Handbook for Mortals : A guide to settings and services : Adult day services

Adult day care programs combine personal services and light medical and nursing care in a "center" that is used daily or a few days each week. Such centers are typically open long hours during the day so that family members can work and raise children. Adult day care centers can provide important support to family caregivers and enrichment to patients.

There are two types of adult day services. One is more informal with no legal requirements, required activities for the clients, or staff qualifications. Medicaid and other insurance do not cover these "social day care centers," therefore, most clients are funded through private payments.

"Medical adult day care," in contrast, is regulated, licensed, and often paid for by Medicaid. The center can be freestanding or affiliated with a nursing home or a hospital. Participants are similar to those usually found in a nursing home. This service allows people with mild to moderate dementia, chronic physical problems, or other conditions requiring daytime care to live at home because the daily burden of care is reduced for their caregivers. Licensure is mandated, along with requirements for certain services including transportation to and from the facility, medical monitoring, group activities, and medication administration.

Providers sometimes specialize in specific conditions. For example, there are day programs for people with AIDS or multiple sclerosis. Others are operating like outpatient sub-acute care centers, offering services such as occupational therapy, intravenous therapy, speech therapy, and wound care. Clients may need these services for just a month or two, and day care can be a good alternative to the more expensive and restrictive care one could receive in a nursing home.

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Handbook for Mortals book cover Copyright © 1999, 2006 by Joanne Lynn. This extract from the Handbook for Mortals by Joanne Lynn, M.D. and Joan Harrold, M.D. is used with permission. To learn more about improving care at the end of life visit the main web site for Americans for Better Care of the Dying.
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