Chapter%206.%20Adult%20Day%20Care

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Chapter 6. Adult Day Care

• Long-Term Care Managing Across the Continuum
• (Second Edition)

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Learning Objectives

1. Define and describe adult day care
2. Identify sources of financing for adult day care
3. Identify and describe regulations affecting adult
   day care
4. Identify and discuss ethical issues affecting
   adult day care
5. Identify trends affecting adult day care into the
   future and the impact of those trends

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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

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Philosophy of Care

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

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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

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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

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Types of Adult Day Care

• Three categories of adult day care
• Social Day Care
• Adult Day Health Care
• Dementia Care

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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

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Health Services

• Added health care services may include
• Medications
• Monitoring
• Therapies
• Nutrition counseling
• Social services
• Health education

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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

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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

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Market Forces

• Social and demographic changes
• Managed care
• Competition among other providers

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Regulations

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

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Financing Adult Day Care

• Reimbursement Sources
• Public funds (Medicaid, PACE)
• Managed care
• Private insurance
• Self-pay and other sources

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Staffing

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

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Legal Ethical Issues

• Similar to other providers issues
• Consumers rights

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Management Qualifications

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

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Management Challenges Opportunities

• Meeting the growing demand
• Achieving cost-effectiveness
• Marketing

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Significant Trends

• Continued increase in demand
• Attractiveness to MCOs
• Movement toward the health model
• Expanded services

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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