Adult Day Care & Adult Day Health

 

 

Adult Day Services are organized and certified programs that offer family caregivers a break from what can be a twenty four hour a day responsibility. For working caregivers, it can mean the difference between keeping the family member at home or placement in a long-term care facility.

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Participants benefit too. They are able to be cared for properly and with dignity and respect. They are given the opportunity to have fun, interact with their peers, and to receive limited therapies that are needed for maximum functioning.

 

 

Types of Adult Day Services

There are three basic types of Adult Day Services.

  • Adult Day Care - the social model of care
  • Adult Day Health - the medical model of care
  • Specialized - providing care to specific groups such as those with dementias or developmental disabilities. Sometimes, specialized services are offered within an Adult Day Care or Adult Day Health setting versus as a free-standing separate service.

Adult Day Care Participants

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Adult Day Care (social)

Adult Day Care provides an organized program of services during the day in a community group setting for the purpose of supporting the personal independence of older adults and promoting their social, physical, and emotional well-being. Services are provided in a home or center certified to meet state standards (in most states) for Adult Day Care programs. Some facilities accept Alzheimer's patients and/or those with developmental disabilities.

What is offered from center to center and state to state will vary.

Very limited medical services, if any at all, are provided. Typically, there are no medical personnel on-site. Minor cuts or scrapes would receive first aid as you would expect in any group setting. However, in the event of an emergency, social programs call 911. Social programs cannot administer medication but, they can remind a participant to take their own medication which they have brought with them.

An Adult Day Care program provides:

  • structure, interaction, support and stimulation to older adults living in the community
  • respite for the caregiver
  • a way for working families to keep their family member living at home, providing supervised care while family members work

 

Centers usually operate during normal business hours, five days a week. Some programs offer services in the evenings and on weekends. Some offer transportation services.

Activities and assistance offered may include :

  • Individual activities - fun recreational stimulation that encourages social interaction and independent functioning. Examples might be reminiscence therapy, sensory stimulation, music, art, pet therapy, intergenerational programs, special holiday programs, etc.
  • Help for the family - case management, education, counseling, referrals
  • Meals and snacks - noon-time meals with morning and afternoon snacks; special dietary needs can be accommodated
  • Personal care - help with activities of daily living such as toileting, grooming, eating and other personal needs
  • Supervised care by trained staff
  • Therapeutic activities - exercise and mental stimulation
  • Transportation - door-to-door service for a fee (fee may be included)

Adult Day Care Participants

Services may change given the group needs and individual needs and the capability of staff. If there is something you want that is not offered, ask - preferably before deciding whether or not to use the program.

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Adult Day Health (medical)

Adult Day Health provides an organized day program of services in a community group setting for the purpose of supporting older adults’ personal independence, and promoting social, physical, and emotional well-being. Services must include health care services and a variety of program activities designed to meet the individual needs and interests of the participants, and referral to and assistance in using appropriate community resources.

Older Couple

Medical models are more appropriate for clients who require medical attention throughout the day, for example, a diabetic client who needs an insulin shot every few hours. Often, speech and physical therapies are made available.

Activities are very similar to those offered through an Adult Day Care program with the addition of more health oriented services, including medication management. Adjustments may be made to the type of activities for fun and stimulation that are offered based on the functioning levels of participants. Staff training would be in line with the increased responsibility for health care needs.

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Choosing a Program

The National Adult Day Services Association, formed in 1979, is a trade association dedicated to ensuring the quality of Adult Day Services. They:

  • developed national recommended operating Standards and Guidelines
  • provide standardized national accreditation
  • provide professional development and training geared to the needs of adult day services managers and direct care workers in the field

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The National Association of Social Workers launched a consumer site in 2005 called "HelpStartsHere.org". They offer a National Social Worker Finder database and provide information on various topics related to social work. They offer information on how to choose an Adult Day Services Program.

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Finding a Program

AAA Staff Person

The easiest way to find an Adult Day Services program in your area is to contact your local Area Agency on Aging.

When you call them, also ask about how quality is ensured, if there are any special programs you can make use of such as Older American's Act funded Adult Day Services programs, and what things to be sure to ask about when you are evaluating a program.

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Paying for Service

Financial assistance for Adult Day Services is limited. Consumers should expect to pay for services themselves. Talk to the center staff about your financial situation. Find out what options are covered within the fee and which are extra. Ask staff how to best receive needed services for the best price.

Find out what level of transportation costs are provided. Find out if meal costs are provided. Find out what other services are provided and compare that to the cost and safety/security/consistency issues related to providing the same level of care within the home. Another thing to consider is the cost of providing long-term care versus utilizing Adult Day Services - both on an emotional level and the cost of care level.

Typically, financial assistance is most readily available for programs that are under the medical model umbrella which would include those accepting Alzheimer's clients and those with developmental disabilities.

Medicare does not cover Adult Day Services costs at this time. However, some covered therapies may be available at an Adult Day Services center.

Medicaid may pay all the costs for a licensed Adult Day Health or Specialized Program (those using a medical model or who accept Alzheimer’s clients) if the person qualifies financially.

Check directly with the center. Many Adult Day Services centers are run by non-profits. Some offer financial assistance either through "scholarships", through their funding agencies, and/or by utilizing a sliding fee scale based on income.

Private medical insurance may pay for some or all of the cost when a medical model center is used - Adult Day Health or Specialized Program. They will usually require that the program be registered, certified, and/or accredited depending on what the state requires and where the insurance company is located, and that the center uses licensed medical personnel.

Long-term care insurance, depending on the policy, may pay for Adult Day Services.

Dependent care tax credits may be available to the caregiver. Check with your accountant or tax professional to see if you qualify.

Veteran's Administration contracts may be in place that would allow assistance with payment for eligible Veterans.

Not only do Adult Day Services vary from state to state on cost, they also vary on state regulations related to cost and fees. Costs also vary depending on the level of services. Adult Day Health and Specialized Programs will have higher costs due to the type of care provided and the level of staff training/qualifications needed to ensure a quality program.

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Quality of Care

Adult Day Services oversight varies from state to state. They are not federally regulated. Some states require licensure or certification. Some states have more stringent codes, laws, and regulations than others. Additionally, different funding sources may have requirements. There may also be requirements attached to particular services provided.

Typically, oversight and requirements are more defined and stringent for Adult Day Health and Specialized programs (medical models) than for Adult Day Care.

Some Adult Day Services choose accreditation. That means they agree to abide by standardized minimum standards set by the National Adult Day Services Association.

As a result, quality may vary from center to center and state to state. What is a consumer to do?

With so many variables, it might be best to contact your Area Agency on Aging and/or your state chapter of the National Adult Day Services Association. They will be able to provide you with information on your state's regulations and what to look for in a quality program.

 

 

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