Three types of adult day services
Adult day care is divided into three types: (social) adult day care, adult day health (medical) care, and specialized adult day care. Oftentimes one adult day center will offer all three types of care.
(Social) Adult Day Care
Supervised activities, meals, socialization, and limited health services, typically for seniors. Abbreviated ADC or ADS. It may require a health assessment by a provider before admission.
Adult Day Health Care (ADHC)
Structured therapeutic health services and supervised activities for the aged who meet nursing facility level of care requirements. Also called adult day medical care. There are trained nurses on staff and medication administration is provided. It does require a health assessment and recommendations by a provider.
Specialized Adult Day Care
Typically for Alzheimer’s, though it is usually open to people with most forms of dementia. There is an additional focus on preventing wandering, injury, and behavioral changes, and staff have specialized training in dementia. May be referred to as Alzheimer’s day care or day treatment, or dementia day care.
Is adult day care paid for by insurance?
Adult day care centers are partially or wholly paid for through the following programs:
Medicaid and Medicaid waivers
Program of All-Inclusive Care for the Elderly (PACE) & PASSPORT
Long-term care insurance (LTCI)
Managed long-term care plans (MLTC)
Senior services tax levies (these are county-specific)
Veterans Administration (VA)
Family Caregiver Support Program (FCSP) (under the Caregiver Respite Care program)
Private pay
Note that Original Medicare does not currently pay for adult day services.
**For detailed information on adult day care coverage through these programs, see our Guides on Who Pays for Adult Day Care? and Sources of Respite Care Coverage.**
Who participates in adult day care?
The average age of the adult day center care recipient is 72 and 66% of all recipients are women.
35% of the adult day center care recipients live with an adult child, 20% with a spouse, 18% in an institutional setting, 13% with parents or other relatives, while 11% live alone.
More than half of all participants have some level of dementia.
Programming can delay nursing home placement. Approximately 90% of centers offer cognitive stimulation programs, almost 80% provide memory training programs, and more than 75% offer educational programs.
Over 80% of participants attend full days and 46% attend five days per week, enabling family caregivers to remain in the workforce.
Most centers also provide caregiver support programs, including educational programs, caregiver support groups, and individual counseling.
The top conditions of older adult participants of adult day services are:
Dementia
Chronic disease (i.e., heart failure, COPD, hypertension)
Physical disability
Cardiovascular (heart) disease
Diabetes
Why use adult day care?
While loved ones may be reluctant at first to leave their home and go to an adult day services center, all the research concludes that loved ones benefit as much or more from this type of respite care, likely because it is:
physically energizing
combats loneliness and depression
supports a daily routine
is an outlet for expression and learning
promotes better sleep
In turn, caregivers benefit from adult day services in the following ways:
Role overload. This in itself is not detrimental, but it can cause negative outcomes. Reduction in role overload decreases the amount of time spent focusing on the problems of your loved one, resulting in fewer negative experiences (worry, stress, exhaustion, and feeling trapped).
Care-related stressors. These are lower specifically on days that adult day services are used. Seeking out adult day services at the appropriate time (not waiting until you are overstressed) and using the appropriate amount of respite might shield you from the negative effects that chronic stress can cause.
Mood. Mood changes that occur as a result of adult day services were minor decreases in depressive symptoms, anger, and worry - bringing a greater average positive mood.
Health. Caregivers have better perceptions of their own health and report less pain over time, which is also associated with lower burden and role overload. Adult day services also result in potentially less risk for illness. Your physical health may benefit just as much as your mental and emotional health. It has also been found that both dementia patients and caregivers slept better, with fewer disturbances, on the nights before the patients attended adult day care.
Relationships. Relationships between you and others in your can benefit from adult day services by allowing you to feel more rested, and relieved, and do more of the things you enjoy, which all have an association with feelings of improved relationships. You can participate in more social activities, as well as experience less conflict in your family.
Cost. The cost of both caregiving and costs associated with employment may decrease for caregivers who use adult day services, and over time the cost benefits continue.
Symptom management. The amount of time you spend managing symptoms lessens with the use of adult day services, allowing you to complete and engage in personal responsibilities. You may also experience lower levels of stress due to fewer symptoms present in the evenings following adult day services. Caregivers of persons with dementia also report fewer behavior problems and much shorter duration of behaviors when they do occur.
How to introduce adult day care
Introducing the idea of adult day care to your loved one can be a sensitive and thoughtful process. Here are some tips on how to approach this conversation:
Choose the right time and setting
Find a quiet and comfortable setting where you can have a private conversation without distractions.
Choose a time when both you and your loved one are relaxed and not rushed.
Express concern and empathy
Start the conversation by expressing your concern for your loved one's well-being and your desire to ensure they receive the best care.
Use empathetic language and assure them that your goal is to support and enhance their quality of life.
Provide information and have something to show them
Whether you have something pulled up on the computer or have hard copy materials from one or more centers, it's best to have appealing visuals.
Walk through them slowly and deliberately one at a time while discussing what's on each of them.
Offer detailed information about the specific adult day care program you have in mind. Discuss the daily schedule, activities, and qualifications of the staff.
Share any testimonials or success stories from others who have benefited from similar programs.
Highlight the benefits
Emphasize the positive aspects of adult day care, such as social engagement and building new friendships, structured activities, and an outlet for expression and learning.
Mention that it can provide a break for both of you, allowing you to maintain a healthy balance between caregiving and personal time, and that it may even improve your relationship.
Address concerns and listen
Be prepared to address any concerns or fears your loved one may have. Common concerns might include a fear of the unknown leading to reluctance to leave the home, worries about loss of independence, or anxiety about being in a new environment.
Actively listen to their concerns and validate their feelings. Reassure them that their well-being is a top priority.
Involve them in the decision-making process
Ask for their input on the choice of the adult day care center and any specific preferences they may have.
Empower them to make decisions about their care and express their preferences.
Visit the adult day services center together
Schedule a visit to the adult day care center for you both. This allows them to see the facility, meet the staff, and get a feel for the environment.
If the visit goes well, arrange a trial run with the center for your loved one to test it out (a few hours one day).
Be patient and offer reassurance
Understand that it may take time for your loved one to adjust to the idea of adult day care. Be patient, and allow them to express their feelings and concerns.
Reassure your loved one that your relationship will remain strong and that adult day care is intended to enhance their well-being and provide support, not replace you as their caregiver.
Seek professional guidance
If needed, involve healthcare professionals, social workers, or counselors to provide additional support and information.
