For the vast majority of older adults, aging in place at home is the preferred approach. But often, there comes a time when more hands-on support is needed. For some, this means it’s time to move to assisted living, but for scores of older Americans, the high cost of such communities is prohibitive.
Enter adult day care centers, which provide many of the services you’d find in an assisted living community during weekday business hours but are available to seniors living at home or with their primary caregiver.
Adult day care was the right choice for Sue Ryan, an experienced family caregiver based in Naples, Florida, when her husband’s dementia progressed.
Ryan, who is also cofounder of The Caregiver’s Journey, a nonprofit that provides resources to support dementia family caregivers, says her husband had been a very social person. “It became harder and harder for me to combine keeping him in a routine to keep him stable and keeping him engaged, which kept him happy and mostly at peace,” she says.
She needed a solution to support both her and her husband, so she began shopping around for the right adult day care center.
[READ: Group Homes: Pros and Cons for Senior Care.]
What Is Adult Day Care?
“Adult day centers are community spaces designed for older adults who want to maintain their independence while receiving the support they need,” explains Sarah Milanowski, manager of enrollment and marketing at LifeCircles PACE, a nonprofit that offers services to seniors based in West Michigan.
“These centers are also a key support for the families and individuals caring for older adults who need time to themselves or are juggling multiple responsibilities,” Milanowski adds.
In some ways, adult day health centers are similar to day care for preschool-age children. Still, Merle Griff, a gerontologist and founder and CEO of SarahCare, a Canton, Ohio-based network of adult day health centers, cautions that these centers are not just grown-up day care centers. “Adult day care is not a term we like to use because it sounds like we are babysitters, but we do so much more.”
These centers provide meaningful social contact and caregiving during the day for older adults who need hands-on support and caregivers who need some time away from a loved one during the day. Specifically, SarahCare and other similar adult day health centers offer a structured daytime program with social, medical and personal care services for older adults, Griff says.
These centers are a third place (outside the home and workplace) where older adults can find safety, support and socialization.
[READ Loneliness in Older Adults: Challenges and Remedies]
Adult day care center staffing
These centers are typically staffed by a variety of geriatric health professionals, which may include:
— Registered nurses
— Certified nursing assistants
— Activity coordinators
— Recreational therapists
— Social workers
Some states regulate adult day centers, while others do not — some may have strict licensing or oversight requirements, such as staff-to-resident ratios.
[READ 7 Myths About Caregiving and Home Care Costs]
Services Provided in Adult Day Care
The slate of activities and services can vary from center to center, but generally, most adult day care centers offer services including:
— Medication management, monitoring of chronic conditions and symptom management
— Meals, snacks and nutritional support
— Personal care assistance, including grooming and toileting
— Social activities, such as arts and crafts, listening to music, bingo and discussion groups or lectures
— Exercise and physical activities, such as stretching or chair workouts
— Holiday and birthday celebrations
— Outings to local cultural offerings, such as theater shows, concerts and museums
— Transportation to and from the center and local outings
— Respite services for caregivers, including counseling, education and planning support
— Pet therapy programs
— Opportunities for volunteerism and multigenerational interaction
Benefits of Adult Day Care
Most adult day care centers aim to enrich seniors’ lives while keeping them safe and offering assistance with activities of daily living similar to assisted living. This kind of focused support can provide a number of benefits:
— Reduced isolation and loneliness
— Stimulating educational activities may help delay cognitive decline
— Physical activity can help reduce the risk of falls
— Improved independence and agency for seniors who otherwise might be completely housebound
— A sense of support and reliability for the primary caregiver that can help them avoid burnout
“We think of our day centers as offering some of the best aspects of traditional senior assisted living or retirement communities without uprooting individuals from the homes and families they love,” Milanowski says.
For some, these centers can become an extension of the senior’s home.
“Our day centers are a place where everybody knows your name. Folks who use our day centers enjoy getting out, engaging with others who share common experiences, pursuing meaningful activities and the pleasure of going back to the homes they love at the end of the day,” Milanowski adds.
Are there drawbacks to adult day care?
Yes, adult day care can have drawbacks. Quality varies among centers; some may not adequately meet your loved one’s needs.
