Adult Day Care Overview

Complement to aging in place and a needed social outlet

Nurse talking to older woman in home
Adult day care offers respite for caregivers and much-needed socialization for elders. Cultura RM Exclusive/Tim MacPherson/Getty Images

Adult day care offers both respite for caregivers as well a much-needed socialization for seniors. This article provides an overview of adult day care centers for readers.

The typical Adult Day Services (ADS) program was initiated in 1992 as a single-site, stand-alone, private, non-profit service provider.

According to Met Life, the typical day center has been in operation an average of 17 years.

Profit Status

Twenty-seven percent of centers are for-profit up from 22% in 2002.

Almost three-quarters of all centers (71%) are non-profit (56%) or affiliated with the public or government sector (16%). The majority are state-certified or licensed.

Administration and Staffing

  • One-third of the center directors have business or healthcare administration backgrounds.
  • Almost 60% come from nursing, social work, and activities/recreation therapy.
  • Almost 80% of ADS centers have either a registered nurse (RN) or a licensed practical nurse (LPN) on staff.
  • The direct care worker-to-participant ratio is one direct care worker for every six participants (1:6).

Funding and Fees

  • Half (55%) of the funding comes from publicly paid participant fees and one-quarter (26%) from privately paid participant fees.
  • Medicaid and state and local funding are the top two sources of funding.
  • The Veteran's Administration (VA) accounts for 10% of total revenue but is growing.
  • Standard fees average $61.71 based on number of hours of care or a flat daily fee of $57.96.

    Participation and Demographics

    • The average maximum capacity has increased to 51 people.
    • The average number of participants served per day is 34.
    • Approximately 29% of centers have a wait list.
    • The majority of participants are women; 69% of participants were age 65 and older, 21% of participants were age 41 to 64, and 9% of participants were age 40 and younger.

      Health Conditions

      • The three most prevalent conditions experienced by ADS participants are dementia (47%), hypertension/high blood pressure (46%), and physical disability (42%).
      • About a third of participants experienced cardiovascular disease (34%) and diabetes (31%).
      • Chronic mental health issues were experienced by 25% of participants and 20% had a developmental disability.

      Services Provided

      • Care Planning
      • Assistance with activities of daily living (ADLs)
      • Nursing and health-related services
      • Therapeutic and Medical services
      • Meals and Transportation
      • Activities and Targeted Programs
      • Wellness Practices and Disease-Specific Programs

      MetLife has recommended that in anticipation of future needs and growth, ADS:

      • Need to understand the evolution that needs to take place as society grows to demand these services.
      • Be prepared to treat a higher acuity client.
      • Advocate for new funding sources with healthcare reform.
      • Market to other key players in the long-term care network, such as hospital discharge planners.
      • Reach out to employers who can use these programs.
      • Educate policymakers about the vital role day services plays in society.

      As society moves away from institutionalized care to home-based care and aging in place, the vital role that adult day services play will grow.

      Now is the time to consider this as a viable business option and also an option for a loved one under your care.

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