Savvy Senior: How to Choose an Adult Day Care Service

Dear Savvy Senior,

Can you offer any tips on finding and choosing a good adult day care service for an elderly parent? My 82-year-old mother, who is moving in with me, has Alzheimer’s and needs attention during the day while I’m at work.

Looking for Help

Dear Looking,

Adult day care services can be a great option for caregivers who work, or for those who just need a break during the day. Here is what you should know, along with some tips to help you find and choose one.

Adult Day Services

The business of adult day care services has grown rapidly in recent years. According to the National Adult Day Services Association, there are around 5,700 programs operating in the United States today.

As the name implies, adult day care provides care for elderly seniors who cannot care for themselves at home. While services will vary from center to center, they typically provide personal care, meals and snacks, various activities and social interaction in a safe, supportive environment. Additionally, many centers also provide health services such as medication management, various therapies, exercise and transportation to and from the facility.

Adult day care centers generally operate programs during normal business hours five days a week. However, some centers may offer services in the evenings and on weekends, too.

Costs for care will vary as well, usually between $25 to more than $100 per day (the national average is $65/day), depending on where you live.

Unfortunately, in most cases original Medicare (Part A and B) does not pay for adult day care, but some Medicare Advantage (Part C) plans and many long-term care insurance policies do. But, most seniors or their families pay for care out-of-pocket.

If your mom is lower income and cannot afford this, many states offer Medicaid waiver programs, and some have PACE programs that provide financial assistance. Contact your state Medicaid office (see Medicaid.gov) for more information. The VA even provides adult day care to eligible veterans enrolled in their Medical Benefits Package. See VA.gov/geriatrics to learn more.

How to Choose

Your first step in shopping for an adult day center is to determine the kinds of services your mother and you need. After you do that, here are some tips to help you locate and choose a good provider.

Start by contacting your Area Agency on Aging (call 800-677-1116 to get your local number) to get referrals to adult day service programs in your area. You can also search online at the National Adult Day Services Association (NADSA) website at NADSA.org/locator, or check your phone book yellow pages under "Adult Day Care" or "Senior Services."

Once you have a list of a few centers, call them to find out their eligibility criteria, if they offer the types of services your mother needs, if they are accepting new clients, their hours of operation, if they are licensed and/or registered with a state agency (this is not required in all states) and what they charge.

After you identify a few good centers, go in for a visit. Find out about the staffing ratio (at least one staff member for every six participants is recommended) and what kind of training they have. While you are there, notice the cleanliness and smell of the facility. Is it homey and inviting? Does the staff seem friendly and knowledgeable? Also be sure to taste the food, and consider making an unannounced visit.

To help you rate your visit, the NADSA offers a helpful checklist of questions to ask at NADSA.org – click on "Choosing a Center."

Then, after your visit, be sure to check their references. Get names and phone numbers of at least two or three families who have used the center you are considering and call them.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of "The Savvy Senior" book.