The U.S. Centers for Disease Control and Prevention recognized 4,800 adult day centers active in the United States as of 2012. Non-profits operated the largest percentage of adult day centers, at 54.9 percent, followed by for-profit companies, at 40 percent, and government agencies, at just 5.1 percent.

Nonprofit adult day programs have flourished in recent years, thanks to the Lifespan Respite Care Act of 2006. Lifespan Respite Care programs are coordinated systems of community-based respite care services designed to offer much-needed relief to family caregivers of children and adults of all ages with special needs, including those with dementia and Alzheimer’s.

Through the Lifespan Respite Care Act of 2006, the Administration on Aging (AOA) awards grants of up to $200,000 each to eligible state agencies working in collaboration with public or private nonprofit statewide respite care coalitions or organizations.

The AOA awards grants in an effort to expand and enhance respite care services throughout the country, to fill gaps in service where necessary, and to improve the overall quality of respite services. As of 2012, the AOA awarded grants to eligible agencies in 30 states, as well as the District of Columbia.

Adult Day Programs: What Are They and Who Are They For?

Adult day programs, which may be nonprofit social activity day programs or medically supervised adult day care programs, provide respite care for caregivers while also providing a number of health services, therapeutic services, and social activities for seniors in a group setting.

Adult day programs may satisfy or appeal to specific populations of seniors. Some may be social in nature, while others may meet a specific medical model and are therefore able to care for seniors with specific physical or mental challenges. For example, some adult day programs provide services exclusive to those with medical conditions like dementia or Alzheimer’s. Although program offerings vary, most provide respite care for several hours a day to a full day.

NASDA reports that nearly half of all participants have some level of dementia. Other chronic diseases among participants include: mental illness, physical disability, cardiovascular disease, diabetes, and chronic hypertension, to name a few.

Nurses and social workers, who provide everything from health monitoring to physical therapy to medical management, staff day programs that meet a medical model. Specialized day programs within the medical model focus on care specific to a population, such as those with Alzheimer’s or dementia. Still others offer a combination of both social and medical services.

The type of adult day program depends on the needs of the senior participating in the program. However, according to the ARCH National Respite Network and Resource Center, a quality day program should:

• Conduct individual needs assessments before admission to determine the senior’s range of abilities and needs
• Provide programs that meet the senior’s daily social, recreational, and rehabilitative needs
• Develop an individualized treatment plan for the senior and adjust the plan as needed
• Provide the senior’s family with referrals to other community services
• Have clear criteria and guidelines for termination based on the functional status of the senior
• Provide a full range of in-house services, such as:
  • Rehabilitative services
  • Counseling
  • Meals
  • Health screening and monitoring
• Provide a safe and secure environment
• Use qualified and well-trained volunteers
• Meet or exceed existing state and national standards and guidelines

Covering the Cost of Adult Day Programs Available through Nonprofits

Lifespan Respite programs and state resources can be found using the Lifespan Respite Care Act ARCH National Respite Locator. Since non-profit programs are largely supported by grants from a variety of sources, the cost associated with adult day services is usually minimal, and in many cases it is completely free to those who qualify. Free and reduced cost adult day services benefits are available through a number of sources:

• Medicaid waivers: State Medicaid offices provide information on Medicaid waivers that cover the cost of adult day programs.
• Medicaid State Plan: Seniors living in a state that adopted the Section 1915 Medicaid State Plan Option for Home and Community-Based Services may qualify for free or low-cost adult day programs without the need for a waiver.

Note: Medicaid may pay for all the costs associated with care in a licensed adult day program with a medical model or an Alzheimer’s environment, provided the senior qualifies financially.

• Medicare Hospice Benefit: Caregivers of seniors on Medicare and in hospice may qualify for adult day programs through the Medicare respite benefit.
• National Family Caregiver Support Program: Local Area Agencies on Aging (AAA) administer the National Family Caregiver Support program, which provides funding for caregivers caring for someone over the age of 60 or someone with Alzheimer’s or other types of dementia. The AAA has an Elder Locator for finding programs that meet these requirements.
• State Family Caregiver Support Programs: Some states have state-funded family caregiver support programs. Information on these programs is available through the Family Caregiver Alliance.
• Veteran Benefits: Veterans may be eligible for therapeutically focused outpatient day care, with services contracted or provided directly by the staff of the Veterans Health Administration or another provider.
• Private Medical/Long-Term Care Insurance: Private medical insurance policies may cover a portion of adult day programs, provided registered, licensed medical personnel are involved in the care. Long-term care insurance may pay for adult day programs, depending on the policy.