A saving grace

Adults with dementia and their families in San Mateo County find Catholic Charities adult day program a blessing

By Christina Gray

Not long after Grace Sakoda’s 96-year-old father came to live with her family in their San Carlos home, she began to notice changes in his temperament and memory.

“He would complain that no one fed him,” said Sakoda, who admits to being confused and a little hurt. “I had just cooked him a full meal.” It was her husband who eventually recognized it might be late-onset dementia.

She had moved her Japanese-born father, Tsuyoshi, out of an assisted care facility in Southern California near her brother because “he just wasn’t thriving there.” It didn’t help that he had lost his hearing in the Korean War and only spoke Japanese.

“I was luckily working from home, and so was my husband, so we kind of took turns with him,” she said.

Still, caring for her father, working from home and raising teenagers was overwhelming. A Veterans Administration social worker told Sakoda about an affordable adult day care program run by Catholic Charities of San Francisco. Located on a leafy residential street in San Carlos only a mile from her home, the licensed adult day facility provides a safe, therapeutic environment for adults with the cognitive impairments of Alzheimer’s disease and other dementias, strokes, Parkinson’s diseases or traumatic brain injuries.

“I fell in love with everybody there, the clients, the staff and the volunteers,” she said. “The moment they would see my father coming they would run out the door to greet him. It made him smile.”

On typical weekdays, she dropped him off at 9:30 a.m. and returned at 2 p.m. The schedule gave her a much-needed respite and her father a community outside the family home.

One volunteer who knew Japanese surprised her father by engaging him in his native tongue. “That was a real comfort to him,” said Sakoda.

A year after her father’s death at 98, she and her two sons return regularly to the center, this time as volunteers.

Grace, a former auditor, helps with administrative work, including the production of the weekly activity schedule. Her eldest son plays the guitar for special event sing-alongs, and her youngest takes time out of his job as an emergency medical technician to lead once-a-week stretching exercises.


Dementia is an umbrella term for a variety of diseases and injuries that affect the brain, impairing one’s ability to remember, think or make decisions. Alzheimer’s disease is the most common type of dementia, which is the seventh-leading cause of death and one of the major causes of disability and dependency in older people worldwide, according to the World Health Organization.

Currently. more than 55 million people have dementia worldwide, and every year, there are nearly 10 million new cases.

A dementia diagnosis is life-changing news for any person. But it also particularly changes the physical, mental and often financial health of family caregivers, particularly women, to whom caregiving disproportionately falls. Hiring in-home caregivers is expensive — $45-$60 an hour in the Bay Area — as are local assisted living facilities, many of which cost more than $10,000 per month.

In a family with limited financial resources, caregiving often falls unfairly on the shoulders of one member who works 24/7, unpaid, to care for a family member, often on top of their regular job and/or raising children.

More than 65 million people, or 29% of the U.S. population, provide care for family members, according to the National Alliance for Caregiving.

“It really does take a village to raise our children, but it also takes a village to care for our elderly,” said Patty Clement, associate deputy director for Catholic Charities of San Francisco and an aging and dementia expert.

Clement has worked for Catholic Charities of San Francisco for more than 30 years. She oversees its Aging Support Services, which includes the adult day care program in San Mateo County, and another in San Francisco, which has an Alzheimer’s Day Care Resources Center. Aging Services in San Francisco also include the OMI (Oceanview, Merced Heights, Ingleside) Senior Center, and Breaking Bread with Hope (formerly Handicapables), a monthly opportunity for disabled persons to share Mass, lunch and fellowship. Aging Case Management is offered in San Francisco County and will soon expand into San Mateo County.

Catholic Charities partners with city, county and state agencies to help make aging services possible in each of the archdiocese’s three counties. This currently includes the San Francisco Department of Disability and Aging Services, San Mateo County Health, Aging and Adult Services, and the support of local foundations, civic organizations and private donors.

“We are currently working on expansion of aging support services into Marin County,” said Dr. Ellen Hammerle, CEO of Catholic Charities of San Francisco.

Parishioners in all three counties of the Archdiocese of San Francisco were surveyed by Catholic Charities in 2021 to assess their top three social service needs, according to Jane Ferguson Flout, director of community and strategic partnerships. “Aging Support,” “Rental Assistance” and “Linkage and Referral” (being pointed to resources for help) were identified as the top three social service needs in that survey.

Having dealt with dementia both personally and professionally, Clement is emotional when asked what message she wants to get across to local families trying to cope with a diagnosis of dementia.

“We want them to reach out and ask us for help. It’s OK to ask for help; you actually need to ask for help,” she said. “Nobody should have to make this journey alone. It’s too hard.”


At its core, adult day centers are about helping clients age in place with dignity and preventing their premature placement into higher levels of care or assisted living facilities.

“We’re a smaller program by design,” said Clement. The smaller group size of no more than 25-28 clients means the staff can handle behaviors that come in later stages of dementia.

Carmen Santoni is the longtime program director for adult day care services in both San Mateo and San Francisco counties. She is a calm and comforting presence, and clients seem to bloom in her presence.

She is there well before the first clients arrive at 9:30 a.m., either dropped off by a family member or arriving by Redi-Wheels, the San Mateo County para-transit service. She’s there again when they depart by 3 p.m. Extended care is available for an additional hourly fee for working family members.

Each day is structured, but offers new activities that include light exercise and games, art projects, music, pet visits from the Peninsula Humane Society, intergenerational events with local schoolchildren and much more.

The full daily fee is roughly $100, with adjustments calculated individually on a sliding scale based on ability to pay, and a limited number of scholarships available at a reduced rate.

While the program is non-medical, Clement says staff members routinely apply their professional training and experience to observe physical, emotional or behavioral changes in participants that family may need to be aware of or may require immediate intervention.


Clement said Catholic Charities also provides community education by showing the movie, “Too Soon To Forget,” to those interested in learning more about dementia.

“The goal is to show it to community groups and talk about it afterward,” she said. It was the impetus for Memory Cafe, a fun monthly social gathering at the Burlingame Parks and Recreation Center for clients with mild to moderate memory loss and their care partners.

Santoni also hosts and facilitates a Zoom caregiver support group in partnership with the Alzheimer’s Association. Here, family caregivers share feelings and experiences, coping mechanisms and relevant information with others while taking a break from their daily caregiving demands.

“Getting support so that you can still have a life of your own but know that your loved one is well taken care of is vital to family caregivers,” said Santoni. “That’s what we are here for.”

Christina Gray is the lead writer for Catholic San Francisco magazine.