Alma Troccoli is the picture of good health and cheer, so put together and well-spoken, it’s hard to imagine her any other way.

But the 80-year-old Davis resident and grandmother of four says if you’d met her for the first time just a couple of years ago, you would have encountered a very different person.

Struggling with her own health problems at the time, she also was the around-the-clock caregiver for her husband, Charles, now 90, who suffers from Alzheimer’s disease. And as so often is the case for aging caregivers, Alma Troccoli’s own health was deteriorating alongside her husband’s.

“My health was going down the tubes,” she says. “I weighed about 98 pounds. I had no interest in food and all the things that are part of everyday living. All I could do was care for my husband and it was wearing me down.”

Fortunately, her daughter was able to put her in touch with Peggy Phelps, the caregiver resource specialist at the Yolo Adult Day Health Center, and that changed everything.

A bus now arrives at their Davis home four mornings a week and Charles Troccoli is picked up and driven to the Woodland center, where he spends his day socializing, exercising and being cared for by a team of nurses, therapists, social workers and activity directors, before returning to Davis in the afternoon.

Alma Troccoli, meanwhile, reaps the benefits of some respite, all while knowing her husband of more than 50 years is content and well cared for, and still able to live at home with her.

Were he not spending four days a week at the center, she said, “he would be sitting in a recliner all day and deteriorating. He wouldn’t even be walking if he was at home.

“I often think now, ‘How in the world do other people manage who don’t come here?’ ”

It’s a question on the minds of many, ever since the state, in a budget-cutting move earlier this year, removed adult day health care from the list of benefits covered by Medi-Cal.

Beginning Dec. 1, said Yolo ADHC program manager Dawn Myers Purkey, that will leave about 75 percent of the center’s patients without coverage, and the center itself unable to continue providing the services it now does.

Currently, Yolo ADHC serves about 80 Yolo County residents over the age of 18 who have health conditions that interfere with independent living. Two-thirds of them, Purkey said, need assistance with basic care like dressing, bathing and using the bathroom.

Nearly 40 percent have a mental illness ranging from depression to schizophrenia, and 54 percent suffer from dementia. Many have primary caregivers who work full-time or, like Alma Troccoli, are no longer able to care for their loved ones 24 hours a day, so they come to the center up to five days a week, from 9 a.m. to 3 p.m. Monday through Friday.

Should the center have to close its doors due to the end of Medi-Cal coverage, the consequences for many patients here would be immediate, staffers say.

“Thirty percent of them would go straight to skilled nursing the day we shut our doors,” said social worker Jodie Valley.

Many more, she said, will become “frequent fliers” in emergency rooms or end up on psychiatric wards without the preventive care they are getting daily at the center.

That care includes everything from regular check-ups to assistance with medications, blood pressure and blood sugar monitoring and occupational and physical therapy.

Small medical issues are caught quickly here, Valley said, before they turn into something bigger.

Take a common urinary tract infection, she said. At the center, it likely would be caught and treated quickly, just because a staff member notices a patient using the restroom a little more frequently. Left untreated longer, that UTI could turn into something more serious — and more expensive to treat, she noted.

In fact, said Valley, any cost savings the state will see by eliminating coverage for adult day health care could immediately be canceled out by the much higher costs of skilled nursing care, ER visits and a general lack of preventive care.

Assemblywoman Mariko Yamada, D-Davis, authored legislation that would have restored funding for an alternative adult day health care, but Gov. Jerry Brown vetoed the measure in July.

The result, Yamada said, is that many adult day health centers across the state already have closed and many more will follow.
Purkey, however, is adamant that the Yolo County center won’t shut its doors entirely, no matter what.

“We’re going to remain here,” she said. “We’re not going away. We’ll rebuild and, with community support, I think we’ll rise from the ashes. Adult day health care makes too much sense to see it go away.”

Discussions are under way — including at a community forum held earlier this month — about what to do about the loss of funding. Participants — including the Yolo County Commission on Aging and Adult Services, the Yolo Healthy Aging Alliance and Woodland Healthcare — are focused on finding a way to continue providing community care even without Medi-Cal coverage.

And everyone still awaits the outcome of a federal lawsuit filed earlier this year that argues the state cannot eliminate Medi-Cal funding for adult day health care without providing appropriate replacement services. A U.S. district judge in Oakland will hear arguments in the case on Tuesday, Nov. 8.

“We’re staying optimistic,” Purkey said of the lawsuit.

They also continue to seek other sources of funding, including from the community.

The Friends of Adult Day Health Care, for example, will hold their annual fundraiser, “Blues Harvest 2011” on Friday. The event, which takes place from 7 to 11 p.m. at the Heidrick Ag History Center in Woodland, features live music, an auction and raffle, all benefiting Yolo ADHC.

For more information, call (530) 666-8828 or visit http://FriendsofAdultDayHealth.org.

— Reach Anne Ternus-Bellamy at [email protected] or (530) 747-8051.

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Charles Troccoli, 90, left, works on chair exercises with certified activity coordinator Laurie Smith on Thursday at the Yolo Adult Day Health Center in Woodland. Sue Cockrell/Enterprise photo

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Alma Troccoli shares a laugh with Dawn Myers-Purkey, program director at the Yolo Adult Day Health Center. Troccoli’s life has changed since her husband Charles has begun spending four days a week at the center in Woodland. Sue Cockrell/Enterprise photo

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Antonio Hernandez performs some occupational therapy under the watchful eye of Occupational Therapist Donna Tweltridge at the Yolo Adult Day Health Center. Sue Cockrell/Enterprise photo

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