Susan Jusino, right, has been attending the Adult Day Health center since November.
NORTH ADAMS, Mass. — A year ago, Susan Jusino was not in a good place.
"I had been suffering from depression and suicidal thoughts because I started losing my vision five years ago, and it keeps getting worse and worse and worse," Jusino recalled recently.
"They thought that the the socialization would be good for me because what I was doing was just sitting in my house doing nothing because of the depression.
"This place saved me, I can tell you."
"This place" is the Brien Center's Adult Day Health center.
Since November, Jusino has been a regular at the center, which offers critical support to 30 Northern Berkshire vulnerable elders and people with disabilities.
Three days a week, Jusino arrives at the center at 8:30 a.m. and enjoys coffee, tea and breakfast and companionship with other clients. That begins an active day that includes table activities, exercise, lunch, reading (the center has an audio book player) and special events like last week's "Christmas in July" party.
At first, Jusino said she was reluctant to get involved with the activities at the Brien Center. It took some time to break out of the cycle of depression.
But now, "I enjoy coming, I really do," she said. "The staff all knows what they're doing, too. They're really good. I may not be able to see clearly, but I see a lot of stuff. I get the feel of a place — who cares and who doesn't. But they all do here. I can honestly say that."
Jusino, a former certified nursing assistant in the Alzheimer's wing of a nursing home, knows how to spot a caring professional, she said.
"And they do take good care of us," she said. "Not to talk up the staff too much, but they're really good people."
Amoreena Gazaille echoes that sentiment.
Gazaille's mother-in-law was diagnosed with the beginning stages of Alzheimer's last October, and she has been coming to the Brien Center's Adult Day Health for about nine months.
The six hours her mother-in-law spends at the facility are the highlight of her day, Gazaille said.
"Coming here has boosted her," she said. "It makes her happy. It's something that she needs, and she needed it long before she came here.
"She looks forward to coming here. It gives her the interaction she needs to keep her healthy. It gives her people to care for her when the family can't because we've got to work."
Providing respite for caregivers like Gazaille is a major goal of program's like the Brien's ADH center.
"This is a great place for the caregiver to send their parent to know they're having a safe, fun-filled day without just sitting around all day watching television or sitting at home," said Kathy McLain, the program's director who has nearly 28 years of experience at the Brien Center.
Although the program is open to adults 18 and older with a physical or mental disability, the majority of the clients are senior citizens, including one 93-year-old who lives on her own but needs the part-time support the Brien Center can provide, McLain said.
"It does tend to be an older population," she said. "And I think the reason for that is you have that 'sandwich generation' that is taking care of their children and their elderly parents and working full-time jobs."
Sometimes, the caregiver is not a child but a loving spouse. That is how it was for Jusino, who is happy that her husband can get a break while she is at the Brien Center.
"It was important for me to come here to give him time for himself because he's having to do a lot for me now because my eyes are so much worse," she said. "I never said that to him. I told him that I needed to get out of the house. This is how I put it to him, 'I have to get out of the house and be with other people.'
"And he would have rather I stayed at home, but the reason I do it is to give him a break and get me back out of the depression."
Gazaille said her entire family benefits from the time that her mother-in-law spends at the ADH center.
"I am a full-time mother," she said. "I am a full-time worker. My children have after-school activities they do. As a family, we need this program for her and for us to have peace of mind. It is a wonderful program.
"She loves coming here. We love having her come here. If it wasn't for this program. I really don't know what we would do."
Gazaille only wishes the ADH program was better funded. As much as the participants get out of their time at the Brien Center, there is more that the program could offer if it could afford additional staff.
"They do have a wide range of clientele here," Gazaille said. "They could have a few extra [staff] and take people like her outside. There's a beautiful circle here in downtown North Adams. They could go outside and walk. They could take a day trip once or twice a month — take them to a restaurant or over to the movies.
"You wouldn't be able to do that with the current staffing — even a half-hour walk around the block."
Unfortunately for the ADH program, funds are not easy to come by.
According to numbers provided by Brien Center, the current Mass Health reimbursement rate is $58.83 per day/per person, based on the 2009 costs. The current actual cost per day for an ADH client is $70 per day/ per person.
"Statewide, [advocates] were looking to get an adult day health rate increase, which has been voted down several times — once in the House and once in the Senate," McLain said.
That frustrates Gazaille.
"They have paid their taxes, they have paid their dues, they've worked hard, and when it's their time, when their health goes a little crazy, it's time for us younger generations to pick up the slack and pay our taxes and be able to afford programs like this for them," she said.
The good news is that while the Brien Center's program may be underfunded, it also is underenrolled at the moment. McLain said it is licensed for 30 clients per day, and of the 30 total clients in the program, not all come five days per week.
She said a lot of residents don't know that the program exists as an option for families who want to keep their loved ones at home but don't have the resources to provide a safe environment 24/7.
For many families, that dilemma leads to the nursing home, which, according to Medicaid data, can cost the state more than $72,000 per year/per person, as opposed to adult day health services, which cost less than $17,000 per year/per person.
In addition to being more cost effective, programs like ADH that allow people to age at home are simply a better option for many individuals, Gazaille said.
"Unfortunately, the elderly people in our community kind of get lost in the shuffle," she said. "[Officials] really want you to go from home to nursing home. They leave out these great things in between where they don't have to go to a nursing home. They can still be part of our community and appreciated.
"My mother-in-law … says the last thing she wants to do is go to a nursing home. She knows that once she goes there, it's more toward the end. And for her and for us, it's heart-breaking. We do know that's the future, but as long as we can keep her in her home and keep her in programs like this and keep nurses and home health aides coming into the home, she functions wonderfully in her home.
"Here, she has a wonderful community, and it keeps her going."
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