Providing daily care for a spouse, parent, other relative, or friend can be a challenge. When someone you care about needs help with basic living skills or requires supervision due to confusion, you want to do everything you can for them; however, you may have work and/or family responsibilities to attend to. How can you balance caregiving with your own fast-paced life and make it all work?
Although a variety of caregiver interventions are available (e.g., support groups, home health care, respite care) not every intervention is appropriate or accessible to everyone. Adult day care is one option that may help you to manage the tasks of daily life and the stress associated with caring for a loved one.
What is adult day care?
Adult day care is a community-based service intervention designed to assist older adults with functional or cognitive limitations. These adult day care programs enable elders to socialize with each other, participate in planned activities, and have meals while their primary care provider is otherwise engaged.
There are more than 4,000 adult day centers throughout the United States. Most adult day centers provide care Monday through Friday during normal work hours, but some may provide evening or weekend care. Some participants in adult day care attend five days a week, while others participate on a part-time basis. Fees vary from center to center.
Participants of adult day care programs average 76 years of age. They may need nursing services, supervision due to cognitive impairment, or assistance with daily living skills.
According to the National Adult Day Services Association (NADSA) of the National Council on the Aging, quality adult day centers should:
- Assess individuals before admission to create an individualized plan.
- Monitor progress of individuals.
- Include social, recreational, and rehabilitative programs as part of their routine.
- Provide a safe environment with qualified and trained staff/volunteers.
- Meet or exceed the Standards and Guidelines for Adult Day Care developed by the National Adult Day Services Association (NADSA).
- Provide a variety of in-house services.
- Make referrals to other services available in the community.
Selecting a Center
Although you may not know what to do when selecting an adult day care center for your loved one, it is important you remember to be a wise consumer. Asking questions, shopping around, and being informed are all important parts to making a careful decision. Here are some tips to help:
- Consider the needs of both the older adult and the caregiver. What assistance, supervision, or services are needed for the older adult? Is transportation a need? If the caregiver works, do center hours coincide with his or her work schedule?
- To locate adult care centers in your area, check the telephone directory, the local Area Agency on Aging, or a senior citizen center.
- Request a packet of information from the adult day care center to review before your visit.
- Make a list of questions to ask during your visit. Some questions you may want to ask include:
- How long has the center been open for business?
- What are the days and hours of operation?
- Is the center Medicaid certified?
- What is the cost of care? Do fees vary with level of care?
- What are staff qualifications? What is the extent of their training?1
- What is the ratio of staff members to older adults?
- What types of activities are provided? Are there both group and individual activities?
- When and how much food is provided? Are there dietary variations?
- How are medications administered?
- What is the extent of supervision provided for confused clients?
- Does the center provide a walker or wheelchair if needed?
- Is transportation to and from the center available?
Once you have reviewed the materials and made a list of questions, schedule an appointment with the director of the center. Take your list of questions with you. Ask for a tour of the center at which time you can check for cleanliness and observe staff and client interaction and activities. Additional things to look for include:
- Space availability (Are clients free to move about? Are they crowded?)
- Safety of the environment (Are exits easily accessible? Are floor surfaces slip resistant?)
- Lighting (Are there windows? Is the lighting sufficient to do activities?)
- Is there a location for a client to lie down if necessary?
Before you leave, ask the director for references of other clients. Call and ask about the experiences of others who have frequented the adult day center you are considering.
Following your visit, make a note of your observations and feelings. How did you feel about the environment? The director and staff? The care being provided to other clients?
You may want to visit a center more than once. You may also ask to try out a center on a temporary basis to see how things work out. If you have questions or concerns be sure to ask the staff. Keeping the lines of communication open with center staff can help you and your loved one adjust more successfully.