Adult Day Service Centers Increase in Number But Waiting Lists Indicate The Need for More

According to “The MetLife National Study of Adult Day Services: Providing Support to Individuals and Their Family Caregivers,” more than 4,600 Adult Day Services (ADS) centers are available nationwide, a 35% increase since 2002.

The study, produced in collaboration with the National Adult Day Services Association (NADSA) and The Ohio State University College of Social Work, reports that these centers serve about 260,000 people, an increase of more than 100,000 since 2002. Twenty-nine percent of the centers have waiting lists. More than half of the participants (58%) are women; 30% are under age 65.

The study, accompanied by a consumer guide, “The Essentials: Adult Day Services,” also found that centers have significantly upgraded the level of services they provide; 80% now have a professional nursing staff and 50% have a social work professional. Half provide physical, occupational or speech therapy.

Approximately 90% of centers offer cognitive stimulation programs, while 80% have memory training. Most centers provide programs for caregivers, including education, support groups and individual counseling. The ratio of direct care worker-to-participant is now 1:6.

“ADS centers make it possible for people to continue to live in their homes and receive affordable care in a supportive, professionally staffed, community-based setting,” said Dr. Sandra Timmermann, director of the MetLife Mature Market Institute. “They also benefit family caregivers by enabling them to remain in the workforce or receive needed respite and support services. The passage of the Patient Protection and Affordable Care Act (the health care reform bill) and an increasing focus on managing chronic illness within the Medicare program both speak to the importance of developing care models such as Adult Day Services to meet the needs of a growing population of older Americans.”

According to Dr. Holly Dabelko-Schoeny of The Ohio State University College of Social Work, in addition to providing needed long-term care services, Adult Day Services centers serve as an emerging provider of transitional care from the hospital to home, providing short-term rehabilitation following discharge from the hospital. “Centers are also offering disease-specific programs to address chronic conditions and meet the needs of participants who have higher levels of chronic conditions and increasing physical disability,” said Dr. Dabelko-Schoeny.

The study provides a snapshot of the typical Adult Day Services center in the U.S.:

• Most operate Mondays through Fridays from 6:30 a.m. to 6:00 p.m. in a 1,000-5,000 square foot facility. Centers are usually administered by a professional in the business/health care administration, nursing or social work field. Professional services are provided by a Registered Nurse (RN) or Licensed Practical Nurse (LPN) and recreational and therapy professionals. The typical direct care worker-to-program participant ratio is 1:6.

• Fees average $61.71 per day and typically come from a public source, including Medicaid waiver, the Veterans Administration, state/local social services or directly from a private-pay participant. Since the average daily cost of care is $68.89 per person, centers supplement revenue with grants and donations.

• Though participants are diverse in age, ethnicity and ability, the average participant is a 65-plus-year-old, white female with dementia, hypertension or a physical disability requiring assistance with at least one activity of daily living (ADL) and medication management. She lives with an adult child or spouse, or lives alone, but primarily receives care from an adult child.

• The average length of enrollment in a program is 24 months.

• The majority of the ADS centers (86%) reported they were state-certified or licensed, a 10% increase from 2002.

• The study reports an increase in the number of for-profit ADS centers.  Currently, 27% are for profit today, compared with 22% in 2002.

“The MetLife National Study of Adult Day Services” and the accompanying consumer guide, “The Essentials: Adult Day Services,” can be downloaded from www.MatureMarketInstitute.com.  It also can be ordered by e-mailing MatureMarketInstitute@metlife.com or by writing to: MetLife Mature Market Institute, 57 Greens Farms Road, Westport, CT 06880.

To find an adult day service center in your community, please visit National Adult Day Services Association.

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