capability, in performing at 100% of their ability
  
• Social Stimulation: interaction in a group, or one on one. Field trips, that includes shopping going to the Zoo, going to the park for a picnic, trip to the Public Library and other activities.
  
• Physical Stimulation; Exercises, dancing and games that require physical movement
  
• Music Stimulation; such as sing along, solo singing and developing a choir. We have had our choir going out to other agencies to perform, with great success

These are all designed to improve ones health, mental stability, and social interaction, functional capability, to bring normality back into their lives and extend their quality of life.

The Day Care Center will also support:

• Sponsorship Program; Through donations and a grant from United Way of Brevard we are able to offer Day Care for our low income families.
  
• Professional Therapist and Restorative Therapy Program; With Alzheimer's patients, as the disease advances, there is a progressive physical decline. The dementia client is often in need of physical, speech or occupational therapy and have limited opportunities because of the restriction placed on them through are present health system. The professional therapists apply therapies to correct or improve the client’s deficiency. The problem begins when as therapists they can no longer provide therapy after three weeks due to the restrictions of the amount of time allowed. If additional therapy is not given, the client will often begin to decline again. Our Restorative Aides will then apply maintenance level therapy to retain and reduce further decline as long as possible.
  
• 24 Hour Respite Program Wing; This program will allow the Caregiver to escape the riggers and stress of caregiving by placing their loved into 24 hour respite, for one day or one week, knowing they are safe.
  
• Congregate Care and Rehabilitation Wing; Our clients will have some form of hospitalization, from falls and other medical problems and where most will require rehabilitation of some kind. To try and eliminate confusion in the Alzheimer’s patient, we will have in-house rehabilitation service. This will also allow them to participate in our Day care activities as additional rehab.
  
• Hospice Wing: Our main mission is to keep the family together and at home, but there will situations where the caregiver is so frail and stressed out that it would be better for the caregiver as well as cost effective to institutionalize into Hospice.

The Facility

Our Outer Core is our Caregiver Outreach

• Caregiver Outreach Program; 24/7 Caregiver Outreach Program with is the outer core to provide initial caregiver assessments to include psychosocial, needs and strengths. Individual / group counseling and crisis intervention services to families. Linkages to resources to include medical updates, financial and legal counsel, home safety issues and compliance as the disease progresses and day to day skills. An in-service / education program that will be offered during the early, middle and late stages of the disease. Develop Alzheimer’s peer support and stress management / relief network. Establish an Alzheimer’s and dementia resource and Service guide for each Caregiver to receive. Develop a public relation program to inform and reach out to families for early interventions.
  
• Caregiver Support Group & Reaching Out To Our Teens (R.O.T.O.T.) Programs: The majority of our Caregivers are struggling to provide care to their loved ones, with intense stress and lack of information about the disease and outside help. With our Support Group Program reaching out to the caregiver is offering our caregivers the knowledge on the disease itself, techniques to use when caring for their loved one and coping skills. Holding support groups with our caregivers, that are caring for the persons with Alzheimer's disease ( AD) or any of the forms of dementia, rate very high on the scale of challenges and can certainly be overwhelming. Frustration is a normal response with common day to day irritations that the caregiver can experience. Extreme continuous frustration the caregiver experiences can have consequences for the person doing the caring and the one being cared for. The stress experienced may have a negative affect on the physical health and can cause the caregiver to become physically or verbally aggressive towards the loved one. This is where we can help by assisting the caregiver in finding techniques for coping so they do not become a victim of these behaviors.

Our R.O.T.O.T (Reaching Out To Our Teens) Program developed and first implemented by Sandra K. Rutherford is another approach that we are now continuing here at Senior Care and will carry over to the new center. We have learned through experience and through statistics, since more of the AD patients are being cared for at home, often the younger generation are still at home. The children of the AD patient may still have children of their own living at home. We have found that often it is very hard for this generation to understand what is going on with their grandparent. We will see the frustration building in the caregiver because they are not only dealing with caring for their parent, but also have to cope with the disruption that this may be causing the family at home.

