- Thousands of older Americans attend adult day services, which provide a safe and stimulating place for people with physical or cognitive disabilities and give caregivers a respite.
- Adult day services are available in many parts of the country, but in Central America and rural areas they struggle to staff and fill centers.
- With the rise in Alzheimer’s disease, adult day services are facing staffing and funding challenges.
Sally White helps her 46-year-old husband get dressed, fed and take the short bus ride from their home to the Third Age Adult Day Center four times a week.
For 74-year-old Roger White, who has been in declining health for more than a decade and suffers from severe memory loss, getting ready for a day out is a daunting task.
“It’s like having a small child,” said Sally White, 78. “This long separation is hell. It’s exhausting. When my son turns 3, I’ll be cleaning the house and running errands.”
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For thousands of older Americans like the White family, Third Age Adult Day Centers and similar adult day services provide a safe and stimulating place for people with physical and cognitive disabilities. , giving caregivers a break.
William Zagorsky, president of the National Adult Day Services Association, estimates there are about 8,000 adult day services centers across the United States for people with a variety of needs who want to remain in their homes. More than half of these centers serve homebound seniors who need supervision and social opportunities.
After raising four children and retiring from teaching, the Whites each began studying to become ministers. During his studies, in 2013, Roger White suffered a hemorrhage in the brain, and his years-old memory problems began to worsen. Sally White said his memory loss robbed her of the intelligent, bright, active man she knew and the life she had planned as they grew older together. Ta.
VNA Caring Center Director Angela Roper, left, sings old songs with client Marilyn Virgo, right, of Milton, Pennsylvania, at the center in Shamokin, Pennsylvania, on May 9, 2024. The facility is the only adult day-service program for seniors with cognitive disabilities in the Susquehanna Valley. (Robert Inglis/CNHI News via Associated Press)
White enrolled her husband in the Third Age Adult Day Center in January 2022 to keep him in a safe environment while she could handle household chores and take time off from her full-time caregiving job.
“What this facility has given us cannot be measured in price,” she says. “Roger has a rhythm and a community here. I pay the bills, keep the house clean, and keep him sane by making sure it’s a safe place for him.”
cost and location
Adult day care services are becoming more common across the U.S., particularly in Southern states such as California, New England and Tennessee, where such programs have increased by 20 percent in the past 13 months, Zagorski said.
Meanwhile, in Central America and rural areas, they are struggling to staff their centers and fill them with customers.
Nationwide, adult day programs cost less than $100 a day, cheaper than nursing homes, which is one reason Zagorski and groups like the National Council on Aging are calling for more support for them.
“Unfortunately, Medicare is not an option, and that creates a barrier to growth,” Zagorski said.
Medicaid covers about half of the revenue collected for these services nationwide, and the Department of Veterans Affairs has been increasing its support for Medicaid, but about 15% of users still have to pay out of pocket.
According to the Centers for Disease Control, only about 237,400 older Americans may participate in structured day programs, even though adults 65 and older make up 18% of the U.S. population. There is.
Sally White said she struggles to pay about $2,200 a month for her husband to participate in the program because the couple doesn’t qualify for Medicaid. As her husband’s health deteriorates, she is left alone to handle all the bills and the stress that comes with it.
Rural areas like central Pennsylvania also present transportation challenges when accessing senior day programs.
“It’s been my experience over my 36 years that adult day care is just not a concept that’s appropriate for the people in this community,” said Holly Kyle, director of the Regional Agency for Aging, which serves Snyder and Union counties in Pennsylvania.
Since 1987, 13 adult day centers have opened and closed in both counties, which Kyle blames on a lack of public transportation, costs and inflexible hours.
“Many families want services in their home, they want to care for their family members themselves, or they equate it with child care,” she says.
Georgia Goodman, Medicaid director for Leading Age, which represents more than 5,400 aging services, said stigma against aging may also be a contributing factor to the underutilization of adult day programs. Ta.
“Many (older adults) don’t seek services until they’re in crisis,” she said, adding that getting services earlier can provide more preventative care.
