Adult Day Care: What Family Caregivers Need to Know

• Specialized centers accept those who have only a particular condition, such as dementia.

Adult day care centers normally operate on weekdays, during regular business hours, though some offer weekend or evening services.

Day care costs

Prices can vary, depending on factors such as geographic region and range of services. The median cost across the U.S. is $1,690 a month, or $78 per day, according to the 2021 “Cost of Care” survey from long-term care insurance company Genworth.

While Medicare generally doesn’t cover the fees, financial assistance may be available through other government programs, like Medicaid, the Veterans Health Administration and state agencies. Thus, adult day care may be a more affordable option for caregivers seeking help and respite than hiring a worker to provide in-home care.

COVID-19 impact 

The pandemic took a toll on adult day care centers, according to data gathered by the National Center for Health Statistics. Between January 2020 and March 2021, nearly three-quarters of centers had to temporarily close or limit their hours. There were 12,272 COVID-19 cases and 1,494 deaths among adult day care participants in that period, and 6,181 cases and 38 deaths among center employees and contract staff.  

As a result, centers became more vigilant about safety, with 72 percent conducting daily COVID-19 screenings, in an effort to reduce the disease’s spread. About 8 in 10 facilities restricted access for family members, visitors and volunteers all or some of the time. Nearly half (46 percent) provided notification of new cases within 24 hours to local health officials and to clients’ caregivers and families. 

Since 2021, adult day care providers in some parts of the U.S. have eased certain COVID precautions, while others have maintained measures such as mask-wearing, based on what their state and local public health agencies require, according to Lance Roberts, associate director of membership and education for NADSA.

When to consider adult day care

NADSA suggests that caregivers look into day care when they start seeing signs that an older loved one:

• Is unable to structure his or her daily activities.

• Feels isolated and lonely and wishes for interaction with other older people.

• Experiences anxiety or depression and needs social and emotional support.

• Has difficulty starting and focusing on an activity, whether it’s conversation, reading or watching TV.

• Seems not to be safe on his or her own or feels uncertain and anxious about being alone.

Family caregivers also should consider adult day care services when they need to work or be away from home for most of the day or if they are experiencing negative effects like anxiety, frustration, depression or other health problems.

Finding and evaluating programs

To find adult day care programs in your area, type your zip code into NADSA’s searchable directory or contact your local Area Agency on Aging, which you can find via the federal government’s Eldercare Locator or by calling 800-677-1116.

Once you identify a center that seems to meet your loved one’s needs, the next step is to visit the facility. NADSA recommends asking some basic questions, such as:

• How long has the center been in operation?
• What licenses, certifications and accreditation does it have?
• What’s the ratio of staff to attendees (the lower the better), and what kind of training do employees receive?
• What days and hours is it open?
• What’s the policy on late arrivals or pickups if you won’t be using transit services that the center provides?

You’ll also want to explore the facility’s full range of services. Does it offer physical, occupational and speech therapy? (Nearly half of centers do.) Does it have specialized care for conditions such as memory loss?

Ask whether the center creates individual service plans for attendees, how often those plans are updated and whether you can provide input.

Spend some time simply observing the center itself.

• Does it seem clean and generally pleasant?
• Is the furniture comfortable and sturdy, and is the facility wheelchair accessible?
• Is there a quiet area where your loved one can relax if he or she needs a break?
• Are the restrooms conveniently located and outfitted with grab bars and space for wheelchairs? 

Pay attention, too, to how the staff and clients interact and whether they seem comfortable with one another.

Helping your loved one adjust

The transition to adult day care can be stressful for an older person with dementia. The Alzheimer’s Association suggests a gradual approach.

Once you’ve vetted a center, take your loved one there for lunch or an activity. Then start using its services a couple of times a week, for a month or so, before making a final decision about enrolling.

Your family member may resist adult day care at first, but participants often warm to it after several weeks and begin looking forward to seeing other people at the center and engaging in activities, NADSA says. If the program doesn’t seem to be working for your family member, you might remove them from it and reintroduce them to it at another time.

Editor’s note: This article, originally created in 2012, has been updated with more recent information.