The phrase “adult day care” is most often used among caregivers and their families to describe a service that provides supervision for seniors outside the home. But adult day services, which is the preferred terminology among experts, are so much more than that.
Adult day services support the well-being of both older adults, and younger adults with special needs in community-based programs, explains Keith Anderson, chair of the department of social work at the University of Mississippi who holds a doctorate in gerontology. “Adult day centers allow the person receiving services to engage with others and to receive care and support, while their caregiver receives respite or a break from caregiving,” he says.
So, what types of adult care and senior care do adult day service providers offer? Experts explain, and share how you can go about finding the right program.
What is adult day care?
“Adult day services are comprehensive programs designed to support seniors, and adults with disabilities while allowing them to continue living in their own homes,” explains Heidi Gras, executive director at LifeCircles PACE, a senior care partner of the Program of All-Inclusive Care for the Elderly (PACE) based in Muskegon, Michigan. “These programs act as a catalyst for connection and purpose for those attending them and can be a respite for caregivers.”
From key features to cost, experts offer a closer look at what adult day services entail:
Services provided by adult day centers
“Some services are universal in almost all adult day centers, such as programs for socialization, health and safety monitoring, meals and respite for caregivers,” Anderson says. While hours and specific features can vary from center to center, all adult day centers generally operate during normal business hours and offer the following services, according to the National Adult Day Services Association (NADSA):
- Social activities planned to provide interaction with other participants.
- Transportation to and from your home and the facility each day.
- Meals and snacks served daily and catered to any special dietary needs.
- Personal care, including toileting, eating and other activities of daily living (ADLs).
- Therapeutic activities such as physical and mental exercise programs.
Licensure and regulations for adult day services
There is a wide variety of organizations that provide adult day services, Anderson explains, including healthcare systems, nonprofit organizations, faith-based organizations and government organizations, such as the U.S. Department of Veterans Affairs.
“Licensure and regulations tend to vary state-by-state, but most states do have guidelines and licensure requirements that govern the staffing, safety, programming, services and administration of adult day services,” Anderson says. There are only 11 states that do not require organizations to obtain a certification or license, according to a report from the U.S. Department of Health and Human Services.
Professionals on staff
According to NADSA, there is one direct care worker for every six adults attending a day service that is trained to help facilitate individualized care in a variety of ways. “Professionals working in adult day services come from many different disciplines, such as nursing, social work, gerontology, therapeutic activities and healthcare administration,” Anderson says.
“Some adult day centers also bring in other medical subspecialties such as eye doctors, dentists and podiatrists to see seniors while there during the day,” explains Michelle A. McKay, a registered nurse specializing in geriatrics and assistant professor at M. Louise Fitzpatrick College of Nursing at Villanova University.
Cost of adult day services
In 2023, the national average cost for adult day services was $95 per day, according to data collected by Genworth, a long-term care insurance company. You can use their interactive Cost of Care map to find rates in your specific area, which vary based on cost of living. Insurance policies, including Medicare and Medicaid, may offer coverage for adult day services as well, McKay says, so she suggests always checking with your agency.
Benefits of adult day services
According to the experts, the biggest benefit of utilizing adult day services is that they allow individuals to continue to live at home despite needing daily assistance, as well as providing caregivers important respite. “Adult day services provide a break so caregivers can rest, engage in other activities and, in some cases, remain in the workforce,” Anderson says.
How to choose an adult day care service
According to McKay, caregivers should start by consulting your healthcare provider to determine if an adult day program may be appropriate. “The type of adult day service and support needed, the amount of time needed and how many days [needed] will be important to think about when considering the available options,” she says. From there, here’s how to find the right center for you, according to the experts we spoke to.
1. Understand your options.
Caregivers typically select a center based on the care needed, according to NADSA, of which there are three types: social, medical and specialized. Here, experts explain how each type of center is designed to meet different needs of participants of all ages:
- Social adult day centers are focused primarily on providing community and peer interaction on a daily basis. Social centers offer all the standard features noted by NADSA, plus they may offer extras like community outings and local service and volunteer opportunities, according to Gras.
- Medical adult day centers provide all the same services as social centers, plus health services, such as medication administration and management and visiting health care providers, Anderson explains. Therapeutic services, including physical, occupational or speech therapy with a licensed therapist, are also a feature of medical centers, and approximately 50% of all adult day centers provide them, according to NADSA.
- Specialized adult day centers exclusively serve patients with cognitive care needs, including individuals with Alzheimer’s disease and other dementias, as well as adults with developmental disabilities. But keep in mind: many medical adult day services are also designed to provide cognitive care.
2. Research to find out what’s available.
“There are several avenues to take to find the adult day center that best meets the needs of your family,” Anderson says. He recommends using NADSA, and specifically their tool for locating adult day centers across the United States, to find out what’s available.
“Area Agencies on Aging are also wonderful resources and should be able to provide a list of adult service centers operating in your area,” Anderson says. “They cover every community in every state.” You can find more on these resources through the Administration for Community Living website or by calling 1-800-677-1116.
3. Schedule in-person visits at multiple centers.
Once you locate an adult day center, setting up an appointment to visit is a great way to see if it will fit your needs, Anderson says. For full-time caregiver Joann Schoenherr, visiting multiple facilities in her town of O’Fallon, Missouri, made all the difference when selecting the right one for her husband, Gerry, who suffered from dementia.
“We looked at many places, but some seemed dark because they didn’t have a lot of windows,” she says. “But the one we fell in love with was neat and clean with big open windows, and the people were sweet. They also had an LPN [licensed practical nurse] on duty and a lady that cooked who we got to meet during our visit.”
4. Ask the right questions.
“During your visit, make sure to ask detailed questions about staff training and qualifications, and inquire about the full range of services offered,” Gras says. She recommends asking these questions as well:
- Is transportation provided?
- How is medical care coordinated within the facility?
- What is your communication process like? For example, will I get daily updates?
- Will there be family care conferences to talk about goals, successes and needs?
- What are your emergency procedures and protocols?
“Finally, request a trial day or half day to allow your individual to test the waters, and build some comfort with the setting,” Gras says.
Helping your loved one adjust to an adult day care program
Gras recommends taking a gradual approach that starts with shorter visits to help everyone adjust comfortably. “It’s crucial to involve seniors in the decision-making process and maintain open communication about any concerns and expectations they may have,” she says. She also finds it helpful to emphasize the social and engaging aspects of the program rather than only care needs day services fulfill.
For caregivers, the adjustment to incorporating an adult day service into your life can be challenging in different ways. Schoenherr admits to feeling guilty when dropping her husband off, but “But I always knew he was going to be taken care of,” she says. “You know it’s the best for them, and if you know they are getting good care, you have to take care of yourself, too.”
The bottom line
Adult day services, often referred to as adult day care, are a non-residential care service provided outside an individual’s home for less than a full day. They serve adults ages 18-64 with special needs, as well as seniors who need assistance with daily living activities by offering programs for socialization, health and safety monitoring and meals. There are also adult day services designed to offer benefits to adults with dementia.
To find a program, experts recommend assessing your loved ones needs first, then visiting multiple centers in person so you can determine the best fit. While it can be hard for families to adjust to utilizing an adult day program, caregivers and experts alike agree the benefits are worth the challenges. “Remember that adjustment takes time, so patience is key,” Gras says.
