Originally published here.
In a world where nursing home care is often seen as the only alternative when a parent or loved can no longer be left alone, adult day care is often overlooked as a viable alternative. There are two varieties of adult day care facilities. Social day care centers offer primarily organized activities, social interaction, planned meals and supervised care. Adult day/health care locations are licensed by the state, but in addition to similar services offered by social day care centers, they provide medical supervision by a registered nurse on staff.
According to the National Adult Day Services Association (NADSA), there are more than 3,500 adult day centers operating in the United States, serving over 150,000 clients each day. Half of those who attend adult day care centers have some degree of cognitive impairment, and almost 60 percent have some difficulty with one or more activities of daily living.
In Central Texas, there are two licensed medical model adult day care centers—Elderhaven in Central Austin, and the Adult Day/Health Center (ADC) in Round Rock.
While daily fees for adult day care services are almost always less than a home health visit, according to NADSA, and almost half of the cost of a skilled nursing facility, such care is still underutilized by caregivers across the country.
Adult day care, Marty Rose, director of ADC in Round Rock says, fills a crucial gap between independent living and a more institutional environment, such as assisted living, a personal care home, or a skilled nursing facility. It is an important alternative that can help families keep a loved one at home for as long as possible.
“There should be a waiting list,” says Rose, “I should be full with Round Rock families.”
According to Kipa Smith, Program Director for Elderhaven, adult day care services can be a lifeline to the family or care-giver, and a safe, enlivening haven for the client.
“They have a good time,” she says, “and they are around peers. If you are at home and your kids go off to work—even if they decide to bring someone in to take care [of you], that’s not a peer, or someone you can necessarily relate to or talk to. They [Elderhaven clients] have a chance to be around other people that they have something in common with.”
Elderhaven is a program of Austin Groups for the Elderly (AGE), and Joyce Lauck, Executive Director of AGE, says another important benefit to the client is the structure attending adult day care provides.
“It, in many ways, normalizes everybody’s day,” she points out. “All your life you get up in the morning and go to school, or go to work. Then, when you retire, you keep yourself busy with whatever activities appeal to you. When you start to lose some of that control…this normalizes your day. You’ve got a place that you’re coming to, with your friends, and your activities…and they [the clients] go home to their family, just like all of us that leave work at the end of the day—we go home to our family.”
Rose says that working with clients’ families is a key element in the success of adult day care services.
“Our goal is to help the whole family work out [their individual] situation,” she says. She also agrees with Smith that the interaction clients have with peers at the center is invaluable.
“[Many] have moved here because they have lost a spouse,” she points out, “so they come to live with family, and they meet their son’s or daughter’s friends. But they don’t meet people their own age at all.”
Rose also points out that adult day care offers a reliability home health agencies cannot always provide. If a home health aide has to cancel at the last minute, the family caregiver most often must remain home from work to care for their loved one. Adult day care centers such as Elderhaven and ADC have multiple staff members to provide care.
Elderhaven and ADC share the same goals, which Rose, Smith and Lauck agree are the fundamental benefits of adult day care:
• to help family members and caregivers keep their loved one at home and in the community, rather than in an institutional environment, for as long as their loved one’s health and circumstances allow;
• to provide a safe and stimulating environment where clients can thrive and interact with their peers, and be treated with respect as adults;
• to observe and monitor any changes in physical health or cognitive ability of the clients while they are receiving care, and immediately make their family or caregiver aware of them;
• to offer families and caregivers a respite from the stress and guilt of constant caregiving by giving them a safe and caring alternative.
Both Elderhaven and ADC encourage any caregiver in need of services for a loved one or family member to visit either location and determine whether adult day care services are the right fit for their family. Private insurance, Medicaid, VA, and private pay clients are among payment plans accepted.