1 Chapter 6. Adult Day Care Long-Term Care: Managing Across the Continuum (Second Edition)

2 Learning Objectives 1.Define and describe adult day care 2.Identify sources of financing for adult day care 3.Identify and describe regulations affecting adult day care 4.Identify and discuss ethical issues affecting adult day care 5.Identify trends affecting adult day care into the future and the impact of those trends

3 What is Adult Day Care? Interim (less than 24 hour) care Provides a structured environment Gives family caregivers a break, or chance to hold a job Mix of social and health services

4 Philosophy of Care Serves both consumers and caregivers Holistic approach to care Maintains or improves quality of life Provides safe, supervised setting

5 Benefits of Adult Day Care Can live with family without being a burden Social interaction with peers Program of stimulating activities Therapy in a non-medical setting ADL assistance with dignity

6 Ownership of Adult Day Care Mostly nonprofit or public (3/4) Less than 1/4 are for-profit Most (3/4) are affiliated with other health care organizations:  Home care  SNFs  Medical centers

7 Types of Adult Day Care Three categories of adult day care: Social Day Care Adult Day Health Care Dementia Care

8 Services Provided Basic services provided by all types: Safe, secure environment Social and recreational activities Assistance with ADLs Transportation to and from the center At least one meal, plus snacks

9 Health Services Added health care services may include: Medications Monitoring Therapies Nutrition counseling Social services Health education

10 Consumers of Adult Day Care Between needing institutional care and being independent Most live with family Unable to handle day-to-day tasks Most are elderly More women than men

11 Caregivers About three-fifths are spouses or adult children Other two-fifths are other relatives, friends, or neighbors Mostly female (three-quarters) Average age of caregivers: 57 One-third are over 65 themselves

12 Market Forces Social and demographic changes Managed care Competition among other providers

13 Regulations 1/3 to 1/2 of states license in some form Highly inconsistent Usually cover space, safety, and staffing

14 Financing Adult Day Care Reimbursement Sources: Public funds (Medicaid, PACE) Managed care Private insurance Self-pay and other sources

15 Staffing Combination of professional and non-professional staff Mix depends on focus (social, health, or dementia care)

16 Legal & Ethical Issues Similar to other providers’ issues Consumers’ rights

17 Management Qualifications Little commonality No national standards If affiliated with other provider type, their regulations may apply

18 Management Challenges & Opportunities Meeting the growing demand Achieving cost-effectiveness Marketing

19 Significant Trends Continued increase in demand Attractiveness to MCOs Movement toward the health model Expanded services

20 In Summary: Adult Day care is becoming very attractive to: Consumers and their families Payers as a cost-cutting measure Other providers as an added service