The number of individuals with disabilities and family caregivers using Adult Day Service centers to address their care needs has nearly doubled in the last eight years—and 35 percent more ADS centers exist today, according to a recent study by the MetLife Mature Market Institute.
The study, produced in collaboration with the National Adult Day Services Association (NADSA) and The Ohio State University College of Social Work, reports ADS centers serve over a quarter of a million people—an increase of more than 100,000 since 2002. As reported in The MetLife Study of Adult Day Services: Providing Support to Individuals and Their Family Caregivers, there are more than 4,600 ADS centers nationwide, a 35 percent increase in eight years. Approximately, 29 percent of the centers have waiting lists, more than half of the participants are women (58 percent), and 30 percent are under age 65.
In the United States, ADS centers provide a wide variety of long-term care services including care planning, assistance with activities of daily living (ADL), chronic health condition treatment and management, nursing, physical therapy, occupational therapy, and meals.
The study, accompanied by a consumer guide, “The Essentials: Adult Day Services,” also found that centers have significantly increased the amount of medical and social services they provide; 80 percent now have a professional nursing staff, 50 percent have a social work professional, and 60 percent offer case management services. The ratio of direct care worker-to-participant is now 1:6, compared to 1:8 in 2002. Half provide physical, occupational, or speech therapy.
With nearly half of all ADS center participants having some level of dementia, approximately 90 percent of the centers offer cognitive stimulation programs, 80 percent have memory training, and 75 percent offer educational programs. Most facilities provide caregiver support as well, including education, respite, support groups, and individual counseling.
“We’re seeing that more and more ADS centers are becoming a staple in communities in recent years,” said Sandra Timmermann, Ed.D., director of the MetLife Mature Market Institute. “Older Americans, people with disabilities and family caregivers rely on them for the services they provide. ADS centers make it possible for people to continue to live in their homes and receive affordable care in a supportive, professionally staffed, community-based setting. They also benefit family caregivers by enabling them to remain in the workforce or receive needed respite and support services.”
There has also been an increase in disease-specific programs to address a higher level of chronic conditions such as hypertension, physical disability, cardiovascular disease, diabetes, mental illness, and developmental disability. With a heightened focus on prevention and health maintenance, nearly 80 percent of ADS centers offer physical activity programs to address cardiovascular disease and diabetes.
“In addition to providing needed long-term care services, ADS centers serve as an emerging provider of transitional care from the hospital to home, providing short-term rehabilitation following discharge from the hospital,” said Dr. Holly Dabelko-Schoeny of The Ohio State University College of Social Work, “Centers are also offering disease-specific programs to address chronic conditions and meet the needs of participants who have higher levels of chronic conditions and increasing physical disability.”
According to Timmermann, the passage of the Patient Protection and Affordable Care Act health care reform bill and an increasing focus on managing chronic illness within the Medicare program speak to the importance of care models such as ADS to meet the needs of a growing population of older Americans.
A snapshot of the typical ADS center in the U.S.:
- Operates Monday through Friday from 6:30 a.m. to 6 p.m. in a 1,000–5,000 square foot facility; centers are administered by a professional in the business/health care administration, nursing, or social work field. Professional services are provided by a Registered Nurse (RN) or Licensed Practical Nurse (LPN) and recreational and therapy professionals. The typical direct care worker to program participant ratio is 1:6.
- Fees average $61.71 per day and typically come from a public source, including Medicaid waiver, the Veterans Administration, state/local social services, or directly from a private-pay participant. Since the average daily cost of care is $68.89 per person, centers supplement revenue with grants and donations.
- Though participants are diverse in age, ethnicity and ability, the average participant is a 65-plus-year-old white female with dementia, hypertension, or a physical disability requiring assistance with at least one ADL and medication management. She lives with an adult child or spouse, or lives alone, but primarily receives care from an adult child.
- The average length of enrollment in a program is 24 months.
- The majority of the ADS centers (86 percent) reported they were state-certified or licensed, a 10 percent increase from 2002.
- The study reports an increase in the number of for-profit ADS centers, 27 percent today compared with 22 percent in 2002.
For more information, contact Frankie Jones-Harris, Communications Director, The Ohio State University College of Social Work, at 614/292-3540 or firstname.lastname@example.org.
Methodology and Background
The MetLife National Study of Adult Day Services, a collaborative partnership of the MetLife Mature Market Institute in conjunction with the National Adult Day Services Association (NADSA) and The Ohio State University College of Social Work, was conducted in 2010. Data was collected and analyzed from a representative sample of 557 Adult Day Services centers, focusing on the characteristics of adult day services, a profile of participants and the range of services offered. When possible the 2010 findings were compared with the findings from the first national study of adult day services conducted in 2002 by the Partners in Caregiving program and the Wake Forest University School of Medicine.
The MetLife National Study of Adult Day Servicesand the accompanying consumer guide, The Essentials: Adult Day Services, can be downloaded from www.MatureMarketInstitute.com. They can also be ordered by e-mailing MatureMarketInstitute@metlife.com or by writing to: MetLife Mature Market Institute, 57 Greens Farms Road, Westport, CT 06880.
National Adult Day Services Association
The National Adult Day Services Association (NADSA) is a membership organization developed for the purpose of advancing the success of its members through advocacy, education, technical assistance, research, and communication services. It serves as the leading voice for the diverse Adult Day Services community. www.nadsa.org
The Ohio State University College of Social Work
The Ohio State University is one of the largest and most comprehensive institutions of higher education and consistently ranks in the top 20 public universities in the U.S. First accredited in 1919, The Ohio State University College of Social Work is the oldest continuously accredited public social work program in the country. Dr. Holly Dabelko-Schoeny and Dr. Keith A. Anderson served as co-principal investigators for the study. Dr. Dabelko-Schoeny’s practice and research interests focus on improving the delivery of community-based services for older adults and their caregivers through collaboration with community agencies. Dr. Anderson’s practice and research centers on well-being and quality of life for older adults and their caregivers across the long-term care spectrum. csw.osu.edu
The MetLife Mature Market Institute®
Established in 1997, the Mature Market Institute (MMI) is MetLife’s research organization and a recognized thought leader on the multi-dimensional and multi-generational issues of aging and longevity. MMI’s groundbreaking research, gerontology expertise, national partnerships, and educational materials work to expand the knowledge and choices for those in, approaching, or caring for those in the mature market.
MMI supports MetLife’s long-standing commitment to identifying emerging issues and innovative solutions for the challenges of life. MetLife, Inc. (NYSE: MET), through its subsidiaries and affiliates, is a leading provider of insurance, employee benefits and financial services with operations throughout the United States and the Latin American, Europe and Asia Pacific regions. www.MatureMarketInstitute.com
For more information, contact Frankie Jones-Harris, Communications Director, The Ohio State University College of Social Work, at 614/292-3540 or email@example.com. To read the November 1 story in The Columbus Dispatch, click here.