Three in four Americans wish to stay in their homes as they age. Increasingly, this wish has become a reality for many thanks to advancements in medicine and technology, as well as the generosity of loved ones. Yet, aging also brings physical, cognitive, and emotional challenges that can be obstacles to independence. When these issues arise, families may need additional support to allow their older loved ones to stay safe at home.
Enter adult day care, an on-site service that allows seniors to receive needed personal and medical care in an engaging social environment. Adult day care service centers allow caregivers to attend to their daily responsibilities with the peace of mind that their loved ones are safe, comfortable, and well-cared for. Currently, there are nearly 5,000 adult day care programs operating across the US—including Senior Day Services here in Lackawanna County, PA—and that number that is only expected to increase based on the country’s growing senior population.
Whether you’re considering adult day care options for a loved one, seeking to volunteer with older adults in your community, or simply want to know more about how adult day care services work, you’ve come to the right place. Below, you can explore the ins and outs of adult day care services—who can attend them, what activities are offered, how much they cost, etc.—as well as how to navigate difficult but necessary conversations about aging with your loved ones. You can also get advice on finding the adult day care service center that is the best fit for your family and access resources for caregivers and volunteers that such programs have in place.
Use the table of contents below to navigate to the information you need:
The National Adult Day Services Association (NADSA) defines adult day care as:
A professional care setting in which older adults, adults living with dementia, or adults living with disabilities receive individualized therapeutic, social and health services for some part of the day.
This provides a helpful starting point for addressing some of the main features of adult day care services; notably, who staffs such programs, who is served by them, what services are provided, and when services are provided. These topics are broken down further below.
“A professional care setting…”—NADSA
Adult day care centers are staffed by trained and credentialed professionals who are well-equipped to deal with clients’ daily personal and medical needs. These can include certified nursing assistants (CNAs), personal care assistants, and health care aides. Programs are typically supervised by directors with experience in business or healthcare administration, an activities director, and either a Registered Nurse (RN) or Licensed Professional Nurse (LPN) to provide healthcare services. Nearly 50 percent of adult day care services also have a social worker on staff. Social workers are an important resource for families navigating the healthcare system and learning to adapt to their role as caregivers. Senior Day Services’ social worker, Amanda Nole, shares, “We work as part of a multidisciplinary team to empower families and give them the resources they need to support their loved ones.” In addition, physical and occupational therapists may offer services on-site, and other specialty providers such as podiatrists may offer care periodically within the center.
"Older adults, adults living with dementia, or adults living with disabilities...”—NADSA
Adult day care centers welcome three primary populations. First, older adults who are not living with disabilities or functional challenges often attend these programs to keep active and build community while also receiving any needed assistance with medication management, ambulation, or other daily tasks. Adults living with dementia and other cognitive challenges can also attend these programs to remain mentally engaged and receive the specialized care they need in a safe environment. Finally, adults with disabilities can receive more intensive therapeutic care and pain management, while also enjoying the benefits of a social group. Generally, three categories of adult day care services have been identified: Social, Medical/Health, and Specialized.
|Serves older adults needing some assistance with daily tasks of living and a social environment||Serves older adults needing higher levels of personal and medical assistance, often living with chronic physical conditions||Serves older adults who have been diagnosed with a specific condition which the center aims to support, such as Alzheimer’s or dementia|
It is important to note that some centers offer more than one branch of service, and others are blurring the lines as populations shift and become more dynamic. For example, Senior Day Services offers four levels of care appropriate for different clients’ cognitive and physical abilities. By providing multi-tiered care, adult day care service centers can more easily continue to accommodate clients even as their conditions may change. In addition, many centers serve as a transitional point for those who have been in the hospital or a rehabilitation facility. Having a day care program to go to, especially one that offers on-site therapeutic services, is one way seniors can regain their activity and independence after an illness or surgery.
"Individualized therapeutic, social, and health services...”—NADSA
Regardless of the category an adult day care program falls into, most offer the following services for clients:
Social and emotional support—A major component of adult day care services is the development of community. Within a day care program, seniors can enjoy socializing while also remaining mentally stimulated. They may play cards and board games with their peers and volunteers, participate in fun activities like arts and crafts projects, and watch performances and demonstrations from community groups. Day care centers often have outdoor space and gardens which the clients are invited to care for. Some centers also offer small group outings and field trips out into the community.
Personal care—Adult day care programs assist clients with activities of daily living including eating, toileting, bathing, taking medicine, and walking. They may also offer assistance with personal grooming, including hair and nail care.
Nutritious meals and snacks—Most adult day care programs (85%) include daily meals and snacks at no additional cost to clients. Meals are prepared with the consultation of a dietician, and special dietary needs are accommodated.
