What’s The Difference . . . between Adult Day Centers?

Author:  M. Celeste Chase, ACC, CDP
               Activity Directors Network
                http://www.activitydirector.org
10/17/2018

 
-Medical, therapy and socialization centers
-Socialization and safety centers
-Alzheimer’s and dementia care facilities

Adult Day Centers are either social or medical in nature with specifically trained and compassionate staff that creates programs to meet the needs, preferences and cultural differences of those they serve. These facilities offer supportive assistance by way of physical activities and cognitive stimulation and/ or medical care during the day-time hours (no overnight stays).

 Family members can plan for daily “predictable respite” for which they might use to relax or go to work or run necessary errands (without the added burden taking their senior loved ones with them). When participants go home to be with their families after a day at the center, families will find their loved ones happy, stimulated, alert and often more ready to sleep soundly through the night. Giving the entire family a most welcomed nighttime benefit which is often desperately needed. Without a doubt adult day health programming leads to improved well-being and increased socialization within a safe, nurturing and comfortable community setting.

Medical vs. Social  - There are two types of adult day care:
Both provide a comfortable, secure place for a senior to reside during the day, enabling them to socialize, stay active, remain productive and enjoy an improved quality of life, Typically, the center provides one or two meals a day. Some centers provide transportation for pick up and/or drop off, which may or may not be included in the cost.
The main difference between medical and social day care is that the medical model also provides an array of medical professionals, which may include on-site registered nurses, speech therapists, occupational therapists, physical therapists, social workers and registered dietitians.
Keeping it simple; the easiest way to identify the difference between these two centers is to take a look at the name. An “adult day care” facility, without the word - “health” in the title are not required to adhere to the same standards and regulations and do not offer the availability of on-site health care professionals from a range of disciplines to provide clinical oversight.

Adult Day Centers and Offerings
Socialization and safety centers – Adult Day Care

Adult Day Care Many centers have well-trained activity specialists who lead dynamic activities programs.  These programs might include arts and crafts, intergenerational programs, music, cooking classes, exercise sessions, movies, discussion groups, live entertainment and trips into the community.  Some care centers offer programs that are especially designed for physically frail individuals with special medical needs such as diabetes, hypertension and post-stroke disabilities, and those with mental health challenges such as dementia, confusion and Alzheimer's disease.  The goal is to be an extension of the home environment with caring, personalized service. These centers rely on private pay reimbursement for services provided.
Medical, therapy and socialization centers – Adult Day Health

Adult Day Health centers offer all of the same services you would find in Adult Day Care centers mentioned above, in addition; they provide ” certified” amenities via trained health care professionals such as physical, occupational and speech therapies, nursing services, personal care, social services and much more depending on the individuals acuity level assessment. These centers are prepared and well equipped to enroll not only very independent individuals but also those with chronic physical illness and/or cognitively challenging needs.
Most states have specific governing bodies that work to establish procedures for licensing and regulation standards to oversee the business of Adult Day Health “medical” care centers. These regulations are mandated and centers are required to adhere to guidelines and protocols to be given licensing privileges. These standards are not only specific to medical record guidelines but are also required for the centers to qualify to submit billing to Medicaid and/or Medicare for reimbursement of services on behalf of those participants pre-approved to receive these benefits.

Alzheimer’s and Dementia Care centers – may be found in either social or medical model centers (medical facilities usually provide for more advanced stages of the disease).
Many dementia patients are at risk for safety and cannot be left unsupervised. Progressive memory and cognitive decline may lead to potential for wandering, risk for self harm from misuse of everyday regular household items. This puts family caregivers in a difficult position, especially if outside help is scarce and/or family members are still working. Dementia programs at adult day centers typically utilize security features to prevent wandering as well as improved staffing ratios to ensure seniors are safe and their needs are met in a timely manner. This provides invaluable free time and peace of mind for the dementia caregivers. Skilled Adult day centers that specialize in the care of those with dementia are becoming more and more in demand in light of the increased numbers of seniors diagnosed with this disease over the past few years. Many states require centers to have staff members obtain specific dementia  training to care for this population.  Trained professionals are able to recognize those seniors that prefer quiet, solitude like environment while others are in desperate need of more stimulation. This expertise proactively minimizes potential disruptive behavior by addressing each     individual’s unique needs. State regulations have been written to target this topic requiring medication management to modify behavior to be used only as the last option after it is documented that all non-pharmaceutical interventions have been implemented without success through the individualized care plan.

Adult Day centers provide an array of activities for attendees to participate in; adapted to each person’s unique abilities to maximize enjoyment and minimize frustration.  Many centers also offer flexible scheduling choices from attending just a few hours each day to attending the entire day for one or more days per week.  The affordable cost of care for Adult Day allows these centers to be more accessible to a wide range of families for senior care options. Clearly, Adult Day Centers are the go to choice for those looking find support that fits into their family values and needs while allowing them to keep their loved one at home.

Author : M. Celeste Chase, ACC, CDP
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