Adult Day Programs

What is an Adult Day Program (also known as Adult Day Care)?

Adult day programs are designed to provide daytime care, activity, and companionship for older adults who can no longer manage independently, or who are isolated and lonely.

• Adult day programs offer a planned program of activities designed to promote well-being though social and mental stimulation. In some settings limited health related services are also available such as therapies or medical checkups.
• Adult day programs are typically “drop-off” programs that operate during daytime hours, Monday through Friday. (Some centers have extended hours.)
• Nutritious meals that accommodate special diets are typically included, along with an afternoon snack
• Many provide transportation.

These programs can be just the answer for families wondering how to manage the care needs of a loved one with responsibilities to a workplace, other family members, or other activities.

• Participants benefit from socializing with others and receiving needed care services.
• Caregivers benefit by getting a break from caregiving duties while knowing that a loved one is in good hands.

Caregivers may feel reluctant to use adult day care services because they seem unfamiliar, or because a loved one is hesitant to try something new. More often than not, however, your loved one will find the Adult Day program an enjoyable, comfortable, and safe place to spend part of their day. In some cases the use of an adult day program will allow a family to keep their loved one in their care longer than otherwise might be possible.

Who operates Adult Day Programs?

Adult day care centers can be public or private, non-profit or for-profit. In our community they are all private and non-profit.

Who can/should attend an Adult Day Program?

Seniors who are likely to benefit from adult day programs are those who:

• Can benefit from the friendship and functional assistance
• May be physically or cognitively challenged but do not require 24-hour supervision
• Are in the early stages of Alzheimer's disease
• Are mobile, with the possible assistance of a cane, walker, or wheelchair
• Usually must also be continent of bowel and bladder 
   

Examples:

• Paul is 69 years old and recently suffered a stroke. He needs some care and supervision so he lives with his son and daughter-in-law, David and Kira. However, because David and Kira both work, they need help to care for Paul during the day. They found a solution to their problem by having Kira drop off Paul at the local adult day care center in the morning, and having David pick him up when he gets off work in the evening. The center monitors Paul’s medications and offers him lunch, some physical therapy, and a chance to socialize with other seniors.
• John is 77 years old and suffers from Alzheimer’s Disease. His wife of 43 years, Terri, is his main caregiver. John is in the middle stages of Alzheimer’s Disease and needs a great deal of supervision and assistance planning his daytime activities. His wife was suffering greatly trying to keep up with his seemingly insatiable need for attention and direction. She thought it had come to the point she was dreading, where she needed to have him live somewhere else. With the support of a local adult day program, Terri now has help Monday-Friday caring for John. In addition, the adult day program she found has caregiver support and education programs that helped her figure out her routine of care for the weekends. So far this solution is working well for both John and Terri.

Are all Adult Day Programs the same?

No, there are several types of programs with different levels of care provided.

Most “Adult Day Programs” are what is called a social adult day care. (We prefer to avoid the phrase “day care” because those programs are more readily identifiable as programs for children.) The goal of these programs is to provide a safe and enjoyable social setting for care and companionship of seniors.

This differs from Adult Day Health Care, which usually requires a health assessment by a physician before someone is admitted into the program. Adult day health centers, which typically use the term "Adult Day Health Care" (ADHC) in their names, often provide physical, occupational, and speech therapy, and are usually staffed with an RN and other health professionals.

A third type of day care, Alzheimer’s Care or Memory Care, provides social and health services specifically for seniors with Alzheimer's or a related type of dementia.

What services does an Adult Day Program provide?

Services do vary, but a well-run adult day center's goals will focus on enriching the participants' lives, building upon their skills, knowledge, and unique abilities and strengths. In addition to the programs for seniors needing care, some adult day care centers provide social services including counseling and training and support groups for caregivers.

Below are some of the activities that may be available:

• Arts and crafts
• Musical entertainment and sing-a-longs
• Mental stimulation games such as BINGO
• Chair exercise, stretching or other gentle exercise
• Discussion groups (books, films, current events)
• Holiday and birthday celebrations
• Some centers offer inter-generational programs that include children

When should I consider using an Adult Day Program?

You should consider using an Adult Day Program IF you/your loved one:

• is isolated and desires companionship
• can benefit from someone else planning and guiding the days activities
• shouldn’t be left alone at home
• lives with someone who works outside the home or who is frequently away from home for other reasons

What should I look for in an Adult Day Program?
First, you will probably want to visit the centers closest to you, and to talk with the staff and other families that use the centers to determine if the facilities and programs available meet your individual needs.

How do I pay for Adult Day Program services?

Costs vary among adult day centers. In our area costs range from $30-75 per day.
While Medicare does not cover adult day care, Medicaid will pay most or all of the costs in licensed adult day health care settings and Alzheimer's focused centers, for participants with very low income and few assets. Be sure to ask about financial assistance and possible scholarships. Many facilities offer services on a sliding fee scale, meaning that what you pay is based on your income and ability to pay.

Private medical insurance policies sometimes cover a portion of adult day care costs when licensed medical professionals are involved in the care. Long-term care insurance may also pay for adult day services, depending on the policy. Additionally, dependent-care tax credits may be available to you as caregiver.

What should I ask when looking at a prospective Adult Day Program?

The National Adult Day Service Association suggests asking the following questions:

1. Who owns or sponsors the agency?
2. How long has it been operating?
3. Is it licensed or certified? (If required in your state)
4. What are the days and hours of operation?
5. Is transportation to and from the center provided?
6. Which conditions are accepted (e.g., memory loss, limited mobility, incontinence)?
7. What are the staff's credentials, and what is the ratio of staff to participants?
8. What activities are offered? Are there a variety of individual and group programs?
9. Are meals and snacks included? Are special diets accommodated?

Next, spend a day at the center that sounds best to you, so that you can get a "feel" for the people and environment. Be sure to bring a site checklist with you (see references and resources below). You may wish to go back a few times to see whether your experience on different days confirms your initial impressions.