Chapter 6. Adult Day Care

1. Chapter 6. Adult Day Care Long-Term Care: Managing Across the Continuum (Second Edition)

2. Learning Objectives • Define and describe adult day care • Identify sources of financing for adult day care • Identify and describe regulations affecting adult day care • Identify and discuss ethical issues affecting adult day care • Identify trends affecting adult day care into the future and the impact of those trends

3. What is Adult Day Care? • Interim (less than 24 hour) care • Provides a structured environment • Gives family caregivers a break, or chance to hold a job • Mix of social and health services

4. Philosophy of Care • Serves both consumers and caregivers • Holistic approach to care • Maintains or improves quality of life • Provides safe, supervised setting

5. Benefits of Adult Day Care • Can live with family without being a burden • Social interaction with peers • Program of stimulating activities • Therapy in a non-medical setting • ADL assistance with dignity

6. Ownership of Adult Day Care • Mostly nonprofit or public (3/4) • Less than 1/4 are for-profit • Most (3/4) are affiliated with other health care organizations: • Home care • SNFs • Medical centers

7. Types of Adult Day Care Three categories of adult day care: • Social Day Care • Adult Day Health Care • Dementia Care

8. Services Provided Basic services provided by all types: • Safe, secure environment • Social and recreational activities • Assistance with ADLs • Transportation to and from the center • At least one meal, plus snacks

9. Health Services Added health care services may include: • Medications • Monitoring • Therapies • Nutrition counseling • Social services • Health education

10. Consumers of Adult Day Care • Between needing institutional care and being independent • Most live with family • Unable to handle day-to-day tasks • Most are elderly • More women than men

11. Caregivers • About three-fifths are spouses or adult children • Other two-fifths are other relatives, friends, or neighbors • Mostly female (three-quarters) • Average age of caregivers: 57 • One-third are over 65 themselves

12. Market Forces • Social and demographic changes • Managed care • Competition among other providers

13. Regulations • 1/3 to 1/2 of states license in some form • Highly inconsistent • Usually cover space, safety, and staffing

14. Financing Adult Day Care Reimbursement Sources: • Public funds (Medicaid, PACE) • Managed care • Private insurance • Self-pay and other sources

15. Staffing • Combination of professional and non-professional staff • Mix depends on focus (social, health, or dementia care)

16. Legal & Ethical Issues • Similar to other providers’ issues • Consumers’ rights

17. Management Qualifications • Little commonality • No national standards • If affiliated with other provider type, their regulations may apply

18. Management Challenges& Opportunities • Meeting the growing demand • Achieving cost-effectiveness • Marketing

19. Significant Trends • Continued increase in demand • Attractiveness to MCOs • Movement toward the health model • Expanded services

20. In Summary: • Adult Day care is becoming very attractive to: • Consumers and their families • Payers as a cost-cutting measure • Other providers as an added service