When many families consider obtaining help for a loved one to stay at home, often private home care is the first option that comes to mind. Another valuable service to consider is an adult day center. These centers, which are regulated by the state, allow adults increased opportunities for socialization while providing assistance with personal care and general activities of daily living. They should not be confused with senior centers, which are designed to provide enrichment opportunities for seniors who can function independently. Adult day centers provide care and supervision for those individuals who require the support of others to remain safe throughout the day.
The Pennsylvania Code identifies the goals of adult day centers as follows:
- Improve the quality of life of individuals with functional impairment
- Provide respite for caregivers and clients
- Provide a community-based alternative to institutionalization
- Promote client functioning to the extent of the client’s ability
In order to meet the above goals, centers provide a variety of services including supervision and physical assistance with activities of daily living such as dressing, toileting, and eating; nursing services such as medication administration and health maintenance evaluation; social services including care coordination with other providers and communication with families; therapeutic activities (a monthly calendar must be posted); nutritional services such as meals, snacks, and specialized diets; and emergency care.
Appropriate services for each participant are determined in part by an intake screening within sixty days of admission to the program. This screening asks for information including personal identification (address, caregivers, etc.), a social history (hobbies, interests, previous occupation, etc.), physical and cognitive functioning, the use of additional support services, and other data relevant to the overall situation of the participant. This information is utilized to develop an individualized care plan. Care plans must be reviewed and/or updated at least every six months. In addition, staff members are required to write a progress note in the participant’s record at least monthly. Participants are required to have an annual physical exam and medical report.
An adult day center is required to be licensed if services are provided for part of a day to four or more clients at the same time, who are not relatives of the operator. The license should be posted in a public place within the facility, and annual inspections are conducted by the state to determine if the facility is operating according to the specific regulations for this type of service.
Staffing is one of the areas covered by the regulations. A center must maintain a minimum staff- to-client ratio of one to seven at all times. Staff members are to include a program director, activities coordinator, program assistants, and a nurse. The nurse may be a full or part-time employee of the center, or nursing services may be contracted through a separate company. All employees are required to have a criminal history background check prior to employment. Requirements for staff education and training also are detailed. Other regulations cover general and fire safety, the physical site, overall requirements, program components, and policies related to the daily operation of the center and special circumstances that may occur.
Adult day services in our area include facilities in Mechanicsburg and Carlisle operated by Messiah Lifeways, Lifetime Adult Day Care in Mechanicsburg, Greenfield Senior Living in Harrisburg, Cross Keys Village and Share and Care in Adams County, and ElderDay in Chambersburg. Payment sources for adult day services may be private, or through long-term care insurance, VA benefits, or waivers with the Office of Aging. The cost of services is dependent upon whether the individual participates in a half day or full day program, and the level of care that is required. Generally, fees are less than the cost of in-home care for a comparable number of service hours.
Adult day services, which usually operate Monday through Friday during business hours, can help lighten the load for caregivers who are on call 24/7 and would benefit from some respite time, or who need/want to continue working yet also desire to keep their loved ones at home. They can be a valuable resource in assisting caregivers to manage a loved one’s chronic disease or dementia. At the same time, they reduce the risk of isolation for some of our more frail citizens who remain in the community. Should adult day services be part of your plan to care for your loved one?
Karen Kaslow, RN