Community-Based Adult Day Services

ByDebra Bakerjian, PhD, APRN, University of California Davis
Reviewed/Revised Sep 2024
VIEW PROFESSIONAL VERSION

    Day care for older adults may involve

    • Treating a problem

    • Maintaining the person's condition

    • Providing social activities or mental health care (such as group therapy)

    People can go to day care facilities for several hours a day for several days a week. These facilities may also provide a place where family members who care for an older person full-time can take the person and get a break from caregiving (a service called respite care). By doing so, they may help delay or avoid placement in a nursing home.

    In the United States, there are only about 4,100 adult day care programs compared with more than 15,300 nursing homes. Most day care programs are small, serving about 20 people. However, in total, these day care programs serve more than 200,000 older adults on any given day.

    There are several types of day care programs.

    Day hospitals provide complex tests and treatments, rehabilitation services, and intensive skilled care. They are designed for people who are recovering from a recent problem, such as a stroke, an amputation, or a fracture, but who are able to return home at night. The primary care physician or a hospital may send a person to a day hospital. These facilities usually provide care for a limited time (6 weeks to 6 months) and are expensive because the ratio of staff members to patients is high.

    Maintenance day care programs provide limited skilled care (such as screening for and monitoring of chronic disorders) and physical exercise. The goals are to prevent deterioration of the person's mental and physical condition, to maintain or improve the person's ability to function for as long as possible, and to prevent chronic disorders from worsening. Also, these programs include activities to improve the person's self-image, provide stimulation, and prevent loneliness, isolation, and withdrawal. Maintenance programs can provide long-term care and are less expensive than day hospital programs.

    Social day care programs provide counseling, group therapy, activities to maintain or improve mental function, strategies to compensate for losses, and social and recreational activities. They may resemble a senior center or a mental health care center, providing care for older adults with dementia or mental health disorders.

    Financial issues

    Medicare does not cover day care services. Funds usually come from the Older Americans Act (which funds services to help keep older adults functional and independent), Medicaid waiver programs, long-term care insurance, and/or private funds.

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