You want the best care possible for your elderly parent, but you don’t have the bandwidth to provide it around the clock. You’re not alone. Hundreds of thousands of families around the U.S. need some form of supplementary care to help with elderly relatives who have physical or cognitive impairments. If your parent isn’t quite ready for full-time nursing home care, adult day care might provide the support you need.
What is adult day care?
Adult day care offers daytime supervision and activities for seniors who aren’t independent enough to be left home alone, while allowing caregivers like you to carve out personal time for work, family responsibilities, and self-care. The range of services offered by adult care centers varies, but programs are structured to fit into one of these three categories:
- Social Adult Day Care, also known as Adult Day Services or ADS: A Social Adult Care center offers structured social activities, learning opportunities, mild exercise classes, nutritious meals, and light supervision. These programs are designed for seniors who are mobile, continent, responsive, and have only mild impairments.
- Adult Day Health Care or ADHC: More severely impaired seniors may require ADHC services, which offer a greater level of medical supervision. Seniors in an adult day health care program would enjoy social activities and meals throughout the day, but they also might participate in physical or cognitive therapy sessions, as dictated by their condition. An adult health center is better equipped to work with seniors who need hands-on help with grooming, walking, eating, taking medications, and toileting.
- Specialized Adult Day Care: Specialized adult day care centers work with seniors who have Alzheimer’s and other conditions associated with dementia.
Benefits of adult day care
The benefits of adult day care, for the senior and the caregiver, are well documented. For you, a reprieve from the full-time job of caregiving reduces stress and wards off burnout. You’ll also be able to enjoy your free time, knowing that your parent is in a safe, supervised environment while you are away.
Your parent, too, will likely appreciate the opportunity to get out of the house, make new friends, and learn new skills. Seniors who participate in adult care programs benefit socially, emotionally, and physically:
- A regular trip to the elderly care center can restore some of the independence your parent has lost.
- The social and cognitive stimulation provided by activities and regular therapy sessions gives your parent the chance to practice logical thinking, communication, and effective use of gross and fine motor skills.
- Seniors who engage socially and receive regular therapy tend to be more alert and better able to interact with their loved ones.
- Adult care centers are staffed with trained professionals who plan and oversee your parent’s care plan. Those team members can often assist with medications, treat wounds, and monitor blood pressure and blood sugar levels. They can also detect any changes in your parent’s condition that develop over time.
Elderly day care requirements
While elderly care centers are regulated by state law, each sets its own guidelines for the type of mental and/or physical impairments it can manage. A specialized care center for seniors with Alzheimer’s, for example, wouldn’t require your parent to be continent. But a Social Adult Center would have stricter requirements, including continence, mobility, and some level of communication skills.
For that reason, you might start your search for elderly day care services by asking your parent’s physician for a referral to an appropriate facility. Your parent’s doctor can also give you some direction on what questions you should ask as you interview prospective care centers. At a minimum, you need to know what types of health conditions each program accepts, and if there are extra charges for seniors who have mental health needs, incontinence, debilitating and chronic illness, or Alzheimer’s.
How much does elderly day care cost?
How much does senior day care cost? One answer is provided by the Administration for Community Living, which reports that the average cost of adult day care in the U.S. in 2016 was $68 daily. Assuming five days of care weekly, that equates to about $1,475 monthly, or nearly $18,000 a year.
Unfortunately, those averages may not be terribly relevant to your situation. According to SeniorLiving.org, adult care costs range from $25 to $100 daily, depending on the set of services your parent needs and where you live. A social program for high functioning seniors will be at the lower end of that range, while a program with medical care will be more expensive. Costs also vary dramatically by state. The median monthly cost of adult day care in Vermont, for example, is $2,678. That’s three times higher than Texas’ median monthly cost of $785.
Will adult day care cost more because of the coronavirus?
There’s one more moving part to consider in the cost equation. Adult day care costs will likely rise as a result of the coronavirus. Starting in March of 2020, most adult care centers had to close due to state-mandated lockdowns. As these facilities reopen, their services will have to evolve to incorporate social distancing protocols. That likely means fewer seniors congregating in shared spaces. As well, staff will have the added responsibility of ensuring seniors follow extra hygiene requirements, like wearing masks and washing their hands throughout the day. Those changes will likely put financial pressure adult care programs and cause costs to increase.
How to pay for adult day care
Rising costs for adult day care is bad news for families with impaired seniors, because these expenses are largely paid for out of pocket. That’s because Medicare and most traditional health insurance do not pay for adult care services. If you need assistance with adult care costs, here are five places to look.
1. Ask about a sliding scale
Some adult care facilities offer their services on a sliding scale. That means the fees you’re charged are based on income; if you have a lower income, you may qualify for lower rates.
2. Try Medicaid or the VA
Medicaid may reimburse you for adult care costs, under certain conditions. Each state defines its own requirements, but reimbursement is often provided under Medicaid community waiver programs. These waivers pay for services outside of nursing home care for seniors who still live at home. However, waiver assistance is not guaranteed to everyone who has Medicaid. There is a review process that considers the applicant’s financial status and medical condition. Your parent would need a prescription from a medical doctor for full-time or nursing home care. Also, Medicaid has caps on the number of people participating in a waiver program at any given time. That means your parent might be placed on a waiting list until space in the program is available.
In about 15 states, standard Medicaid does pay for adult care services. If your parent qualifies for Medicaid and you reside in one of these states, your parent is entitled to the adult care benefit. There would be no extra eligibility or enrollment process as there would be with a waiver program.
Another option is to check the VA. If your parent requires full-time medical supervision, the VA may cover the cost of medically necessary adult care.
3. Use adult day care part-time instead of full-time
If you can’t afford full-time day care, see if you can arrange your schedule to allow for part-time care. Many facilities offer half-day programs with lower rates. Some programs may even charge by the hour.
4. Check with your long-term care insurance
Check in with any long-term care insurance policy your parent might have. Each policy varies in its requirements, but you might qualify for reimbursement of adult care costs if your parent requires medical supervision during the day.
5. Look into cashing out life insurance
Life insurance can also be a source of cash. You can borrow against accumulated cash value in a permanent life policy or you could sell the policy outright in a life settlement. Life settlements generally raise the most cash, since a buyer will pay more than the policy’s cash value to access the future death benefit. There are no restrictions on how you use the cash proceeds from a life settlement.
Not every policy is sellable, however. To determine the marketability of your policy or your parent’s, contact Harbor Life Settlements. The team will prequalify any policy for free and without obligation.
Supplementary day care can keep your parent at home
When you’re not ready to move your parent into a nursing home, a good day care program can provide the supplementary care and supervision you need. The daily cost of care ranges from $25 to $100, depending on the level of care and where you live. If you need assistance with those costs, ask about sliding scale rates or hourly, part-time care plans. Medicaid, the VA, and even long-term care insurance might also be able to help. You can also tap life insurance, your or your parent’s, to generate funds to pay for that supplementary care.