Caregiver guide
A Good First Day
The first day at an adult day center can feel huge, for her and for you. She may worry she’s being sent away. You may worry she’ll feel left behind.
Settling in takes weeks, not a day, and much of it rests on small things: a visit first, a calm morning, a short goodbye, and staff who know her. This guide follows Ruth’s first day. The 3D guide shows each moment twice: first what makes it harder, then what helps.
About 1 in 3
34.1% of people at adult day centers have Alzheimer’s or another dementia (2022). Centers expect people like her.
Weeks, not a day
Some people resist at first, “but they often look forward to the visit after several weeks of attending.”
Short days to start
“Two visits a week is minimum for someone with memory loss,” and short days are easier at first.
Calmer evenings
On center days, caregivers had less stress, and evening behavior problems eased (121 families).
Before the First Day
How it’s introduced shapes how it’s heard. “Day care,” said the night before, can sound like being sent away.
What helps
- Visit together first, for lunch or an activity she’d enjoy, timed so something is happening.
- Give it a name and a reason. Many families call it “the club.” Others point to the music group, a friend, or a chance to help out.
- Let someone she trusts suggest it: her doctor, a friend, or someone from her faith community.
- Write her About Me page together (below), so the staff can greet her as herself.
- Ask how they welcome newcomers. “Staff members are expert at managing newcomer anxiety.” Ask about a buddy.
- Plan short days: two days a week, picked up after lunch at first.
- Don’t announce it too early. If talking about it upsets her, let it go and try again later, closer to the time.
The Morning
She takes her cue from you. A rushed, tense morning, with questions she can’t answer, makes the goodbye harder before you’ve left the house.
What helps
- An ordinary morning: her usual breakfast and routine, with clothes laid out and her bag packed the night before. A predictable routine eases worry.
- Leave enough time that no one has to hurry.
- Say it simply, when it’s time: “They’re expecting you at the club today,” or “I want you to go for a little while.”
- Something from home: her cardigan or a family photo, if the center allows it.
The Goodbye
“Many people with dementia fixate on the caregiver for security,” the Family Caregiver Alliance notes. So the goodbye matters: hesitation reads as doubt, and “remaining calm, positive, and confident during drop-off can help reduce their anxiety.”
| Instead of | Try |
|---|---|
| Leaving her at the door of a room full of strangers. | Hand her to a person, who greets her by name. Ask who will meet her. |
| A long goodbye, then coming back, twice. | A hug, “I’ll pick you up after lunch,” and go. Calm, positive and sure. |
| “I’ll be back soon.” | A time she can hold: “after lunch.” The same words every time. |
| Arguing when she says she won’t stay. | “Let’s talk about that later.” Don’t argue or push. |
On the first visits, a familiar person can stay for the first hour or two, or go along with her.
Settling In
Left alone by the door with her coat on, she may just wait for you. A job and a friendly face help her feel she belongs.
What helps
- A job she’s good at. Some people go to help others; staff can use her About Me and ask her to hand out song sheets or set the tables.
- A buddy. A seat beside someone who shares an interest gets the talk going.
- Her own name and story. Staff use the name she likes and talk about what she loves.
- Help her settle: her coat on the hook, her own cardigan on, her bag where she can see it.
“When Is Ann Coming?”
She may ask again and again when you’re coming. The question is about feeling safe. A different answer each time, or “You already asked,” can send her looking for the door.
What helps
- One answer, every time. “Give the person the answer that he or she is looking for, even if you have to repeat it several times.” Agree it with the staff, in your words: “After lunch.”
- Something she can check. “Offer reminders by using notes, clocks, calendars or photographs.” Tuck a note in her pocket in your handwriting.
- Come back when you said.
- Ask the staff how she did. She may say she didn’t like it and still go back the next day. She may not remember the day; staff can fill in the details.
Give it a month. Try it at least twice a week for about a month before you decide. If she stays very distressed, a break and a fresh try a few months later often works.
About Me
One page for the staff, written with her before the first day. It borrows from the Alzheimer’s Society’s “This is me” leaflet. Print it for the center, or copy it into their forms. It’s kept only while this page stays open.
About me
Please read this before we meet
Kept while this page stays open
Your Day Too
The center is for you as well. One wife planned: “One day I will do something for myself, and the other I will do chores.” On center days, caregivers report less stress, and DHEA-S, a hormone that rose and fell with their good mood, was higher the next day.
Worrying that she’ll feel abandoned is common, and so is a rough first day. It’s “a process.” Stay on message as a family, even when guilt pulls, and judge it after several weeks, not one morning.
This guide offers general information, not medical advice. Every person is different, and what helps can change over time. Your loved one’s doctor or care team, and the center’s staff, can help you decide what is right for them.
Sources: Alzheimer’s Association, Adult day centers · Alzheimer’s Association blog, Adult day centers and how to encourage attendance · Alzheimer’s Association, Repetition · Alzheimer Society of Peel, Tips for attending a day program · Alzheimer’s Society, “This is me” · Family Caregiver Alliance, Adult day care for Alzheimer’s: the first day · UCSF Care Ecosystem, Adult day programs · UCSF Care Ecosystem, Anxiety related to dementia · HōttoCare, Transitioning to a day program · Fairfax County Health Department, Easing the transition to adult day health care · Alzheimer’s Orange County, Selecting an adult day service program · Penn Memory Center, Adult day programs · AARP, Adult day care · CDC FastStats, Alzheimer disease · Zarit and others, 2011, adult day care and caregivers’ daily stress · Zarit and others, 2014, adult day services and DHEA-S · Liu and others, 2021, sleep and adult day services