Adult Day Care is a senior living service for frail, physically or cognitively impaired, seniors and their caregivers. Many stand-alone adult day care facilities and adult day care centers are available in urban and suburban areas to provide elderly care. A large percentage of Adult Day Care Centers are operated on a nonprofit or public basis. Many centers are affiliated with multi-service entities such as home care, assisted living, nursing facilities, and hospitals.

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Congregate, assisted living, or nursing care communities may offer elderly care as an "outpatient" service to the neighboring population on a per day basis. Those that do may also provide respite care for a weekend, or a week. Senior centers may also offer senior daycare as one of their life senior services.

Why Adult Day Care?

Generally, family members are the care providers for disabled or impaired adults. This care permits these adults to stay at home versus placement in a nursing home. Senior day care and senior adult day care enables caregivers to:

  • Retain a job outside of their home.
  • Have help with the physical part of caring for a loved one.
  • The time away may be a rejuvenator for your relationship.
  • Avoid the guilt of putting a parent in a "home."
  • Obtain respite from what can be a 24-hour responsibility.

A center will monitor medications, offer meals and some physical therapy, and a chance to socialize with other seniors.

Thus, Adult Day Care may be a lower cost way of allowing those that require chronic care to stay at home and in their community.

You should consider an Adult Day Care Center when your loved one:

  • has safety issue when left alone
  • seems unable to provide themselves a structure for daily activities
  • has extended daily periods of isolation and misses others

While the center staff will give you information on how to make the transition easier, keep in mind that it may take many visits before your loved one feels comfortable and adjusts to the new environment.

Paying for Adult Day Care Services

Backing for these services comes from fees for service, third-party payers, or public and philanthropic sources. There is a wide range of costs between among Adult Day Care Centers. They range from $40 a day to over $100 per day depending on services offered, reimbursement, and region. The national average cited by the National Adult Day Services Association is $61 per day.

Medicare does not usually cover adult day care. Some coverage aid may be available through a state or federal programs (e.g., Medicaid, Older Americans Act, and Veterans Administration). Learn more about possible insurance coverage on our Insurance information page.

Distinguishing Features between Adult Day Care and Adult Day Health Care Centers

There are three types of Senior Day Care. The lines between may overlap in practice. In shopping for an elder care facility, determine (perhaps with the help of a professional or specialized social worker) what are the needs of the senior and the goals of the caregiver.

The three types of adult or senior day care can be broken down to meet the needs for:

  • Social interaction in a safe environment.
  • Medical care, therapy, and socialization.
  • Alzheimer's or dementia care with all aspects of related attention.

The inclusion of "health" in the type of day care a center provides should indicate that they provide elements of health care, and are not just a model for socialization and babysitting of seniors. The designation of Adult Day Health Care (ADHC) in many states is reserved for those centers that have been licensed by their state to provide health and medical-related care, similar to what might be provided by a state licensed assisted living community or by a state-licensed nursing home. A senior or adult day care center that is not an ADHC, in most states will not be licensed to include, or have available on site, psychological evaluations, licensed social workers, administration of medications, assistance with bathing and hair washing, dressing of wounds and assistance with feeding. Their costs will also not be reimbursed by Medicaid (Medical in California).

Most states require a licensing process for ADHC and a state licensing process to be approved for Medicare reimbursement and/or Medicaid (Medical in California) reimbursement. In some states, the legislature has recognized the cost savings between supporting an indigent person in assisted living at $2,500 - $5,000 per month or in a nursing home at $3,500 -$6,000 per month and supporting them in an ADHC where they return home each night to live with family.

Medicare does not cover day care costs, but in a licensed medical or Alzheimer's environment, Medicaid may pay all of the costs if the senior qualifies financially. Some day care centers offer need-based scholarships. Private medical insurance policies sometimes cover a portion of day care costs when registered, licensed medical people are involved with the care. Long Term Care Insurance policies can cover day care. There are limited spaces for Medicaid provided ADHC, as there are limited spaces for Adult Day Care as a social model, so waiting lists may prevail in both urban and suburban settings.

Adult Day Care Programs

Adult day care centers provide programs for adults in a community-based group setting. These programs are generally planned to provide daytime social/health services to adults who need supervised care outside the home. Some centers may offer significantly more services.

Adult day care and adult day health care offers seniors:

  • The chance to live with family and not be a 24-hour burden
  • Opportunities for social interaction with peers and mental stimulation
  • A program of stimulating activities
  • Meals and snacks with provisions for special dietary needs
  • Physical, occupational or speech therapy in a non-medical environment
  • Help with activities of daily living with dignity
  • Transportation for daily needs

When shopping for an adult day care center for elderly care, look for:

  • Round trip transportation
  • Facilities for bathing and hair washing
  • Licensing for administering medicine and medical procedures
  • Professional qualifications of the staff, interview the staff
  • The owner or sponsoring agency identity
  • Number of years in operation
  • The capacity of the Adult Day Care Center
  • What is expected of you?
  • Schedule of activities:
    • Hours of operation
    • Days of operation (usually Monday through Friday)
    • Trips, if appropriate for seniors' profile
    • Arts, crafts and other disguised therapy
  • Nutritional meals prepared on-site or by a qualified outside source
  • Menus that meet the needs of seniors
  • Can the center deal with medical conditions like dementia or incontinence
  • Compare prices for services offered, if you have a choice
    • Special charges for meals or transportation
    • Available financial assistance o Learn more about possible insurance coverage on our Insurance information page
  • Compare prices with in-home services but be aware:
    • Group environments are more stimulating.
    • We are all social beings.
    • A full activity schedule provides more stimulus.
    • A good adult day care center responds quickly to changing needs.
  • Does the adult day care center also provide respite care?
  • Get some references on the Adult Day Care Center.

An elderly care pamphlet resulting from the United States Senate Special Committee on Aging Report, based on allowed deductions on income tax filing is available by calling 800.829.3676 and asking for IRS publication covering dependent care.

"If a dependent spends at least 8 hours a day living in your home, expenditures made for out of home, non-institutional care are eligible for Dependent Care Tax Credits." The Dependent Care Center must comply with all state and local regulations for expenditures to qualify.

Other Resources

Caregiver Action Network is a non-profit organization providing education, peer support, and resources to family caregivers across the country free of charge.