Adult day services (ADS), or adult day care, is among the newer offerings on the senior care continuum. Consequently, many are still in the dark about this level of care. Special thanks to Faith Hoover, an RN and the Director of Home & Community Services at Pennsylvania-based Landis Homes, for shining a light on this emerging option:
MS: Can you give us some brief background on adult day services?
FH: Adult day services offers several types of centers: the social model, which provides meals, activities, and some health-related services; the medical model, which provides more intensive health-related services in addition to meals and activities; and a combination of the social and medical model; along with specialized centers focused on individuals living with Alzheimer’s or a related dementia, or developmental and intellectual disabilities.
Here are some interesting facts about ADS, per the National Adult Day Services Association (NADSA) website:
- Almost 78% of ADS centers are not for profit or public,
- 70% are affiliated with a larger organization, and
- 52% of the clients in Adult day services have some cognitive impairment.
MS: Please share a bit about what you do specifically at Landis Homes and what types of services are offered there.
FH: We have two centers – one designed specifically for people with Alzheimer’s disease or a related memory-impairing disease, the other for older adults who benefit from daytime supervision. This center, called Eden West, opened in 1989. Eden East, which opened in 1998, is a secure facility where the staff is specially trained to work with people with memory loss.
Our centers are open from 7 am to 5 pm Monday through Friday. Both offer a continental breakfast, a hot nutritious meal at noon, and an afternoon snack. Special dietary needs are honored. Available services include medication administration, supervision by a nurse, assistance with personal care and bathing, health screening and access to therapies, a beauty salon and podiatrist. There is a full program of planned activities each day, from group activities like exercise, discussion groups, music, educational events and field trips, to individual activities based on the interests of our clients – like pinochle, computer games, creating blankets for Project Linus, crafts and exercising on the NuStep.
Activities are intentionally designed to be meaningful and to focus on the client’s strengths and overall wellness, providing opportunities for success and enjoyment. A significant benefit of Adult Day Services is the opportunity for socialization, friendship and giving to others.
MS: Given these benefits, what keeps people from accessing ADS?
FH: The following are what I believe to be the four major obstacles: 1. not knowing that the service exists; 2. funding – in addition to private pay, funding is available through some long term care insurance policies, the Area Agency on Aging, the Veterans Administration and Office of Developmental Programs. At times, however, there is a significant waiting list to receive these various types of funding; 3. not wanting to leave their home or their caregiver; and 4. transportation – sometimes the bus rides are long (up to 2 hours one way) for the subsidized transportation. Families and home care agencies can also provide transportation.
MS: Why is ADS an important resource, and what should people know about it? What needs to change in order for ADS to be more widely used, accepted, and understood?
FH: Adult Day Services is a wonderful, community based alternative for older adults who want to remain in their homes – with their families – and need some daytime supervision or care. It also provides a break for the caregiver and peace of mind in knowing that their loved one is safe, well cared for, and has the opportunity for social interaction and enjoyable, meaningful activity.
Again, funding creates issues for some prospective clients. Currently, Medicare does not pay for ADS and the funding available through the Area Agencies on Aging (AAAs) may take significant time for approval, or have lengthy waiting lists.
Even still, adult day services are a cost-effective alternative to long term care, with rates averaging about $61/day for 8-10 hours of service. Home care services average between $18-25/hour, and nursing home care is well over $300/day. In addition, ADS keeps spouses and families together.
MS: Tell us about a memorable experience, care connection, or intervention you experienced while serving in ADS.
FH: Oh, there are so many wonderful stories! But here are a few that stand out in my mind: First, there is an 80-year old woman who comes to the center each day and asks if there is a blanket she can make. She has created about 100 warm, soft blankets for Project Linus. She recently said to me, “I don’t even know how to sew but I can still make these blankets. It keeps my hands busy and I like that I am doing something for other people.”
Then there is the group of three women who made patchwork quilts for three children who lost their father. The patches were from their father’s shirts. In her thank you note, the 11-year old daughter said that when she looked at the quilt, she remembered when her father wore the shirts and it made her feel close to him. One of the women said that she never made a patchwork quilt before, and though it was a challenge, she was glad to do it because it was worthwhile.
Finally, the wife of a gentleman with Alzheimer’s disease recently expressed her appreciation for adult day services. “My husband attends every day and he really enjoys it. And I get to do some of the things that I want to do.” She is a warm, loving caregiver for her husband, but she also wisely recognizes the importance of caring for herself as she cares for him.
Clearly, ADS is a valuable resource for caregivers of older adults, and one that, like respite care, is sorely underutilized. So now we want to hear from you: What’s your experience with adult day services? What has kept you from utilizing this senior care resource?