Adult Day Services – A Partnership with the Family

by Debbie Scott, MS in Gerontology
A Grace Place, Adult Care Center

“Mom is becoming more difficult to handle.” “I am so tired, but who will take care of dad?” “I could never put my parents in a nursing home.” Do any of these phrases sound familiar? Every single day, more than 10,000 Baby Boomers reach the age of 65 and this will continue for the next 19 years.”(1) More and more, families need affordable care for loved ones. One option to consider is Adult Day Services (ADS).  ADS facilities, open from 7 AM to 6 PM Mondays – Fridays, providing a safe, stimulating and fun place for participants while caregivers have time off.  A nurse is on site to manage medicine, and emergencies.

Most Adult Day Services have Alzheimer’s or Memory Care Units, which provide activities geared to these clients. Some ADSs accept participants with Autism, Parkinson’s, Muscular Dystrophy, and Cerebral Palsy. Shop around to find what best fits your needs.

How to choose an Adult Day Care Service

Considering Adult Day Service first, determine location.  Convenience is a must, not to add the stress. Often, if a suitable ADS is not available nearby, transportation services are available.

Next look at the hours of operation and determine if they fit into your schedule.

Cost is a third factor to consider as many options exist ranging from private pay, or a non-profit who accept Medicaid, waivers, and scholarships.  ADSs are a cost effective option to nursing home, retirement communities and even in-home services, running about $65/day currently.

The National Adult Day Services Association did a cost comparison of care options in 2010: ADS care cost  $13,780 per year; Homemakers services $37,758; a Home Health Aide $41,184; a Semi-Private room in Assisted Living $43,282; Semi-Private room in a Nursing Home $65,7000; and a Private room in Nursing home $73,000. Families found ADS to be an affordable, life-enhancing arrangement.

Fourth, consider the population that the ADS serve. Some ADS will accept 18yrs and older, some age 55 yrs and up, still others start at 60-65 yrs and up.  Assess the situation to make sure it is the best option for your loved one.

Next consider licensure. Licensed facilities have standards they must maintain for accreditation. Quality staff, trained to handle difficult behaviors, can provide the personal care, programming and a healthy quality of life.  Nurses, for example, will monitor participant’s health daily and alert the caregiver before a condition becomes problematic.

Last, consider ADS exclusions. Many ADSs have exclusions of care for certain population groups. For example: Mom has Alzheimer’s but is still continent and does not wander. Will the facility still allow her to stay if she becomes incontinent and starts to wander?  Ask “what if. . .” questions when choosing an ADS. Some ADS allow participants to move to another area within the facility when behaviors progress, while others might require patients to relocate to another facility.  “What if…” questions can provide important answers up front.

When is the Right Time for an ADS?

If your loved one exhibits a few of the following, it may be time to consider an ADS:

  1. Need help in self-care
  2. Requires supervision
  3. Is socially isolated and lonely
  4. Is mentally confused
  5. Is unable to manage personal care and hygiene
  6. Has poor nutrition
  7. Requires medical supervision and care
  8. Is prone to wander
  9. Needs stimulation
  10. Needs a quality of life despite disability/illness
  11. Needs assistance with life skills
  12. Needs temporary placement
  13. Has a family or caregiver who needs support and a break from care responsibilities.

Caregiver Stress and Fatigue

An ADS is good for participants, but is also helpful to caregivers who often experience headaches, anxiety, depression, guilt, anger, muscle tension, sleeping and eating problems.(3)  Caregivers  experiencing these symptoms need a break.  Some  23% of caregivers experience a decline in health.(4)  The reasons are clear.  The stress of juggling family, work, and 24/7 caregiving responsibilities is exhausting.  “70% of working caregivers suffer work-related difficulties due to their caregiving roles. 69% report having to rearrange their work schedule, decrease their hours or take an unpaid leave in order to meet the caregiving responsibilities. 5% turn down a promotion, 4% choose early retirement and 6% give up working entirely.” (5) ADS can help.

Adult Care Services can be beneficial for loved ones and caregivers alike.  They allow clients to have the care during the day while the caregiver works without worrying about safety, security, loneliness, meals, or entertainment.  There are many things to consider when you are a caregiver, but an ADS can make this job an easier responsibility with a more fulfilling outcome.


  1. Online ISSN  1758-5368 – Print ISSN 1079-5014  copyright 2011 The Gerontological Society of America, Dr. Steven H. Zarit, Gerontology Center, The Pennsylvania State University, Henderson South 105, University Park, PA 16802.
  2. (
  3. The Elder Care Educator, Blanche S Katz M.S.N., R.N., G.N.P.
  4. & 5. – Family Caregiver alliance. 180 Montgomery St, Suite 900, San Francisco, CA 94104

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