What Is Adult Day Care?0 USER TIPS ADD YOUR TIP
Adult day cares, also called adult day services, are a form of respite care. These structured programs offer supervision and support for older adults during the day or for part of the day. They can give caregivers time to rest, run errands, or go to work.
Adult day services typically offer activities—art making and music workshops, for example—and provide meals. Some also offer transportation. Hours vary at different centers. They tend to be open from seven to 10 hours a day, and some may have weekend and evening hours. Some programs may even offer overnight services.
State regulations vary, with some states requiring licensure only, some requiring certification only, some requiring both, and some requiring neither. You can find out more about the licensing, staffing, inspection, and other regulations in your state in this report from the U.S. Department of Health and Human Services.
Types of adult day care
- Adult day services (ADS) are for older people who don’t need medical support during the day, but may need supervision and a social experience. These programs focus on activities and outings. The people who attend can generally get around on their own. This is sometimes referred to as the social model of adult day services.
- Adult day medical care (ADMC), also referred to as adult day health care services, is for people who may be more frail, have a medical condition, and/or suffer from memory loss or some form of mild dementia. These centers offer activities but are also able to adapt to the medical needs of attendees. They can often help with medications; monitor things like blood pressure, blood sugar, and food and liquid intake; provide assistance with eating, walking, and toileting; and even provide rehab services. Staff includes skilled nurses or others with health training and certification. This is also known as the medical model.
- Alzheimer’s day care or day treatment centers offer more specialized care for people with Alzheimer’s and other types of dementia. Staff may be specially trained to watch for wandering and other issues related to dementia. (If a person has dementia, it may take time for them to adjust to a new daily routine, but over time, they may begin to look forward to going, say experts.)
Some adult day services accommodate more than one type of care listed above, so ask detailed questions when researching programs.
Cost and how to pay for it
Adult day care costs vary widely depending on location and type of care provided. While the national median cost is $70 per day, according to the Genworth Cost of Care survey, there is a wide range (look for the median in your area here).
In Mobile, Alabama, for example, you might spend $20 per day, while Manhattan’s daily average is closer to $150. And for an adult day care in New York City that provides more intensive medical services, you could pay as much as $250 a day.
Some day cares are private pay and some are government-funded, meaning either the center has received federal or state funding to provide some form of adult day care at a low cost, or the person can rely on their Medicaid or Medicare coverage to help with costs.
For example, PACE (which stands for Programs of All-Inclusive Care for the Elderly) is a Medicare program and Medicaid state option that offers care and services—including adult day services—to people 55 or older who otherwise would need nursing home care. You can have either Medicare or Medicaid, or both, to join PACE, according to Medicare.gov. But PACE is only available in some states that offer PACE under Medicaid.
The VA will pay for adult day health care but not adult social day care. Adult day health care is included in the VHA Medical Benefits Package. A health care provider needs to determine if the veteran qualifies for the level of care and supervision provided in an adult day health care centers. A co-payment may be required.
Those who are eligible for a VA pension can also receive additional payment known as Aid & Attendance. This can be used to help pay for long-term care, including adult day care. To qualify for Aid & Assistance you must require assistance with daily activities such as bathing or toileting, be bedridden, be in a nursing home, or be visually impaired.
Other sources of financial help
- Private day services may offer services on a sliding scale, where caregivers pay according to their financial ability or income.
- If the person in need of care has long-term care insurance, it’s worth investigating if the policy covers adult day care.
- Consider asking family for contributions to cover costs.
- Look into local resources for free care, such as churches and medical centers.
What to look for in an adult day care
Finding an adult day care program that you feel is safe for your loved one, that you can afford, and that your loved one will enjoy is no simple task. Ask friends and family for recommendations. Doctors and other health care providers, geriatric care managers, social workers, and elder care attorneys may also have suggestions. You can browse adult day cares in your area using our service finder:
Consider what kinds of services your loved one might require: Do they need medical assistance, such as help with insulin shots or medication? Special care for dementia? Help eating or using the toilet? Specific dietary needs? Then as you consider different programs, ask about the services you need, as well as questions like these:
- How long has the program been in business?
- What kind of licensing or certification does the program have? Is it Medicaid-certified?
- What are the basic fees? Are there any additional fees for services such as field trip transportation (some groups may visit a museum or the library, for example)?
- Is there any financial assistance?
- What are the hours and are there minimum attendance requirements?
- Is there a payment policy for absences?
- Will the center evaluate the person’s needs? If so, how often?
- What types of activities are offered? (Are they ones that your loved one would enjoy?) If your loved one has dementia, find out if there are activities appropriate for them.
- Are people with dementia separated from others or included in general activities?
- What types of health care professionals are on staff? How are they screened? Are they certified? Get details on certification programs they’ve attended to be sure the training programs are reputable.
- What kinds of health services are provided, and who provides them? Some examples of services include blood pressure checks; physical, dental, foot, eye, or ear examinations; and physical, occupational, speech, or mental health therapy services.
- What types of personal care are offered? Some day services offer hairstyling, bathing, and other personal care help.
- What kinds of snacks and meals are provided? Sample the food. If your loved one has special diet needs, ask if the program can accommodate them.
- Is the staff trained in dementia issues? Do they know how to patiently care for people who have speech difficulties, wander, suffer from incontinence, experience hallucinations, or exhibit sexually inappropriate behavior?
- If your loved one uses a wheelchair, can the service accommodate them?
- How are emergency situations handled?
- Is transportation to and from the service available?