Health services—Adult day care centers are staffed with clinical professionals who oversee the unique medical needs of each patient. In lower-level (social) facilities, medical services may include blood pressure regulation, vision screening, diabetes monitoring, and diet and weight management. Higher-level facilities may also offer therapeutic services (e.g. physical therapy, occupational therapy, and speech therapy) as well as chronic condition management. Programs caring for individuals with dementia or Alzheimer’s may have additional health specialists on staff to address their unique cognitive challenges.
Transport—In order to accommodate caregivers’ schedules, many senior day care programs offer door-to-door transportation. Senior Day Services provides free transport to clients within a 12-mile radius, though costs per round trip can range from $5 to over $20 nationwide. Drivers typically operate DOT-certified, licensed and insured vans which are outfitted with lifts to accommodate the needs of clients with disabilities.
"...for some part of the day”—NADSA
Typically, adult day care programs accommodate normal business hours, running from 7 in the morning until 6 in the evening. Most operate five days per week, though some are staffed seven. Most do not offer evening or weekend care. Over 80 percent of participants attend full days, and 46 percent attend five days per week. Such frequent attendance enables caregivers to remain in the workforce and engage with other daily tasks. It also provides a sense of consistent routine for the clients who are taking part in the programs.
One more aspect of adult day care services is not mentioned in the definition above, but it is just as important to address:
While rates vary widely by type and location of center, the national average cost of adult day care services is around $75 per day. According to the Genworth long-term care calculator, the average daily cost for adult day care services in the Scranton area is $65 per day (Senior Day Services' on-site day program costs $68 per day), as compared to $150 per day for a Home Health Aide and $84 for an assisted living facility. In this way, adult day care services may be a cost-effective option for those needing mild to moderate levels of care and supervision.
Adult day care services are typically NOT covered by Medicare, but they may be partially or fully covered by Medicaid, private insurance, or VA benefits. County-wide Area Agencies on Aging may also help pay for adult day services. Those seeking funding should contact their local Agency on Aging and ask to speak with a care manager, who will conduct an assessment to determine eligibility for financial support. Finally, programs with a medical component may offer additional coverage options.
Now that you have a better understanding of what adult day care services are, let’s turn to the benefits. How do these services meaningfully impact seniors and their families? In short, the benefits can be broken down into two groups: benefits for the senior clients who attend, and benefits for clients’ primary caregivers.
How are the benefits of adult day care services different than other services for older adults? Click here to find an infographic to compare adult day care with home care, assisted living, and nursing homes, courtesy of National Adult Day Services Association.
Ensuring your older loved one is safe and happy during the day is your top priority. But it’s often difficult to tell when it may be time for some extra support. This checklist from NADSA describes some warning signs which may help determine when an adult day care program may be the right choice for your family.
A senior may benefit from adult day care services when they:
While exploring the options, you should also consult with your loved one’s medical care team to ensure you make the best decision for you and your loved one. It is important to note that adult day care services are not the right fit for all families. Things that may indicate adult day serves are not right for your family include:
Adult day care programs are also sometimes used in the transition from the hospital back to home care to establish routine and new way of life after major surgery or medical challenge. If your loved one is currently hospitalized or recently released, ask their care team if adult day care service could be a beneficial next step in their recovery process.
Whatever the outcome, having these conversations early and often is essential so your loved one can contribute to the conversation before it is “too late.”
When an accident or medical issue occurs, things often move very quickly, and emotions and tensions run understandably high. As a result, having a plan in place early and communicating about it often can save families time, stress and unnecessary guilt. Many experts recommend having the first conversation about aging at the 40/70 split—when adult children are around age 40 and parents are around 70—to ensure a plan is in place even if its implementation is far in the future. AARP offers a comprehensive planning guide with assessment guides, checklists, and discussion prompts for approaching difficult conversations about aging.
After doing some research and consulting with your family and trusted medical professionals, you may be considering adult day care services to supplement your loved one’s care. Before you go too far into the process, however, there is one thing you must do: discuss the issue with your older loved one. Though you may feel a great deal of responsibility for your loved one’s care, and indeed may have to make some difficult decisions at the end of the day, involving your loved one in a conversation about the options will help them maintain their dignity and independence, which is especially important when talking about their need for additional support. And as mentioned above, the earlier these conversations happen, the better. Ensure everyone involved has the opportunity to make their wishes known.
What should conversations about adult day care services look like? Every situation will be different, but below are some practical tips you can employ before, during, and after any conversation to ensure discussion goes as smoothly as possible and you are prepared for any concerns or resistance that may arise.
What happens following your conversation is up to you and your family. Some may be comfortable diving right into an exploration of local adult day programs and setting up tours of several facilities. For others, the next step may look like another conversation—or two, or three—to continue to discuss what options will be best for the family. You may want to even contact a local senior day care center near you and ask to speak to some of their existing clients and caregivers to gain some outside perspective.
In any case, don’t rush into a decision, but keep things moving forward. It is a good idea to keep your loved one’s medical provider informed about decisions regarding their care, and continuing to communicate with your loved one’s themselves is essential even if most of the next steps fall on you as the caregiver. In addition, perhaps your conversation revealed that adult day care services is not the best option for your loved one; in that case, you may want to look into in-home personal care or senior companion programs which offer varying levels of personal and medical service while allowing older adults to remain in the home.
