Chapter 6 Adult Day Care LongTerm Care Managing

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

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 2

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

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

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

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

Types of Adult Day Care Three categories of adult day care: üSocial Day Care üAdult Day Health Care üDementia Care 7

Services Provided Basic services provided by all types: üSafe, secure environment üSocial and recreational activities üAssistance with ADLs üTransportation to and from the center üAt least one meal, plus snacks 8

Health Services Added health care services may include: üMedications üMonitoring üTherapies üNutrition counseling üSocial services üHealth education 9

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

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

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

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

Financing Adult Day Care Reimbursement Sources: üPublic funds (Medicaid, PACE) üManaged care üPrivate insurance üSelf-pay and other sources 14

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

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

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

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

Significant Trends üContinued increase in demand üAttractiveness to MCOs üMovement toward the health model üExpanded services 19

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 20