What’s more, as with other senior care options, staffing can be an ongoing issue at adult day care centers, Ryan notes. “There tends to be high turnover in staffing, so the people caring for your loved one are frequently not familiar with them. I struggled finding a day care center that had staff with longer than six months tenure.”
Lack of medical oversight may be another concern, depending on your loved one’s condition. For example, if your loved one has an advanced chronic condition, such as Alzheimer’s disease or another form of dementia, a day care center may not be able to adequately address their needs,as team members with the appropriate training may not be available.
It’s important to evaluate each center carefully and consider alternatives if one falls short.
[READ 10 Things You Should Never Say to a Caregiver]
What’s a Typical Day Like in Adult Day Care?
A typical day in adult day care can vary almost as much as the individual experiencing it, but there are some commonalities across centers. For example, many offer transportation to help seniors get there, and once they arrive, they’ll have options for activities and social contact, meals and supportive care.
For seniors attending one of two LifeCircles PACE locations in Holland and Muskegon, Michigan, a typical day starts at home. A home care aide meets them at home to help them get ready for the day before they are transported to the center.
At the center, a common progression of events is:
— Socializing with friends
— Participating in classes and games
— Eating a healthy lunch
— Receiving any necessary therapy services
— Attending special events, such as birthday parties or visits from school children
— Heading out in the community to shop, hear a concert or visit an art gallery
— Going back home at the end of the day via center-offered transportation
“Our day centers operate during regular daytime hours, and we provide transportation to and from the centers so participants and those who love them don’t have to worry about the logistics of getting there,” Milanowski explains.
When to Consider Adult Day Care
Adult day care can be a good fit for many older adults who are living at home or with their primary caregiver rather than in an assisted living situation. The following groups of seniors might benefit most from adult day care:
— Seniors who are no longer able to manage and structure daily activities
— Seniors who feel isolated or lonely during the day, especially if their primary caregiver works outside the home and they’re left alone for several hours at a time
— Seniors who may be unsafe when left at home alone
— Seniors showing signs of cognitive decline or an early-stage dementia diagnosis who do not yet require 24/7 supervision
— Seniors who want to make connections with other adults and take advantage of structured activities and support in the community
Some adult day health centers have restrictions on who can access this care. For example, LifeCircles PACE serves older adults who are 55 and above and eligible for nursing home care but prefer to remain in their own homes, Milanowski says.
How Much Does Adult Day Care Cost?
According to Genworth’s CareScout Cost of Care Survey, the national monthly median cost of adult day health care is $2,167 — about $100 per day or $26,000 annually.
This makes adult day care the most affordable of the senior care options Genworth tracks. For comparison, the annual median cost of a home health aide is $77,792, while assisted living clocks in at $70,800. The median cost for a nursing home is $111,325 for a semiprivate room, while a private room comes in at $127,750 annually.
Some centers are certified through the Centers for Medicare & Medicaid Services and may accept reimbursement from Medicaid for those who meet qualifying criteria. The Home and Community-Based Services Waiver allows some states the option to provide care to those who meet a nursing home-level of care, but would prefer to stay living independently in their community. Medicare does not usually cover the cost of adult day care.
How to Find Adult Day Care Near You
Ryan recommends beginning the search process by identifying what’s most important to you, the caregiver. Adult day health centers can offer time for caregivers to go to work, run errands, engage in self-care and more, so consider how much time you want available each day.
For some caregivers, that might be 4 hours per day, five days per week, while for others, a few hours per week will do.
Then, identify what’s most important for the care of your loved one, Ryan recommends, which will vary based on an individual’s:
— Chronic medical conditions and health care needs
— Medication requirements
— Personal care needs
— Dietary considerations
— Capacity for socialization
— Level of stimulation they can tolerate
Once you’ve identified your priorities, contact local centers to see which offers the best mix of services to meet those needs and can accommodate your preferred timeline. Your local Area Agency on Aging is a great place to start your search for a good local adult day health center. You can also ask your local senior center for advice and suggestions. Ryan says her caregiver support group was also a good source of leads and insight about local centers.
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What Is Adult Day Care? originally appeared on usnews.com
