Local outreach copes with Alzheimer’s and aging

Nelson Girardin, 88, spikes a balloon during a game of Alzheimer’s-friendly volleyball at Al’z Place in July. Al’z Place is an adult day care program that engages clients in memory-stimulating activities.

Published: Friday, August 1, 2008 at 6:01 a.m.
Last Modified: Saturday, August 2, 2008 at 12:52 a.m.

Beneath bushy, white eyebrows, Nelson Girardin sets his cane aside. It’s dancing time.

It starts in his toes, enclosed by Velcro shoes. It moves to his head, covered by a traditional flat cap. He ends up out of his seat, clapping his hands and tapping his feet.

“I like to dance with someone in my arms,” he says. “Every time I get a chance I dance, but not as much as I used to.”

Girardin has Alzheimer’s disease. But you wouldn’t know it by the way the 88-year-old bops to old favorites like “At the Hop.”

These days, he boogies at Al’z Place, a nonprofit day care for adults that provides a structured and stimulating setting. He was admitted into the program in early June after being on the program’s waiting list for eight weeks.

The number of names on the waiting list for Al’z Place has doubled in the past year. Those suffering from Alzheimer’s and other severe memory impairments are suffering longer, their disease worsening every day as they sit and wait.

Al’z Place, which is open eight hours a day, five days a week, is licensed by the state to care for up to 26 clients, said Anthony Clarizio, executive director of ElderCare of Alachua County. Because of advancements in technology and health care,

clients are living longer in the program. In turn, individuals must wait, some up to a year, to get into the program.

But Alzheimer’s doesn’t wait. By the time individuals are admitted into the program, they typically are at a lower-functioning level than when they were first put on the list. Individuals at a lower-functioning level are in the later stages of the disease. Last year, about 25 percent of clients were in the later stages. Now, it is 50 percent.

“The good news is people are living longer,” Clarizio said, “and the bad news is people are living longer.”

Consequently, the recreation-based program has changed. Fine arts and crafts have been replaced with less challenging activities. Clients are increasingly aggressive and disruptive, Clarizio said. Staff and volunteers exert more time, energy and attention.

“It’s just more stressful for everyone,” he said, “and I honestly don’t see this getting any better in the future.”

Alzheimer’s is a progressive and fatal brain disease divided into an early, middle and late stage, according to the Alzheimer’s Association. About 5 million Americans and 500,000 Floridians are affected by the disease, which destroys brain cells that are responsible for memory, thinking and behavior.

Stacy Merritt, program coordinator for the Central and North Florida Chapter of the association, said the three stages are guidelines that everyone goes through differently.

In the early stage, individuals begin to forget recent events and have difficulty performing complex tasks such as managing finances or planning dinner for guests, she said. They may behave out of character, too.

Clients entering Al’z Place at a lower-functioning level because of waiting list lengths are in the next two stages of the disease.

In the middle stage, individuals need some assistance with day-to-day activities. They may become confused about where they are and the day of the week, which can lead to screaming and struggling.

By the worst and last stage of Alzheimer’s, individuals cannot speak or control their movements. They lose the ability to sit, swallow and even smile without assistance.

Clarizio, who works for ElderCare, said he is seeing more aggressive behavior as clients are admitted into the program at lower-functioning levels. Two clients attempted to break out of Al’z Place in separate incidents. It was the first time an incident like this had occurred, and it happened twice in the last four months, he said.

“They’re angry at the disease and don’t know where they are,” he explained. “They don’t know why they’re here, how they got here or if anyone is coming to pick them up.”

Clarizio said he has observed some clients progressively deteriorate during his year and a half with ElderCare. John Baldwin Jr., 78, is one such client. Clarizio said he has trouble remembering his location, most recently thinking he was back in Kentucky.

Standing at 6 feet 2 inches, Baldwin was a part of the University of Kentucky Wildcats football team that won the national championship in 1950. He wears an engraved ring touting the championship.

All the activities at Al’z Place are designed to stimulate memory and motor skills in a failure-free environment. Clients play games and puzzles, talk about current events, share memories and sing songs from their era. They have the highest success rate with music.

“You’ll see them kind of remember the song,” Clarizio said, “and they’ll start singing and swaying.”

Clients do things at Al’z Place they wouldn’t be able to do in a nursing home, Clarizio said.

For example, Jim Yopp has assumed the position of master gardener. Yopp, who recently turned 73, fumbled around his first few weeks in the program, Clarizio said. He was subdued and withdrawn and couldn’t find his place.

“One day, he was walking up with his wife,” Clarizio said, “and he noticed that it was pretty weedy out there.

“He wanted to know if he could be the gardener. Now, he has a purpose in coming here every day. This is his project; this is his pride.”

Yopp described how the oranges on his tree at home are nearly ripe, measuring about the size of his fist. He said he grows flowers, green beans and tomatoes, too.

“My garden is number one,” he said with a smile.

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