Laura Sakae, a petite 81-year old, jokes that she comes to Kuakini Health System's adult daycare program every weekday so she can stay out of trouble.

"I didn't have anything to do, so my daughter brought me here, so I wouldn't get into any mischief," said Sakae, who chats with friends, plays bingo and takes part in other activities while attending the program.

"It lets me feel young again."

Sakae, a retired state worker, is one of hundreds of Hawai'i senior citizens who attend adult daycare centers. At least three programs have opened up on O'ahu in the past 18 months, offering a money-saving alternative for families who might otherwise have to pay for in-home care and nursing-home care. They also provide a respite for caregivers or families worried about leaving elders with minor physical or mental problems alone during the day.

Dora Lum, an 81-year-old, attends the Kuakini program on the grounds of the Honpa Hongwanji Mission on the Pali Highway. Lum said her daughter has peace of mind about her while at work, while she gets to exercise, play games and meet with friends during the day.

If not for the center, Lum said she'd be at home eating and watching television alone.

Families can save thousands of dollars at adult daycare compared to some of the alternatives. The average adult daycare program costs $45 to $50 a day, or about $1,000 a month, and compares to the $6,000 to $8,000 monthly cost of a nursing home, said Audrey Suga-Nakagawa, head of Honolulu-based ASN Consulting Services, which specializes in healthcare and elder-care services.

"People are becoming more aware of their choices and that nursing homes aren't their only alternative," Suga-Nakagawa said. "We'll continue to see this."

The day programs also help families avoid overpaying for costlier options when all that's needed is some activities and light care, said Barbara Kim Stanton, state director for the American Association of Retired Persons.

She said the programs are also valuable in that they keep the elderly in communities and with families instead of being sent to nursing homes where they may be more isolated.

"Sometimes you need a broader community," Stanton said. "It's not just keeping them busy, it's also a place where they can meet with friends.

Nationally there are more than 3,500 adult daycare centers that cater to more than 150,000 older people, according to the American Association of Homes and Services for the Aging. The daycare programs typically operate during business hours weekdays and offer activities, limited healthcare monitoring, meals, snacks and sometimes outings.

For people who have a bit more complex medical needs, there are adult day health programs that charge $65 to $80 a day, Suga-Nakagawa said.

Some of the programs are linked with medical centers, churches and nursing facilities. There are also for-profit operations, though Nikolaus Thelen, administrator of Wonderful Hawaii Adult Day Care in Salt Lake, said it isn't a business where one gets rich.

His center opened earlier this year and, like other programs, had to go through an extensive licensing process that includes getting $1 million of liability insurance, inspections by state agencies and background checks.

Kilohana Adult Day Care, which opened last month, is tied to Kilohana United Methodist Church and managed by Arcadia Elder Services. Bonnie Ho, program director, knows firsthand the trials of caring for aging adults, having previously quit a job to take care of her parents.

Add in school-age kids and some couples feel they are sandwiched in between generations requiring care, Ho said.

"It just gets difficult. The church felt there was a need in the community."

GOOD MATCH WITH PROGRAM IS TOP PRIORITY

Finding the right daycare program for your parents or loved one is crucial if you are going to use these services, according to Jan Shishido, who directs Kuakini Health System's 34-year-old adult daycare program.

"What we're looking for is the best fit for the senior," said Shishido. She recommends shopping around and finding where the person benefits the best because it will be easier for everyone involved, including program staff members.

"You don't want it to be like dragging in a kid," she said.

The National Adult Day Services Association recommends the following steps for finding the right program: