Issues Affecting Adult Day Care
- Because the seniors who utilize adult day care usually have physical or cognitive impairments that make driving impossible, their caregivers must supply transportation to and from the centers. A study conducted by The Gerontology Institute at the University of Massachusetts Boston found that nearly 7 million Americans live an hour or more away from the older adult they care for. This distance prevents many caretakers from being able to transport seniors to day care centers on a regular basis. To solve this transportation problem, handicapped-accessible vans, along with van assistants who ensure safe transportation to the centers, must be provided for day care attendees.
- The services that adult day cares provide include personal care, exercise, assistance with toileting, serving meals and health monitoring. These services are labor-intensive and expensive. Paula Span, a columnist for The New York Times, reports that the average cost of attendance in 2010 was $67 a day. While Medicaid will sometimes pay for health care that is provided in state-licensed day cares, Medicare does not. As a result, caregivers and state and local communities must find ways to pay for the care.
- According to the National Adult Day Services Association (NADSA), there are currently more than 4,600 adult day care centers nationwide. While all centers are required to follow specific building codes, fire codes and zoning laws, regulations relating to adult day care differ from state to state. Because no central agency is responsible for overseeing the industry, there are few national standards and no way to fully regulate the industry. A patchwork system of accreditation, certification and licensing makes it even more difficult to monitor all centers adequately, and elder abuse, negligence, and unsafe conditions can result.
- Although studies have shown that direct care workers, including day care workers, chose their occupations because of a desire to help people, positions are low paid with few benefits. The AARP Public Policy Institute reports that the low financial compensation, combined with inadequate training, lack of control over their jobs and few opportunities for advancement, all contribute to high turnover. When an adult day care can't retain its staff, the quality of care suffers. Workers with less experience leads to more accidents, and there are higher levels of under-staffing and reduced access to services.
