Adult day care

Adult day care is a daytime program where older adults or adults with disabilities spend time in a safe group setting with trained staff. Programs may offer activities, exercise, meals, help with personal care, and some basic health services. The person goes home at the end of the day, and family caregivers get a regular break.

Some programs focus mostly on social activities and supervision, while others also have nurses, therapists or social workers on staff. The names are not used consistently, so ask each program exactly what health services it provides and who provides them. Utah’s Medicaid Aging Waiver, for example, calls its service adult day health.

It often suits someone who shouldn’t be home alone all day, needs some help with daily tasks, or has become isolated, and who lives with a family member who works or needs time off. It can also help people with memory loss stay active and on a routine. People who need constant one-on-one nursing may need a different kind of care.

Yes, many programs serve people with Alzheimer’s or other dementias. Utah requires more staff when at least half of a program’s clients have a diagnosed dementia: one staff member for every six clients. Ask how the program handles wandering, confusion and changes in mood.

Programs usually offer half-day or full-day attendance, often several days a week, and some help with transportation. Many families start with a few days and add more as needs change. Ask about hours, late pickup rules, and whether the program can adjust to your work schedule.

Yes. The Utah Office of Licensing licenses adult day care programs under state rule R501-13. An assisted living facility can run an adult day program under its own license instead, but it must have its adult day policies approved by the state and follow the assisted living rule’s adult day section.

Talk with your loved one’s doctor about their needs, then call your local Area Agency on Aging for programs in your county; Utah Care Network can also help at no cost. Visit a few programs before choosing. Expect an intake process where the program learns about your loved one’s health, routines and needs.

Utah’s adult day rule sets minimums based on group size. With 8 or fewer clients, one staff member must supervise at all times with a second qualified person immediately available; with 9 to 16, two staff must supervise; with larger groups, it is one staff member per 8 clients. When half or more of the clients have dementia, it is one per 6.

In Utah, direct-care staff must be at least 18, complete 8 hours of orientation for the program, and complete 10 hours of training every year. The director must have a relevant professional background, such as nursing or social work, or work with a licensed professional who does. Ask what dementia and first aid training the staff have.

Ask what a typical day looks like, how meals and special diets are handled, whether staff help with toileting and medications, and how they respond to a fall or medical emergency. Ask about transportation, costs, and what would make the program no longer a good fit. Watch how staff talk with participants.

Be concerned if participants are mostly sitting in front of a TV, staff seem stretched thin, bathrooms are not clean, or no activity schedule is posted. Vague answers about costs, staffing or emergency plans are also warning signs.

The Utah Office of Licensing has a public search for licensed programs that shows the past 36 months of compliance history. You can also call the office with questions. Ask the program to explain any findings you see.

Ask whether the program offers a trial day or short visits to start. It can take a while for someone to feel comfortable in a new place, so give it a few visits before deciding whether it works.

Programs usually charge by the hour or by the day, and costs vary by program and the level of care needed. Adult day care is often less expensive than in-home care or a nursing home. Ask what the daily rate includes, such as meals, transportation or personal care.

No. Medicare does not pay for adult day care, and Medigap and most private health insurance don’t either. Medicaid and some other public programs may help.

Two Utah Medicaid waivers include adult day services. The Aging Waiver serves people 65 and older who need nursing-home level care and meet Medicaid’s financial rules; it has limited spots and a waiting list. The New Choices Waiver also covers adult day services for adults who qualify, mainly people moving out of nursing homes or other facilities.

Yes. VA Adult Day Health Care is available to enrolled veterans who meet clinical criteria, where a program is available. A copay may apply depending on disability status and finances. Ask your VA social worker, who can help you complete VA Form 10-10EC and find a program.

Some long-term care insurance policies pay part of the cost of adult day care. Check your policy or call the insurer to learn what it covers and what proof of need it requires.

Many Area Agencies on Aging run caregiver support programs that may help with respite and adult day care. For example, Mountainland’s program, which serves Utah, Summit and Wasatch counties, lists adult day care among its services, has no income requirement, and has spending limits. Call your local agency to ask what is available where you live.

Expect a written agreement that covers the program’s rules, services, costs, refunds, and what happens with absences. In Utah, programs run by assisted living facilities must have one signed by the participant, the responsible party, and the director. Read it carefully and ask about anything that is unclear.

Yes, programs can end services, but they should tell you why. Utah requires programs run by assisted living facilities to have a written admission and discharge policy that explains the reasons someone may be dismissed. Ask for the policy before you enroll and ask what happens if care needs or behaviors change.

Ask how the program reports falls, injuries and other incidents to families. In Utah, programs run by assisted living facilities must write reports for injuries, deaths, a participant leaving unsupervised, fights, suspected abuse and other serious events, and the responsible party reviews injury reports.

Signs include needing help through the night, frequent falls, or care needs the program can’t safely meet. Next steps may include in-home care, assisted living, or memory care. The program staff and your loved one’s doctor can help you judge when it’s time.

Some assisted living facilities in Utah offer short respite stays, which Utah’s assisted living rule allows. This can give a caregiver a few nights off. Ask local facilities whether they take respite guests and how far ahead to book.

Start by talking with the program director. If that doesn’t resolve it, file a concern with the Utah Office of Licensing, which investigates possible rule violations in licensed programs. If you suspect abuse, neglect or exploitation, call Adult Protective Services.

No. Utah Care Network is free. No one pays us, not families and not providers.