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SIOUX CITY -- A personal care attendant arrives at Carol Lipsey's home on weekday mornings to help her mother, Dorothy Moore, get dressed.

While Lipsey heads to work, Moore is chauffeured by van to the Siouxland PACE Center for a fun-filled day of activities. 

PACE staff take care of Moore's laundry, transport her to dentist appointments, keep her entertained during the day with crafts, games and other activities, feed her breakfast and lunch, do physical therapy exercise with her, deliver her medications to her home and more.

"I could go on and on. There's so many great things that PACE has provided for my mother," Lipsey said while seated next to her mother in a conference room at the PACE Center. "I think my mother is really happy here and loves being here."

Moore, 75, agreed, saying of PACE, "I love it." She has made pencil containers, hats, flower pots and other trinkets at the center.

PACE, which has served people 55 and older who live in Woodbury, Plymouth, Cherokee and Monona counties for a decade, seeks to keep older adults as active and healthy as possible in their own homes. Using a team approach, PACE works with participants' families to meet their goals and needs. Individuals eligible for Medicaid and Medicare, or Medicaid only, pay no premium for services.

Stephanie Al Tamimi, recreation coordinator for PACE who has worked with the elderly for about 20 years, said there is great need in the community for the services that PACE provides.

"I've worked in the health care field with the elderly for about 20 years. I believe the need is definitely increasing," she said.

About 34.2 million Americans have provided unpaid care to an adult age 50 or older in the last 12 months, according to the National Alliance for Caregiving and AARP. The Alzheimer's Association says about 15.7 million adult family caregivers care for someone who has Alzheimer's disease or other forms of dementia.

Nursing homes can have long waiting lists and many families may not be able to afford the high cost. Finding a paid caregiver could be challenging as well. Numerous home health aides and nurses in their 50s and 60s are retiring, leaving Iowa with a paid caregiver shortage. By 2020, the state will need 95,000 paid caregivers.

Moore has spent most of her life living in Niles, Michigan, where she was born and raised. When she was diagnosed with the early stages of dementia, she went to live with her younger daughter and son-in-law in Indianapolis, but when the family couldn't find a suitable care program for her, Moore made the move to Sioux City in 2017 to live with Lipsey. Without PACE, Lipsey, who works full-time as a home visitor for Community Action Agency of Siouxland, said she wouldn't be able to care for her mother and keep the job that she loves.

"It's like our roles have reversed, where I feel like I'm the mother and mom is the teenager. It can be stressful because of the role reversal," Moore said. "I know if I didn't have the support of PACE, I wouldn't be able to do it."

A survey recently conducted by the National PACE Association, found that the program significantly reduces the caregiver burden on family members. PACE offers a caregiver support group that meets the third Thursday of each month.

Nearly half (49.6 percent) of family members reported high caregiver burden at the time their loved one enrolled in PACE. After enrollment, more than 58 percent of those who had rated their caregiver burden as moderate to high reported they experienced less burden. According to the survey, 96.6 percent of family members said they are satisfied with the support they receive through PACE, and 97.5 percent of family caregivers said they would recommend PACE to someone in a similar situation.

"Mostly people that are active and social and kind of have a purpose, they usually do a little bit better than if they are just sitting at home and not having that stimulation," Al Tamimi said. "Here in the center, they have the opportunity to built friendships and find other people who are maybe in the same situations."

Lipsey said her mother has thrived in the 15 months that she has been enrolled in PACE.

"The time she spent in Indianapolis, we saw a regression, because there was nothing for her. Here, she's being stimulated," Lipsey said of her mother. "It just has taken so much stress off of me. I don't have to worry about her all the time."

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Health and Lifestyles reporter

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