Centering On Care
The Reisterstown Road storefront of Renaissance Adult Medical Center is unremarkable, but pass through the secure entrance and you enter a vibrant world. The energy is palpable inside the walls of this spacious facility: The singing, card playing and lively debate from its senior citizens provide a window into how an adult day center can provide a sense of community for its clients.
Lazar Khodorkovskiy, 80, from Baku, Azerbaijan, has been attending the center for three years.
“I have many friends here,” said Khodorkovskiy, who lives in an apartment building on Park Heights Avenue. “I talk with people … because I’m alone at home. This is my life.”
Catering primarily to Jewish clientele from Russian-speaking countries, the Renaissance Center is part of the decades-long evolution of senior care. Centers like it began as merely an alternative to nursing homes or in-home elder care, but as aging in place has become an attractive option for mobility-challenged seniors and their families, adult day centers have expanded to provide specialized services, allowing seniors the opportunity to stay active, maintain a level of independence, receive the medical care they need and still reside with loved ones.
In Maryland, where regulations govern everything from staff to client ratios and standards of care, Levindale Hebrew Geriatric Center and Hospital launched one of the state’s first such centers in the late 1970s, said Michelle Mills, the institution’s director of adult day services. “They had some elders who kept coming every day and didn’t need the nursing home but needed some level of care. So [Levindale] worked with the state, got the regulations and got started that way.”
In addition to its hospital, Levindale, a part of LifeBridge Health that operates as an agency of The Associated: Jewish Community Federation of Baltimore, runs two adult day centers and a partial hospitalization program at its complex off of Northern Parkway.
Mills, a 20-year veteran in the senior-care industry, has witnessed adult day centers evolve from ad hoc programs into full-fledged facilities. She said that the overall goal remains for “people to either delay or prevent nursing home placement.”
According to Mills, two factors have helped fuel the growth of adult day care. With advances in medical care, patients in general are living longer but often with chronic, manageable illness. Adult day centers, she said, are able to provide needed care and — because ancillary costs such as living expenses are either nonexistent or much lower — at a cost far lower than that of nursing homes.
In addition, noted Mills, adult day centers are able to answer the challenges faced by hospitals, whose government-imposed reimbursement rules establish penalties whenever patients are readmitted for treatment within 30 days of discharge. If an elderly patient is sent home, for instance, he might not take medications correctly and become unwell again or suffer an accident, necessitating a return to the hospital. An adult day center, said Mills, could prevent that scenario from unfolding.
“When you walk into an adult day center you see all the activities; you see cooking classes and bingo and discussion groups,” she said. “But what’s really going on behind the scenes is all the nursing coordination and reaching out to community doctors.”
At the Renaissance Center, in addition to the medical treatment rooms, several other components fill the enormous former furniture showroom. Sporting a high ceiling and filled with long communal tables and dozens of chairs, the main hall functions as a dining area, performance space, chat area and game room. There is a billiard and dominoes area, and in warmer weather double doors open outside to tables and a patio. Members can take a chair-yoga class, learn computer and English-language skills and visit a small screening room with overstuffed chairs. There is a small library, a medical office, a visiting manicurist and barber and a chess area that Donna Tatro, activities director at the center for four years, said is constantly occupied.
“We’re a mini-city,” said Marina Sokolin, program director at the center.
According to Yelena Gelfen, 51, whose parents Dora, 77, and Gregory Solomyenik, 85, have attended Renaissance for about five years, the program provides peace of mind.
“Oh my God yes, that center is like my savior,” she said. “They’re open seven days a week including holidays.”
Gelfen and her husband work full time and cannot provide the daily medical care and transportation needed for her parents. The Solomyeniks were self-sufficient until several years ago, when Gelfen’s father developed macular degeneration and could no longer see well enough to drive; her mother has had three major surgeries and now needs extra assistance because of severe back problems. Gelfen mentioned a Renaissance driver named Avto, who is so attentive to her mother’s needs that she talks about him as if he were her own son.
Gelfen’s story echoes that of Alexandra Rakhman, 50, who, in addition to her husband, children and brother, works full time and cannot provide the care needed for her mother, Odessa, Ukraine-native Lia Ayzenberg, 87.
Ayzenberg lives at Weinberg Senior Living and has attended Renaissance for two-and-a-half years. Fluent in English and Russian, she worked in the United States after her arrival in 1979. Rakhman explained that it’s not as much the language needs but the cultural comforts that really make the difference at Renaissance.
“The older you get, the more that native culture comes out,” said Rakhman. “The food is more familiar; she still does think in Russian.”
Rakhman pointed out that her mother, like other Russian seniors who have lived in the U.S. for decades, would gladly eat sushi and Chinese food when dining out, but when dining in, she prefers the comfort foods of her native home. Rakhman talks to her mother a couple of times a day and sees her regularly along with the rest of the family, but she admits that her mother needs more than that.
“The level of socialization and care there is amazing,” she said. “It makes me feel nice and cozy while I’m working, and I don’t have to worry.”