If they can understand why their grandparent is behaving the way they and teaching them techniques on how to deal with the issue will help lessen the severity of problems they may be experiencing themselves. By offering a group “rap session” will allow them to voice their concerns without feeling intimidated of being criticized. Education is a wonderful tool that can help alleviate confusion, and acting out on the part of the teen. Fear of the unknown is worse then the known. Knowing that someone cares and understands their feelings we believe will help to bring about positive behavioral responses.

• Home Health Care; A lot of our Caregivers are frail and unable to perform task required in the care of their loved ones. With our Home Health Care, we will be able to perform these tasks, such as dressing, bathing, toileting, getting them in and out of bed and normal household tasks.

This Holistic Model in the care of Alzheimer’s and other dementia is estimated to save 44% in the overall cost of care over a 10-year period, and can be replicated throughout The State of Florida and The United States.

Special Needs

The Alzheimer population in Florida is already estimated at over 500,000 with 15,887 in Brevard County alone.

Florida faces three major problems in the special needs of Alzheimer's and dementia:

1. Lack of infrastructure to properly to care for these individuals
2. Lack of facilities that can provide hurricane shelters for Special Needs persons (ie. Alzheimer's and dementia)
3. Lack of skilled staff, or knowledge to support and shelter this particular part of the population.

The Solution

Rampart Group,Inc., a not for profit corporation has developed a new concept that would combine both an operational facility for Alzheimer's and dementia patients and a special needs emergency shelter for server storm events and post-storm recovery periods.

The Rampart model provides a 24-Hour Caregiver Support Care Center providing adult day care, 24 hour respite, congregate care and hospice. The financial benefit:

1. 54% estimated cost savings of care over a ten-year period per patient.
2. Reduce the cost associated with disaster preparation, sheltering, and post disaster care.
3. Skilled experienced staff trained in the care of Alzheimer's and other dementia.

The Facility

The 42,000 +/-- square foot facility will be planned to:

• Full emergency shelter standards to withstand 150 mph Hurricanes, Tornado's and other sever storms.
• The highest possible levels of sustainable and energy efficient design. Reduce energy usage to approximately 25% of a similar facility of conventional design.
• Dramatically reduces shelters support system for power generation and its associated fuel requirements, etc.
• Water collection and purification, for use during and after the storm will be developed to occur on site, in the event of the failure of publicly supplied potable water.

This will allow the shelter to be fully functional even in a worse case post storm recovery scenario. Conventional back up systems, such as generators, will be provided and advanced systems, such as solar hot water, and solar electric systems, are planed to be integrated to assure that the necessary levels of care are provided even if the state's infrastructure (electric grid, natural gas and conventional fuels supplies or their distribution system) disruptions take place.

Shelter in Place

During potential serious events:

• Daycare, congregate care and hospice patients will be able to shelter at the Center during the storm event, and when necessary remain post event, until such times as it is possible to return safely to their homes.
• Outside Alzheimer's or/and dementia population that are not regular daycare center patients will be able to "pre-register" and be able to utilize the facility as a special needs shelter for additional 200 persons.
• Pre-registration would provide proper planning, staffing, provisions, and available shelter spaces.
• Caregivers would be required to shelter with the patient to assist in their personal needs.
• The Center would also be required to staff the shelter during the storm event and post storm recovery time.

Previous hurricanes in Florida, and even more dramatically Katrina, clearly illustrated the crisis and lack of infrastructure available to care for special needs patients before, during and after such events. By providing this valuable service, emergency management teams can focus on many of the other issues that they provide services for before, during, and after potential disasters, without having to concern, coordinate, and facilitate, the special care needs of dementia suffers and their caregivers. The cost savings alone for this effort can be tremendous to both the locals and state disaster assistance and emergency management teams.

THERE IS CURRENTLY NO REAL DEMENTIA SPECIAL NEEDS SHELTERS
AVAILABLE THAT PROVIDE THIS SPECIFIC NEED.

E- mail: ray@rampart-group.org  with questions/ comments about this website
 Last modified: March 1, 2007

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