Even after a disabling accident forced Jenon Laurene of Burien to leave her position as an intensive care nurse, she retains one patient.

Since 2007, Laurene noted her "full time job, and it is a full time job," has been protecting and caring for her mother, Doris Jean Hoogstad.

Though Hoogstad had lived in eastern Washington for decades, Laurene knew that she had to take in her Alzheimer's-affected mother when her brother and sister, also eastern Washington residents, attempted to sell Hoogstad's property and place her in a nursing home.

Once the initial legal battles were over, Laurene began the process of structuring her life around the "24-hour" care her mother required.

Her nursing experience has been invaluable, Laurene noted. "She's getting a professional standard of care," she said of her mother, noting that her training has helped her remain patient and provide a well-organized, healthy environment.

One of the services meant to fill the care-giving niche between independent life and nursing home, Elder and Adult Day Services, has become critical for Laurene and Hoogstad.

According to Cindy Sharek, the Puget Sound area program aims at actively improving the cognitive and physical abilities of participants in order to maintain their quality of life.

"Every activity we do has a therapeutic component," she said. Like Hoogstad, the other participants suffer from diminished cognitive abilities.

Sharek said that Laurene's fight against isolation for both her and her mother is typical among caregivers. Besides allowing caregivers with opportunities for commonplace outside interactions, she added, the program forges connections between participants.

The isolating nature of care giving also makes it difficult for Sharek and other EADS personnel to reach the people who could benefit most not only from the day programs, but also the Des Moines caregivers' support group, begun in March.

Held on the fourth Monday of each month at the EADS building on the Wesley Homes campus in Des Moines, the group allows caregivers to discuss challenges and learn skills necessary to meet the basic needs of their relatives. Respite care is provided during the meetings. Additional information is available at www.eads-cares.org.

Although providing care and social opportunities for her mother on her monthly disability payments is challenging, Laurene was quick to point out that the task is in many ways gratifying.

"I've always had a different relationship (with my mother), and it's just deepened," she said. Without the presence of her domineering father, Laurene noted, she has gained an appreciation for her mother's character.

"She has a sense of humor and really good insights," Laurene said.

"There are frustrations," she added, but the cross-generational contact between her sons and grandsons and her mother has been far richer than it might have been if they could only visit Hoogstad in a nursing home. "The other rewards are far greater."