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Adult Day Care: What Family Caregivers Need to Know

How to find the best adult day center for your loved one's needs

Caregiving, Adult Care Options, Card Game Playing, AARP

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En español | Adult day care programs can provide caregivers with a needed break while giving older adults a chance to socialize with their peers and remedy the isolation and loneliness many experience.

In 2016, the most recent year for which figures were available, about 4,600 adult day care centers across the nation served more than 286,000 participants, according to the National Center for Health Statistics.

Evidence shows that older people who attend these centers have a better quality of life. A 2017 review of research on adult day care programs published in the journal The Gerontologist found they provided health, psychological and behavioral benefits for participants, particularly those with dementia and other cognitive impairments.

Arranging for a loved one to spend time in adult day care also can have beneficial effects on a caregiver's wellbeing.

A study published in the American Journal of Geriatric Psychiatry in 2014 looked at 151 caregivers who take care of people with dementia. In an eight-day period, the caregivers showed higher levels of DHEA-S — a chemical that helps protect the body against the damaging effects of stress and may reduce the risks of illness — on days after their loved ones spent time in adult day care. Regular use of such services allowed caregivers’ bodies “to mount a protective and restorative response to the physiologic demands of caregiving,” the report concluded.

While traditional community senior centers can be a great place for healthy older people who don't have major physical or cognitive disabilities to exercise or take classes, adult day care centers serve those who need more supervision and services. More than half of older people who attend adult day care have some degree of cognitive impairment, according to the National Adult Day Services Association, an industry group.

Adult day services available

Centers may vary in their programs and services, the association says. But most offer therapeutic exercise, mental interaction for participants, social activities appropriate for their condition and help with personal care such as grooming and using the toilet.

They often provide meals and snacks, including special diets for those who need them, and door-to-door transportation for participants.

Some centers focus on specific areas of care:

  • Social centers concentrate on meals and recreation while providing some health-related services.
  • Medical/health programs provide more intensive health and therapeutic services in addition to social activities.
  • Specialized centers take participants who have only a particular condition, such as those diagnosed with dementia.

Nonprofit organizations, such as medical centers or senior organizations, run more than three quarters of adult day care centers. They normally operate on weekdays during regular business hours though some offer weekend or evening services as well.

Day care costs

Costs for adult day care can range from as little as $25 to more than $100 a day, depending upon factors such as what services are offered, according to the U.S. Administration on Aging. The average cost is just under $70 a day.

Adult day care services

Among the most common programs offered at adult day care centers:

• Counseling
• Education
• Evening care
• Exercise
• Health screening
• Meals
• Medical care
• Medication management
• Physical therapy
• Recreation
• Respite care
• Socialization
• Supervision
• Transportation

Source: U.S. Administration on Aging

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

When to consider
adult day care

The National Adult Day Services Association suggests caregivers look into day care when they start seeing signs that an older loved one:

• Is unable to structure his or her own 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 to be no longer safe on his or her own or feels uncertain and anxious about being alone.

Family caregivers also might consider adult day services when they need to work or be away from home for most of the day or if they are themselves experiencing ill effects such as anxiety, frustration, depression or health problems.

Finding and evaluating programs

To find adult day care programs in your area, you can type your zip code into National Adult Day Services Association'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. The association recommends asking some basic operational questions such as these:

• 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 or 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 feels the need for a break?

Are the restrooms conveniently located with grab bars and space for wheelchairs? Pay attention, too, to how the staff and attendees interact and whether they seem comfortable with one another.

Helping your loved one adjust

The transition to attending 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 loved one 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, the association says. If the program doesn't seem to be working out for your family member, you might take them out of the program for a time and try reintroducing them to the center later on.

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

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