Adult day care: What it is and how to choose a center
The decision to seek outside care for a parent or grandparent is a deeply personal — and often difficult — one to make. Every family must weigh the pros and cons of different senior support services to determine what might work best for them. Adult day care centers (also referred to as senior day care facilities) can be a great option for families looking for a safe place for their loved one to spend time during the day, or for active seniors who thrive in more social settings.
Compared to in-home care or assisted living facilities, these centers can be a more economical option for seniors with advanced medical challenges. If you’re considering enrolling yourself or your loved one in a senior day care center, here’s what you should know.
Defining adult day care
Senior day care centers are professionally managed care environments for older adults, particularly those with health challenges, such as dementia or physical disabilities. These facilities provide a safe setting for adults during the day, as well as access to medical care, social activities and meals. Everything — from the trained staff to the materials — is tailored to meet the physical, emotional and mental needs of older adults or those with mental or physical limitations.
Jody Gastfriend, vice president of senior care at Care.com, describes her family’s reason for choosing adult day care and their experience with the service in her book My Parent’s Keeper .
“During the first few years of my father's dementia, we never considered a nursing home. Bubbie's four-year stint in a home with long hours tied to a chair had left a bad taste in our mouths. How could we possibly put my father in a place like that? As the disease progressed, we knew there might come a day when my mother could no longer handle my father’s care.
So we explored supports that would give my mom a break and provide my father with some variety to his day. We landed on adult day care, a cost-effective and often overlooked option for care. At an average daily cost of $68, it’s a bargain. Adult day care offers flexibility and support in a community-based setting. Some programs, like the one my father attended, are specifically designed for people with dementia and Alzheimer’s disease.
My dad enjoyed the sing-alongs and exercise program (okay, he played catch with a beach ball while sitting in a wheelchair, but he loved it!). My mom drove him to the program several times a week (transportation was extra). And my father looked forward to the change in venue while my mother had some time for herself.”
Benefits of adult day care
Nearly all centers will provide the following for seniors:
A safe environment during business hours, where adults will have someone to turn to for help, if needed
Meals, including for those with special dietary restrictions
Social interaction with other adults
Personal care, such as grooming and toileting assistance
Health services, including medication management and exercise opportunities
Some centers may offer more advanced or additional services, such as:
Rides to and from the location
Evening or weekend care
Training programs like computer classes or memory training
Advanced medical care
Flexible scheduling, such as half-day care or attending only a few days a week
In some cases, these centers can help seniors with chronic or degenerative medical conditions delay moving to an assisted living facility. For many, the simple chance to get out of the house and engage with friends and peers can raise spirits and improve their emotional well-being.
For the caregivers, adult day care can offer a welcome respite for families experiencing emotional stress due to caring for an aging parent or grandparent.
Types of senior day care settings
Each center offers a slightly different range of services, depending on their community, clientele and ownership. Generally speaking, centers fall into one of three categories:
Social centers — These locations primarily offer opportunities for adults to socialize, with a limited scope of health-related services.
Medical centers — These sites have the staff and equipment needed to provide more advanced health care, including things like physical therapy and counseling. They also provide some social activities.
Specialized facilities — These centers tailor their programs to adults with specific needs, such as those with memory issues, that may require more personalized attention and care.
How to know if senior day care is right for your family
For seniors who enjoy social activities and need a small to moderate amount of assistance during the day, enrolling at a senior day care center could be the best option for them. However, for seniors who require advanced, highly specialized care, in-home or assisted living situations might be more appropriate.
Before determining what kind of outside care to pursue, speak with your loved one and their primary care physician to see what (if any) advanced care and/or financial considerations should factor into the decision-making process, and work from there.
Choosing the right center
Start by deciding which type of facility you’re looking for—social, medical or specialized—and then see what’s available in your area. Next, tour the facilities and talk to attendees and their primary caregivers to see what they like or dislike about the center. Be sure to inquire about or take note of:
Experience levels of the staff and background checks
Types of activities and events that they offer
Frequency of bathroom breaks provided
Medication times and who dispenses it
Emergency plans for natural disasters, etc.
Are there garden or outdoor areas
What is the setting like -- cheerful, cluttered, clinical
Costs and how to pay
On average, the daily rate for senior day care centers cost about half the cost of assisted living, a third of in-home care, and a quarter of that of nursing facilities, according to the American Elder Care Research Organization. In 2017, the national average was $72 per day, ranging from $38 to $125 per day, depending on the state. The costs of adult day care centers vary widely, but for the most part, it is cheaper than other senior care options.
Many families will need to cover the bulk of the costs of senior day care out of their own pocket. Standard Medicare health insurance does not cover senior day care services, and Medicare Advantage (Part C) plans, as well as private insurance plans, are not required to cover any of the costs either. It’s still always a good idea to call the insurance provider to check, as different plans might cover some costs.
Medicaid, on the other hand, does often provide at least partial coverage for many seniors attending social adult day care centers, but coverage and enrollment criteria often vary by state, and some areas have a waiting list for participating programs. In many cases, whether or not an insurance provider (including Medicaid) will cover the cost of senior day care will depend on the medical needs and diagnoses of the senior.
Some day care facilities have scholarships or sliding scale options for low-income seniors who aren’t able to pay the full cost of the services. When touring facilities, be sure to ask the staff if they have financial assistance available and, if so, how to qualify.
Find a program near you
To find a center convenient to your area, do a web search for a nearby Area Agency on Aging (AAA) — a general term for a public or nonprofit agency designated by an individual state to handle the needs of seniors at a local level. The Eldercare Locator on Eldercare.gov or at 800-677-1116 can be helpful in finding these resources. More general information on adult day programs can be found at the National Adult Day Services Association at nadsa.org or by calling 877-745-1440.
Lauren Garcia contributed to this report.