Adult Day Services provides a planned program that includes nutritional, health, social and support services in a protective environment. For the participant, services offered at an adult day services center can provide an enjoyable day spent with friends of their own age, engaging in creative activities in a safe and encouraging environment. It gives them the opportunity to continue to feel independent and participate in their choice of activities. For caregivers, adult day services offer an opportunity to continue gainful employment or to take care of other responsibilities a caregiver may have. It is essential that a caregiver have time to also care for themselves.

Adult day services may be perfect for a loved one that you don’t feel comfortable leaving home alone but may not be ready for placement. Adult day services may also be needed when the physical and psychological health of the caregiver is negatively impacted by the demands of providing care, as this service can ease the burden for the caregiver and provide time and space to restore their own health, interests and personal relationships. An example of indications of the need for Adult Day Services may include a person, who’s having difficulty managing the daily activities of life such as medication management or cooking, is without companionship or supervision for periods and is unsafe being left alone, is isolated or lonely, or needs health monitoring. It appears to be best for the person to begin attending Adult Day Services while they can still enjoy the activities and company of others. As their abilities change, they will already be familiar with the comforting structure and routine of the center.

Caregivers should search for a center that is licensed by the State of Florida. This can be determined by going to the website www.floridahealthfinder.gov. It will list all of the licensed centers in your area. It should provide the opportunity for care planning with the family/caregiver to meet individual needs and provide person centered care culture. Activities that are varied and programming that includes mentally-stimulating games, one-on-one time, physical exercise, walks, education and fun. Services should be provided in a clean and safe environment focused on enhancing each client’s well-being. Nutritious meals and snacks should also be provided. Caregivers should also ensure that the adult day center can meet the personal care needs of their loved one. See “Questions to Ask When Visiting an Adult Day Center” and “Site Visit Checklist” at www.nadsa.org.

Words and finesse can mean everything. A caregiver can often successfully encourage their loved one to attend an adult day services program by referring to the center as the office, class or the club. Finesse gives meaning and a sense of importance to the activity of going to an adult day center. A caregiver can tap into the person’s sense of daily routine or daily obligation. For some people going to an adult day center is like going to work. A helpful method is for a physician to write a prescription for adult day services stimulation three times a week (or more, if needed). At this point the caregiver can say “Your doctor wants you to attend an adult day program.”. Routine is very important so it is helpful if the person attends the same days each week.

First impressions are very important! The adult day center staff will do everything possible to ensure that your loved one has a positive experience. An individualized care plan will ensure that the participant’s likes and dislikes are honored, and individual likes and dislikes are honored.

Group exercise, group discussions, games, sharing mementos from a person’s home, daily walks, history review, memory stimulation, upbeat current events, poetry readings, weekly themes, arts & crafts, music, and one-on-one time are just a few of the activities offered in adult day center settings. These activities can also be adapted to provide optimal benefits to clients.

While adult day services centers provide a wide array of benefits to participants and caregivers, some families reach a point when a higher acuity of care is necessary. Distress behaviors such as altered sleep patterns, combativeness, wandering and/or increased cognitive impairment are common issues precipitating alternative care. The good news is that persons who participate in adult day www.floridahealthfinderprograms tend to have improved health and better attitudes. Staff will provide updates and revise care plans to enable a participant to remain in attendance and living at home. If alternative care becomes necessary, the center manager or social worker will work with the family to find the best choice for care.

Adult day service (ADS) centers provide a coordinated program of professional and compassionate services for adults in a community-based group setting. Services are designed to provide friendship, social, nutrition and some health services to adults who need supervised care in a safe place outside the home. These programs enhance the quality of life for more than just the participant. They help the caregivers as well by offering respite from the daily demands and responsibilities and provide the ability for working caregivers to continue employment. Many caregivers are in need of ADS programs because they too are elderly with multiple health problems or are employed. Most centers generally operate during normal business hours five days a week. Some programs offer services in the evenings and on weekends.

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: Transportation Social Services Meals Nursing Care Personal Care Counseling 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.

A break from being “cared for” by family. A boost in self esteem. Time to socialize and enjoy the day with friends. Celebrations and Parties. An enhanced appreciation in the quality of life Physical activities, pet therapy, memory games, conversation and social interaction. Personal care – help with toileting, grooming, eating and other activities of daily living. Nutritious meals and snacks. A heightened focus on health maintenance and prevention.

A break from daily tasks of caregiving. Time to continue to work and/or run a household. Free time to relax and enjoy the pleasures in life. Peace of mind, knowing that your loved one is being well taken care of and encouraged to have a happy day among friends. Better health and emotional results for everyone. Support and understanding from other caregivers. Education on wellness subjects for you and your loved one.

Ask the center to provide you with any written documentation such as brochures, calendars and menus. Questions to ask when visiting a center: How many years has the center been in operation? Does the center have an adult day care license, and what was there Agency for Health Care Administration survey outcome? What are the hours of operation? Are transportation services offered? What is the cost? Hourly or daily charge, other charges? What type of payments are accepted? Is financial assistance available? Is specialized care provided for conditions such as memory loss? What is their admission criteria and discharge criteria? Do they have a nurse on staff? What is the staff/ participant ratio? What kind of training does staff receive? Do participants have access to services such as physical or occupational therapy? What type of activities are provided? Are meals and/or snacks provided? Dietary assistance?

Did you feel welcome? Were the center services and activities properly explained? Were you given information regarding staffing, programming, and costs? Is the facility clean, pleasant and free of odor? Is the building and site wheelchair accessible? Is the furniture sturdy and comfortable? Are there loungers and chairs with arms for relaxation if appropriate? Is there a quiet place in the center? Did the staff and participants seem cheerful and comfortable? Are participants involved in planning activities?