Adult day services are community-based group programs designed to meet the needs of functionally and/or cognitively impaired adults through an individual plan of care. These structured, comprehensive programs provide a variety of health, social and other related support services in a protective setting during any part of a day, but less than 24-hour care. Adult day centers generally operate programs during normal business hours, five days a week and some programs offer services in the evening and on weekend.
Adult day centers are designed to serve adults who are physically impaired or mentally confused and require supervision, increased social opportunities, assistance with personal care or other daily living activities. A survey conducted of adult day centers nationwide¹, found that: the average age of the adult day consumer was 72; two-thirds of all participants were women; 11% of the participants lived alone; 55% lived with a spouse, adult child or other family and friends. One half of the participants of the centers surveyed had some cognitive impairment, and one third required nursing services at least weekly. 59% of the participants required assistance with transferring and 41% required assistance with three or more daily living skills.
It is estimated that 3,500 adult day centers are currently operating in the United States. 78% are operated on a nonprofit or public basis, and many are affiliated with larger organizations such as home care, skilled nursing facilities, medical centers or multi-purpose senior organizations.
There are adult day centers in every state in the United States and the District of Columbia. In Florida, there are over 165 licensed centers. Since the beginning of the adult day center movement in this country in the 1970’s, the number of centers operating has rapidly increased. New centers are opening their doors every day.
The “average” adult day center offers a wide range of services, which typically include:
- Social Services
- Nursing Care
- Personal Care
- Therapeutic Activities
- Rehabilitations Therapies
Adult day service regulations differ from state to state and also by funding source. The Standards and Guidelines for Adult Day Care developed by the National Adult Day Services Association (NADSA) provide important benchmarks for states that have elected to regulate adult day services. Funding sources also define the range of services for which they will reimburse while an eligible participant is at an adult day center. The State of Florida requires that adult day centers go through a formal licensing process including a bi-annual inspection by the Agency for Health Care Administration.
The fees for adult day services vary, depending upon the region of the state and the range of available services provided by the center. Daily fees also vary depending upon the services provided and the reimbursement levels where applicable. On average, adult day centers in Florida charge $46 per day. Funding for adult day services comes from participant fees as well as public and philanthropic sources. The average charge for a day at an adult day center is a bargain – often much less than a visit from a home health nurse and about half the cost of skilled nursing facility care.
A high quality adult day center:
- Conducts an assessment of individuals before admission to determine their range of abilities and needs;
- Provides an active day program that meets the social, recreational and rehabilitative needs of the impaired adult;
- Develops and individualizes a treatment plan for participants and regularly monitors their progress;
- Provided referrals to other needed services in the community;
- Has clear criteria for service and guidelines for termination of services, based upon the functional status of the person;
- Provides a full range of in-house services, which may include: personal care; transportation; meals; health screening and monitoring; educational programming; counseling and rehabilitative services
- Provides a safe, secure environment;
- Utilizes qualified and well-trained staff and volunteers;
- Adheres to or exceeds existing state and national standards and guidelines
¹ A National Study of Adult Day Services, funded by Robert Wood Johnson Foundation, conducted by Partners in Caregiving (with PMD Advisory Services, LLC, and the Seniors Research Group of Market Strategies, Inc.) 2001. Wake Forest University, Winston-Salem, NC.