Adult day care programs are supportive services designed to meet the needs of adults with disabilities who have difficulty performing activities of daily living.
These programs provide for adult's physical and emotional well-being through healthcare services, social and recreational activities.
By staying active during the day and returning home in the evening, adults keep a sense of independence and remain close to their families.
Centers for senior care are typically open from 7:00AM to 6:00PM, Monday through Friday. Seniors may attend one day per week, every day of the week, or anywhere in between. Whatever schedule is most appropriate for the individual and their family.
Adult day programs keep adults busy throughout the morning and early afternoon... they return home in the evening more relaxed... and their family can enjoy some much needed personal time.
These day programs give the families peace of mind, knowing that their loved one is enjoying companionship and care which allows them to handle their daily commitments without worry or interruption. Most importantly, participation in an adult day program allows the senior to remain in the community enabling their families to continue caring for them at home.
In choosing a program and center, think about your family member's needs as well as your own. Consider the available physical or occupational therapies, socialization opportunities, recreational activities, health monitoring and personal care services from which your family member might benefit. Programs offering these services provide the caregiver with occasional free time, coverage while working, and emotional support. These services can alleviate stress and improve time management for you and your family.
Factors to decide if adult day care is needed
All too often, families ignore the importance of looking after their own needs such as handling work commitments or taking some ‘time off’ . It is understandable that they are hesitant about having a family member cared for by others but assistance with their care giving responsibilities is a necessity.
Factors to be considered include: "If something happens to me, who will take care of "Mom"... "Dad"... "Spouse" " ? "Personal time for the caregiver is a must for their overall health". "Roles are now reversed - the family must now decide what is best". "Give your loved one the benefit of some outside stimulation". "Do not wait - having help can keep them home longer". Remember, an active daytime program for the adult benefits them and their family.
Why would caregivers hesitate to get a family member started in an adult day program? Comments heard from family members after they learn about adult day care programs include "Mom is too good for day care"... "Dad is better than the others attending"... "my Spouse was never very sociable".
Experience has shown that individuals attending a Center will readily adapt to the routine and respond positively to the social interaction with others. Sadly, the reluctance to attend typically rests with the family.
Self imposed feelings of guilt... no one else can help... they are not that bad... I can do it myself, are all commendable, but very wrong.
By not encouraging your loved one to stay as active as possible and interacting with others outside of their usual surroundings, the truly life changing decision regarding your family member may have to be decided upon much sooner than expected... the decision regarding nursing home or group home placement. By comparison, the decision to get them started in a program is one that is so much easier to make!
Adult day care programs offer day-time care for adults with disabilities in a comfortable group setting. Often serving as an alternative to nursing home care, these programs provide social and health services, engaging activities, gentle exercise and meals--in a safe, caring environment. Transportation assistance is also available.
In the U.S. today, 80% of care for the elderly and disabled or special needs adults is provided by family members. Adult day programs help family caregivers maintain their balance by providing a safe, dignified place for their loved one to spend the day, and by allowing the caregiver to continue to work outside the home, attend to other household duties, or take a needed break.
Research studies have shown that regular attendance may decrease an individual’s chance of falling or having an accident that would require a visit to a hospital or an Emergency Room.
Kinds of adult day care programs
Programs vary in type, such as: Adult Day Care (ADC), Adult Day Health Care (ADHC), and a Program of All-Inclusive Care for Elders (PACE).
Some programs are geared specifically toward elders; others also serve younger people who have some types of cognitive or physical limitations. Many programs are geared to serve individuals with memory loss, Alzheimer’s Disease or other dementias.
Programs provide engaging social and recreational activities, companionship, and meals, along with personal care for each participant. Individual care plans are developed for each individual. Activities may include art projects, gardening, reminiscence groups, bingo and trivia games. For many, the friendships that develop become an ongoing source of joy and meaning in their lives.
Adult Day Health Care programs also provide a medical component and are for those with more intensive health and therapeutic needs. Medical services include nursing care, physical therapy, speech therapy, and occupational therapy. A social worker and nurse are part of the program.
The Program of All-Inclusive Care (PACE) serves the very impaired and frail elderly who meet state medical insurance eligibility criteria for nursing home-level care. Funded by state medical insurance and Medicare, the PACE model of care assumes full financial responsibility for the health and health-related care needs of all enrolled participants. PACE program participants receive a wide range of social, medical and health services.