Marilyn Vargo, 79, of Milton, Pennsylvania, has been attending the VNA Caring Center in Shamokin since February. Vargo worked for many years as an administrative assistant to several presidents at Bucknell University, but about five years ago she fell and suffered a traumatic brain injury. She now has short-term memory loss and is unable to care for herself.
“It’s very difficult,” said her husband, Joe Virgo, 81.
“VNA has helped in many ways,” Vargo said, standing in the couple’s dining room, filled with family photos and Christmas decorations that have yet to be put away. “My daughter is more social and she loves riding the bus. She often asks what she did that day and she can’t answer.”
More than dancing and dominoes
VNA Caring Center is the only adult day services program serving cognitively impaired seniors in the Susquehanna Valley. The cost for full-day attendance weekdays from 8:30 a.m. to 3:30 p.m. is $44, including meals. Director Angela Roper said the center can accommodate 19 clients, but only five are registered.
Zagorski said another major barrier to expanding access to adult day services is a lack of public awareness and research about the benefits of services that can help reduce depression, loneliness and isolation. said.
There is a national effort to rebrand the programs as adult day services rather than day care, to distinguish them from child care and senior centers.
“We do more than dancing and dominoes,” Zagorski said. “We encourage fun and social activities, but we also offer cognitive-based activities, physical games and range-of-motion exercises.Food insecurity is a big problem for older people, and we provide nutritional support. We help reduce falls and reduce medication errors by having people at their fingertips. We are long-term care’s best-kept secret. We provide a comprehensive level of care to help you stay healthy and with your friends.”
At the VNA Caring Center, Roper begins her day by reading the newspaper aloud.
“We recently found out that students from Our Lady of Lourdes are putting on a production of ‘Finding Nemo,'” Roper said as two patrons sat watching the animated film in hopes of attending a school play.
Reading newspapers is “essential to keeping them interested. Reading newspapers opens up memories,” Roper says. The center is filled with tables where clients can work on puzzles, paintings, and arts and crafts. It can also be used as a daily exercise space.
Memory Lane Care Services in Toledo, Ohio, has a capacity of 50 people but only serves about 34 people a day. Sally Bolin, the center’s director, said attendance has declined since the facility reopened after being closed for nine months due to the coronavirus pandemic.
“It’s an underutilized service, with many families and professionals either not knowing it’s available or not wanting their family members to be here,” she says. “Most people hear about it by word of mouth, but it’s a difficult marketing strategy.”
Bolin has worked at the center since 1998 and has seen clients come several times a week for 16 years.
The Third Age Adult Day Program is the only center of its kind in the area. It is open weekdays from 7 a.m. to 2 p.m. and charges $20 per hour. Transportation is provided for clients within approximately a 20-mile radius for an additional fee.
The center has been in operation since the 1990s, but since the pandemic it has scaled back its offerings, including no daily meals, as well as activities that stimulate the mind and body and weekly visits from clergy. continues, Director Nicholas Draughn said. The capacity is 50 people, but due to difficulties in securing staff, only 15 can be accepted.
“We have a waiting list of 45 to 50 people,” Drown said. “We get calls every week.”
Staffing is a big challenge, “and salaries aren’t that great,” and the pandemic has dealt an additional blow, said Kathleen Camero, senior director of the Center for Healthy Aging at the National Council on Aging.
“The need for adult day services is expected to increase because of (rising) rates of Alzheimer’s and dementia, and I wonder if we can keep up with the demand unless we improve recruitment and pay,” she said.
This is a sentiment echoed by Mary Miklovic, executive director of OPICA, an adult day services program in West Los Angeles, California.
“There needs to be a greater awareness that more support is needed across the board. We have a tsunami of ageing,” Miklovic said. “People are living longer and people are being diagnosed with (dementia-related) diseases at a much younger age. The need for support is exploding, but the funding is not there.”
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Joe Virgo said he can’t live up to his desire to own the home where he and his wife have lived and raised their three children since 1974, and are considering moving them both into a nursing home soon. he said.
Before Marilyn suffered a brain injury in a fall, the Vargoses never discussed growing old together if their health declined.
“I think about it a lot,” he said. “Perhaps you should.”
