The roles in an adult day center vary by the center's specialty, but everyone who works there should have certain qualities, according to the directors of two area centers.

"They have to be very people-oriented," said Rose Wichmann, manager of the Struthers Parkinson's Center in Golden Valley, part of the Park Nicollet Health System ( "They have to be very patient. They have to be able to give people the gift of time. The more you try to rush people with Parkinson's tends to make symptoms worse."

These symptoms include deficits in skills that healthy individuals perform without thinking, such as speaking and walking. Struthers employs nurses, rehabilitation therapists, social workers and researchers who study the disease. Its therapeutic day program, Club CREATE (short for Center for Research, Education, Artistic and Therapeutic Endeavors), operates three days a week for clients with moderate to advanced-stage Parkinson's, Wichmann said.

Clients come for exercise, creative expression, arts programs, socialization and spiritual care, she said. The program also provides respite for caregivers. Program assistants are trained as certified nursing assistants to provide personal care such as help with toileting, bathing, eating and walking. Other employees include occupational, speech and music therapists, a social worker, a chaplain and an activities professional, such as an occupational therapy assistant or recreation therapist.

"Creative expression is so important in Parkinson's," Wichmann said. "People tell us when they're involved in something that they really love to do, their symptoms are better."

Augustana Open Circle Adult Day Center in Hopkins ( accepts members with Parkinson's, mental health issues, developmental delays and dementia, according to Gail Skoglund, who co-directs Open Circle with Peggy Gaard. All staffers are cross-trained to work with members based on their immediate needs.

Open Circle employs registered nurses to assess members, administer medication, and provide skilled nursing care. Certified nursing assistants provide personal care such as showering and shaving.

Program coordinators offer a variety of activities for members to choose from. Their backgrounds include marriage and family therapy, art, social services and occupational therapy. Open Circle also employs a coordination specialist who is also a music therapist, a recreation therapist, and a couple of therapy dogs.

"Our staff is really very eclectic in what they bring," Gaard said. "They have so many gifts. When they meld all those gifts, we have the ability to do almost anything."