Before starting to search for an adult day care center, the National Adult Day Services Association recommends that you first identify your family’s specific needs. What is most important that your loved one have access to in a center—staff trained to deal with specific medical issues? A robust activity schedule? Further, consider what as a caregiver do you need from the center—daily coverage so you can work? Transportation services? Here are topics you may wish to make part of your evaluation:
Location—Can this location become part of your morning commute? Or are there affordable bus/transportation services to and from your home?
Level of care provided—What medical and social needs does your loved one have, and how will they be addressed? Is a social center (few medical services) appropriate, or is a medical (more intensive therapeutic services) or specialized (cognitive care) center required?
Cost—Will it be covered by Medicaid, private insurance, or other funding sources? Is its price comparable to other similar services in the area?
Hours—Do they offer care five, six, or seven days of the week? Do their opening/closing times accommodate your family’s schedule?
Size—How many people are in facility, client-wise and staff-wise? Will your loved one get the level of personal attention they need? (The average ratio is six clients to one provider.) Will it be too big or too small for them to be comfortable socially?
Past ratings/recommendations—What are other people saying about it? Is it credentialed in your state and/or a member of the NADSA? Does your medical provider know about it? Do you know others who have used the services? Even checking public reviews on social media and Google are good places to start.
Searching for adult day care services can take many forms. Using a national care center locator like Eldercare Locator will pull from all available records and deliver user reviews alongside data sorted in proximity to your location. County-wide Area Agencies on Aging also provide information about senior care programs in the surrounding community. You may also want to use word-of-mouth to get a more robust picture of a center. Read reviews posted on social media and Google and ask family, friends and your loved one’s medical provider to see which centers they have heard of and what their experiences have been. AARP recommends choosing two or three centers in your area that you would be interested in touring.
Once you have narrowed your options, it is a good idea to schedule a tour with each program. Here are some things to keep in mind when going through the visiting process.
Once you have determined which adult day care service center is best for your loved one, try it out gradually. The Alzheimer’s Association recommends taking your loved one to the facility for lunch or an activity, then having them attend a few times per week for a month or so before making a final enrollment decision. It may take a little while for your loved one to get adjusted, so be patient with any resistance you may encounter and focus on the center’s positive attributes (i.e. fun programming, special personal care like nail grooming). Learn what the center’s policy is for caregivers to drop by or even stay the whole day so that loved ones can feel more comfortable in the beginning.
Senior Day Services' social worker Amanda Nole encourages families to give it a try for at least a day or two. She says, "There is no commitment to come back if you don't like it. But if you do visit, you might meet someone or do something you really enjoy, and you'll be glad you came." Programs like Senior Day Services' also offer flexibility in terms of weekly attendance; you are welcome to come for just one up to five days per week, and if you come Monday and Wednesday one week you are welcome to attend Tuesday and Friday the next. As a result, families can "try out" the program in a way that best fits their schedule.
Finally, when you make the decision there’s one more thing to do: take another deep breath and celebrate. Your older loved one has found a community where they can socialize and receive the care they need, and you have also gained time for work, other family responsibilities, and needed self-care so you can continue to be the best caregiver you can be.
Along with its many benefits for seniors, adult day care programs give caregivers valuable respite time. A large percentage of centers also offer caregiver services, including:
Along with providing additional resources for caregivers as they navigate the multifaceted nature of elder care, such services can also offer a valuable sense of community. Senior Day Services’ social worker Amanda Nole says:
“There is such a benefit to caregivers talking to professionals, getting out, and maintaining self-care, and it’s also so important for them to be in contact with other caregivers. A caregiver support group allows caregivers to come together and talk about the struggles and the joys with others who are currently in their shoes.”
Websites to link you with local and national support groups and other resources for caregivers include:
If you enjoy connecting with the elderly, have weekday flexibility, etc. you may be interested in volunteering with adult day care programs in your area. Volunteers can take on a number of roles, including:
Organizations may also play a role, offering their services (performance groups, yoga or health activities, etc.) or designating days to send volunteers. Hours are often flexible; at Senior Day Services, you can volunteer once a week, month or year. There may also be special events or items you can donate if you are not available on weekdays. Depending on your level of involvement, some programs even offer a small stipend for individuals looking to volunteer with the elderly.
Ultimately, adult day care services are a valuable resource for families, helping older adults maintain their independence, manage daily needs and connect with a community of friends, while also supporting the loved ones who care for them. If you are interested in learning more about adult day care, check out the additional resources below.
If you or a loved one is living in Lackawanna County and think adult day care services might be the right fit for you, visit Senior Day Services’ website to learn more about our program and to connect with our team.
Here are some local, regional, and national resources linking families to senior care:
Further reading about Senior Day Services' programs and caregiver resources: