Adult Day Care Explained: Types, Cost & How to Choose

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Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

Adult day care can be a good alternative to home care, assisted living, or other senior care options — especially if you are a caregiver for a family member. While adult day care does not have everything that your loved one may require, these centers are generally very skilled at the services they provide and can give much-needed caregiver relief.

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Most adult day care centers are affiliated with larger organizations such as home care, skilled nursing facilities, medical centers. However some others are non-profit, stand-alone centers. If you have several choices in your community, you will want to thoroughly explore each one to make the best choice for your loved one.

What is Adult Day Care?

Adult day care is an innovative and creative solution for caregivers and their loved ones. As the name states, care is for the day only and not overnight. If you are a caregiver, adult day care can give you some relief from the day to day duties of caregiving. Some programs do provide options for half-day participation, and others can even offer weekend programming as well. Here are some reasons why you might want to consider adult day care:

  • You may be suffering from caregiver burnout and need support.
  • You are unable to leave your loved one alone due to concerns about safety or wandering.
  • Structuring the day is challenging, as some people with dementia are unable to manage their time. Confusion and inability to concentrate leads to agitation, depression, and anxiety.
  • Your loved one is anxious and isolated. Loneliness happens to everyone, but disproportionality affects older adults who are unable to access social gatherings. People with dementia often need distractions and mental stimulation.
  • Private caregiving is too expensive.

A common solution to the above problems is to hire private caregivers. Home care can be costly, adding up to hundreds of dollars a week, depending upon how many hours you need. Adult day care can be a much less expensive alternative.

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What Are the Different Types of Adult Day Care?

Adult day care centers generally fall into three categories. Each has its advantages and deciding on a center depends on what your loved one’s needs are. However, other services that might be offered at Adult Day Care include recreation, meals, transportation, educational activities, and counseling.

You will not want to choose a daycare that focuses on primarily social activity if your loved one has medical conditions that must be attended to during the day.

Social

There is a large social component to all Adult Day Care centers. Some, however, make socialization the focal point of their program.

They may also have some medical services available, but that is not the focus. These daycare centers have a heavy emphasis on daily activities and social interaction.

Medical

This type of adult day care has medical staff, including nurses, physical and occupational therapists, medication management, health screenings, and chronic disease management.

Alzheimer’s and dementia

Many adult day care programs across the country accommodate people with cognitive impairment and neurological disorders. Social isolation and lack of stimulation are significant problems for people with dementia.

Often, family caregivers can’t provide the level and intensity of social interaction that they need. Adult day care programs design the day to reduce agitation, provide stimulation, and give participants a chance to interact with others.

How Much Does Adult Day Care Typically Cost?

The cost of adult day care can vary widely across the country. It can typically depend on the services offered, other community options, affiliations with health centers, and whether the program is profit or non-profit.

According to Genworth, the daily median cost of Adult Day Care in 2019 was $75. Medicare does not pay for adult day care, but certain types of Medicaid do. Since Medicaid is state-specific and eligibility criteria are complicated, you will want to check with your state Medicaid office to see if you qualify.

If you have a long-term care insurance policy, it might offer a daily benefit to use for Adult Day Care. Check your policy to find out the criteria for accessing this benefit. 

How to Choose an Adult Day Care

Choosing an Adult day care program has its challenges, and the most prominent one might start with your loved one. Resistance to the idea of adult day care is a common problem.

As you go through the steps of choosing the best adult day care, keep your loved one’s needs, preferences, and emotional state in mind.

1. Assess what your loved one can tolerate

Throwing your loved one into an adult day care without a discussion could be a recipe for disaster. They might refuse to go back. You will want to strategize and plan with care and compassion. The idea of going to a program during the day with other people might be terrifying.

Here are some suggestions on how to make the transition a success:

  • Talk with your loved one about the program and emphasize the benefits.
  • Agree to start slowly with perhaps two or three days a week or half days instead of full days.
  • Always give the decision making authority to your loved one. That sense of control will ease their anxiety about the situation.
  • Take your loved one to visit the program first to meet the staff and other participants. Having some familiarity and comfort first can go a long way towards easing into the program. 

2. What are your loved one’s needs?

If your family member has dementia, you will want to find a program specializing in the unique needs of people with cognitive impairment. Conversely, if your loved one does not have dementia it is unlikely they will do well in a program where most participants have this condition.

Check on specific medical services. A program that does not have a nurse or other healthcare professionals might be fine for someone in good health. But if your loved one needs medical attention, you want to make certain that is available. 

3. Check on certifications and licensure

Find out your state’s requirements for certification and licensure of adult day care centers. Verify that the center under consideration meets state requirements.

4. What is the staff to participant ratio?

Participation in adult day care can vary from day to day or week to week. Ask about how the center determines the staff to participant ratio.

Also, make sure to inquire about staff training, especially if the program focuses on dementia or other neurological disorders. 

5. Does the program provide transportation?

Many programs will pick up participants if they live within a specific catchment area or in a minimum range of the day care location.

There might be an additional fee for this service. If the program does not offer transportation, you will need to arrange for your loved one to get to the program and get back home. 

6. Cost and hours of operation

The cost of the program could depend on several factors. You will want to make certain there are no surprise costs associated with health screenings or therapy services. It is possible that many of the medical services are covered by your loved one’s insurance. Are there financial assistance programs available?

Hours of operation are essential because you may have specific times that you require respite. Make sure those times and days are available. 

7. Therapies and other medical services

Physical and occupational therapy can benefit people regardless of their medical or mental health condition. Having this option available could help improve your loved one’s strength, balance, and endurance.

For example, perhaps your family member needs daily blood pressure or insulin checks. If that is the case, make sure that required medical services are offered and that insurance covers those services.

8. Emergency procedures and protocols

Inquire about the emergency procedures and other safety protocols. When you visit, check out the physical layout of the community.

Are their handrails and emergency exits? If your loved one has a medical emergency, what is the process? Are staff trained in emergency procedures?

9. Meal preferences

Can the program accommodate special diets? If your loved one needs a special diet and this is not provided, you may have to send meals or provide food for preparation.

If your loved one has particular preferences, is it possible to incorporate some of those into meal planning?

10. Reasons for discharge from the program

For many people who have dementia or other mental health issues, the center may not tolerate inappropriate behavior. In general, any adult day care program will expect that people with dementia may have agitation and frustration.

Where they draw the line is harm to others or themselves. Find out the behaviors that might jeopardize your loved one’s participation in the program. 

Finding Out About Adult Day Care

In your effort to find affordable and reliable care, adult day care is an option to consider. As you investigate your options, keep your loved one’s needs in mind so that you can find the best fit.

It’s good to know what works best for you and your loved one, and you may find that it helps out more than originally intended.


Sources

  1. “Genworth Cost of Care Survey 2019: Skyrocketing care costs may make the dream of aging at home more challenging.” Genworth Financial. newsroom.genworth.com/2019-10-16-Genworth-Cost-of-Care-Survey-2019-Skyrocketing-care-costs-may-make-the-dream-of-aging-at-home-more-challenging#:~:text=The%20national%20annual%20median%20cost,cost%20of%20%2487.50%20per%20visit.
  2. “Adult Day Care: What Family Caregivers Need to Know.” AARP. www.aarp.org/caregiving/home-care/info-2017/adult-day-care.html
  3. “What Long-Term Care Insurance Covers.” Long-Term Care.gov. longtermcare.acl.gov/costs-how-to-pay/what-is-long-term-care-insurance/what-long-term-care-insurance-covers.html
  4. “State Regulations.” National Adult Day Services Organization. www.nadsa.org/providers/state-regulations/ 
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