Proven benefits for participants
* They provide essential health monitoring and medical services. Due to professional training and on-going contact with participants, staff often identify health and compliance problems before they become a crisis. In one study, emergency room activity decreased by 56%, total hospitalizations decreased by 75%, falls decreased by 72%, and mental status was improved or maintained in 69% of participants after six months attendance at an adult day health program.
* The overwhelming majority of frail elders prefer to live in their own home or the home of a family member. These programs help make this possible for many. Door-to-door transportation to and from the program is provided or arranged for you. Those living alone find relief from isolation and depression in a supportive environment that includes a shared noon meal. Still others are able to live with family members because attendance at a program allows the primary caregiver(s) to continue to work, to meet other responsibilities, and to avoid “caregiver burnout.”
Affordable care for the whole family
* In the U.S. today, 80% of caregiving for the elderly and disabled or special needs is done by family members. Adult day programs provide desperately needed respite for family members, which helps to keep caregivers out of hospitals and institutions. Programs also serve an educational function, sponsoring support groups, workshops and talks on self-care and caregiving skills.
* The financial burden of long-term care is another major challenge, and stressor, for many families. Adult day programs offer care at a fraction of the cost of home care, nursing homes, or assisted living alternatives. Adult day programs with a health care component are covered in full by state medical insurance, or a combination of state medical insurance and Medicare. Private pay rates start at $30/day for adult day care and $60/day for adult day health care. Subsidy programs can further reduce out-of-pocket costs at both types of programs.
Encouraging someone to attend adult day care
Centers offer activities and care to those with mild to moderate symptoms. The cost is usually modest, compared with in-home care. But caregivers may find it hard to get their family members to attend. Here are some tips.
* Convince yourself first. Call for a tour, to see what might interest your family member and to discuss any obstacles you anticipate (e.g., There are too many “old “ people). Staff are expert at inducing reluctant people to attend, and in managing newcomer anxiety.
* Give a convincing reason. Some people attend because they see the center as their “Club” or as “class.” Some go for a particular activity, or to be with a new friend. Some attend to help others, as a volunteer would. Ask the doctor and others to back you up.
* Look for a hook. Schedule your family member’s visit when there is an activity (e.g., music, crafts, exercise, or discussion) that they might enjoy and try out on the spot.
* Take one step at a time. The objective of the first, short visit is simply to have the person agree to return for a day. Don’t push too hard; use a Try-it-and-see approach.
* Be firm. Initially, the person may enjoy going, but complain to you of being unhappy. Don’t argue. Next day just assume that you will return. Try saying, “They are expecting you today,” or “I want you to go for a little while,” or “Let’s talk about that later.”
* Get the right person to take him or her, at least the first few times. Choose someone who can usually et your family member to do things.
* Start with a few, short days. Two visits a week is a minimum for someone with memory loss. Short days are less taxing for newcomers. When the routine becomes comfortable, you can add days. It usually takes a new person weeks to adjust.
* Reinforce the positive. Support any positive experiences that your family member has or that you or staff noticed.
* Sometimes a person frets so much that it becomes counterproductive. Some find that trying again after a few months’ break is more successful. Legal and Financial Frequently Asked Questions
Can I enroll my loved one in a program without his or her consent?
The answer is "yes, but..." it is not advisable. These programs work best for people who want to be there. Often participants who are initially reluctant or even adamant that they don't want to try adult day programs find that, after actually trying it out, they change their minds. Explore why someone is unwilling to consider this option, and what he or she think these programs are all about. You may want to enlist the help of the staff at an Adult Day Care Center to encourage the person you're concerned about to actually visit a program to "see for themselves."
How can we pay for an Adult Day Program?
Medicare does not currently pay for these daytime programs, with the exception of PACE (Programs of All-inclusive Care for the Elderly). Medicare does, however, help pay the cost of important medical services.
Eligibility is based on an individual's number of years of Medicare-covered employment. A good rule of thumb is if an individual is eligible for or receiving Social Security or Railroad Retirement Board benefits, then they are eligible for Medicare.
Can Medicaid help?
Medicaid will pay for attendance at an adult day care program.The federally funded program is administered by individual states. Social workers can help investigate this option and help with the application process.
Additional adult day care resources
The National Adult Day Services Association (NADSA) provides national resources - nadsa.org.
Easter Seals helps family members locate adult day care programs in their area. They offer assistance to individuals with a physical disability, or those who may be disoriented with their surroundings and who need assistance with daily living activities