Adult Day Care – What Everybody Ought to Know Before Enrolling
Adult day care programs are daytime services program based on community support for adult aging or adult with special needs outside their home. The activities of this program include health care services, social and mental support. They offer a safe, secure place for older adults to spend the day. With the help of adult day care services, adult with physical, social, and mental disabilities are able to continue to live normally.
Adult Day Care Programs and Services
Basically there are 3 service models offered in adult day care programs: medical services, social services with no medical care and the combination of both. The latest are the most popular one. Some specific services may also include health monitoring, personal care services, meals and nutrition’s, therapeutic activities, transportation, nursing services, medication management, caregiver support services, rehabilitative therapy, medical services, overnight care, and/or emergency services. But recent trends in this program to include increased availability of ancillary components, such as personal care, ‘‘up and tuck,’’ weekend or overnight respite, up to 2 weeks of overnight stays, rehabilitation therapy, and/or sub acute care.
Most adult day care centers operate 12 hours a day, 5 days a week. Most participants are attending in a combination of days to meet their individual needs. Recent national trends in this program to include increased availability of ancillary components, such as personal care, ‘‘up and tuck,’’ weekend or overnight respite, up to 2 weeks of overnight stays, rehabilitation therapy, and/or sub acute care.
Nearly 80% of adult day care centers are operated on a nonprofit or public basis. But recently, national trends show an increased frequency in profit programs. In urban areas, one program may serve one specific market area, such as dementia, multiple sclerosis, or traumatic brain injury. While in rural areas, the market size typically is not large enough to focus on a particular market niche. In the last two decades there has been a significant increase in this program that provide dementia services, whereas less than 3% of programs had specialized in dementia care in 1984. Because the number of elderly in the population is continuing to increase, there is additional demand for such service.
Adult Day Care Participants
The average participant age is at least 72, with the average age range at 45–91. Most participants are white, female, and unmarried. Participants have physical, mental, and/or social disabilities, and they prefer to live at home with a family member or friend. The participants’ most frequent living situations are residence with adult child (35%) and residence with spouse (20%). Interestingly, the two most prevalent conditions of participants are dementia and frail elderly or risk for social isolation. Most participants are dependent for at least one activity of daily living.
A few studies have provided comparative information about private pay versus public pay consumers. Compared with public pay participants, private pay participants were more likely to be white, to have memory losses, and to have cognitive decline within the 90 days prior to starting adult day care services. Private pay participants tended to have less impairment in activity of daily living.
Participants’ length of stay in this service ranges from short term to long term, providing a continuum of care for older adults. Participants’ average length of stay in ADS is 2 years, with a range from a few weeks up to 8 years. The primary reasons for dis-enrolling from ADS are need for long-term institutional residential placement and death. Non white participants tend to dis-enroll at higher rates than whites.
Adult Day Care Funding
Now more than 4,000 adult day centers are currently operating in the United States with supporting and providing care for 200,000 older Americans each day. Most adult day health care centers are non-profit and operate under a parent organization such as a nursing home, religious group, or hospital. Payment from public sources is typically made for 40–50% of participants. Reimbursement provided by public sources may include Medicaid, social service block grants, Medicare monies for rehabilitative services, Department of Aging food program, Veterans Affairs (VA) medical centers, and state general fund monies. Average daily fee was found to be $46, varying by type of services and location. Private insurance or Medicaid will pay for the care, which can range in price from $31 a day to $130 a day. There is a public pay eligibility gap that frequently impacts individuals with dementia. Some of the public sources require that the ADS facility must provide medical services to receive funding. The number of private pay consumers using ADS has been increasing. The private pay market is mainly found in middle and upper incomes. Approximately 25–35% of ADS consumers are private pay. In recent years there also has been a growth in the number of private long-term care insurance plans that cover ADS.