Respite Care and Adult Day Care for Elders

Respite care and adult day care provides opportunities for both seniors and caregivers to take a break.

Respite care and adult day care are important to the millions of Americans that provide unpaid in-home care for elderly relatives, friends, or neighbors. Respite caregivers and adult day care programs monitor and provide companionship to elders and seniors for a short period of time so that their regular caregivers can take a break or deal with other responsibilities.

This article discusses the different types of respite and adult day care available, when they are a good option for your loved one, how to find and pay for these services, and how to choose a caregiver or program.

What is Respite Care?

Respite care is designed to give both caregivers and seniors a break from the usual routine. It allows caregivers to have some free time, take care of other responsibilities, and obtain (often much-needed) mental and physical breaks. It also allows seniors to talk and spend time with someone other than their usual caregiver.

Respite caregivers provide monitoring and companionship to seniors for short periods of time. In addition to watching over the elder, providers and programs might also prepare meals, provide personal care (for example, assisting with bathing, toileting, and exercising), and, in some instances, tend to the elder's medical needs -- by administering medication, for example.

Care can be provided on a scheduled basis, or just occasionally. Often, the people providing respite care are volunteers -- friends, other family members, members of the community, or church members. But you can also hire someone (either on your own or through an agency) to provide respite care. Respite care can take place in the home, in a church or community center, or in a nursing facility.

What is Adult Day Care?

Adult day care centers are formal programs that take care of elders during the day. They provide companionship, social activities, meals, personal care services, exercise, various forms of recreation, and social services -- including referrals to other agencies and services. Although adult day care centers may be located in a church or community center as some respite care programs are, they differ from respite care in that the programs are more structured and provide more services.

If a day care center is affiliated with a hospital or nursing facility, it might also provide medical services -- administering medication or providing physical therapy, for example. However, most day care centers provide minimal or no medical services. Some day care centers allow drop-ins. Others require that participants pay for scheduled attendance.

When is Respite Care or Adult Day Care a Good Option for Your Loved One?

Respite care is a good option when your loved one requires some assistance with daily tasks but does not need the full services of a nursing home or other long-term care facility. It can help older adults who struggle with chronic health issues or who have a sudden injury or illness. It can also help caregivers who need to take a break or travel. Respite care and adult day care can also serve as a trial run for an elderly person who will eventually move into a senior community or it can serve as the first step of a transition into permanent senior living.

Respite care provides many benefits to the elderly and their normal caregivers. For example it:

  • provides physical and mental breaks for the regular caregiver
  • prevents caregiver burnout
  • helps the elderly person stay in their home for longer
  • reinvigorates a regular caregiver
  • provides variety and stimulation to the elderly person
  • gives peace of mind knowing that a competent person is providing care, and
  • provides an opportunity for the elderly person to engage in activities that are designed to match their needs.

Paying for Respite Care and Adult Day Care

The cost of respite and adult day care varies greatly, depending on the individual or facility offering the services and the skill level of the caregivers. Often, in-home respite services are free or low-cost. At the other end of the spectrum, adult day care centers that provide medical care will cost quite a bit more.

Caring.com estimates that respite care providers usually charge between $15 to $40 per hour for intermittent care and $120 to $200 per day for in-home care. Respite care provided by a facility costs an average of $100 to $250 per day, depending on the level of care needed. Caring.com estimates that adult day care centers charge between $25 to $150 a day. While these costs may seem high, they are much less than the average monthly cost of a semi-private room in a nursing home, which cost an average of $7,513 per month in 2019, according to Genworth's Cost of Care survey.

For help paying for respite care, consider the following:

  • Long-term care insurance. Some long-term care insurance policies will cover part of respite care expenses.
  • Supplemental Security Income (SSI). SSI is a federal program that provides benefits to disabled and elderly people whose income and assets are very low. SSI may cover costs for home health care administered as part of respite care. To learn more about SSI, see Nolo's article Social Security Disability Benefits.
  • Medicaid. Some state Medicaid programs may pay for services provided by adult day care centers for Medicaid recipients who meet the requirements to enter a long-term care facility or who are at risk of institutionalization.
  • Government programs. Federal and state programs may help pay for respite care. To find out what services and funds are available in your area, contact your local Area Agency on Aging (AAA). (See the "Finding Respite and Adult Day Care Programs" section below to learn how to locate your local AAA.)

Also, some facilities may offer sliding-scale fees that make services more affordable.

Choosing a Respite Caregiver or Adult Day Care Center

Start the process by thinking about what types of services you want, the ideal schedule, whether you want regular or occasional care, whether the elder would benefit from group interaction or just one companion, and whether the caregiver will need to provide any medical services.

Finding Respite and Adult Day Care Programs

One of the best ways to find good respite care or adult day care is by word of mouth. Ask your friends, family members, and acquaintances if they have any recommendations or warnings about certain programs.

Here are some other ways to get information about programs and caregivers in your area:

  • Contact your local Area Agency on Aging (AAA) for referrals and information about respite and day care. You can find your local AAA through the U.S. Department of Health and Human Services (HHS) website at ElderCare. You can search by city, county, or zip code.
  • The National Adult Day Services Association (at www.nasda.org) provides referrals to adult day care centers.
  • ARCH National Respite Network and Resource Center has a respite locator that provides links to respite providers in your area. Visit their website at www.archrespite.org/respitelocator.

Choosing a Quality Provider or Program

A referral to respite or adult day care is not necessarily a guarantee of the program's quality. Once you obtain several referrals, do some homework to find out if the care is good and will meet the elder's needs (and yours).

If you are hiring an individual in-home caregiver, do the following:

  • Interview each candidate in person.
  • Specify the following: all duties, schedule of care, compensation, and payment schedule.
  • Ask about the candidate's background, training, work experience, special skills, and experience with medical conditions that might be relevant to the elder's care.
  • Present the caregiver with situations that they may encounter with the elder and ask how they would handle them.
  • Find out if the candidate has insurance.
  • Ask if the caregiver has someone else that can fill in if the caregiver is unable to make a session.
  • Request references and then check them carefully. Ask about the caregiver's competence, honesty, ability to handle the job, punctuality, and anything else that is important to you.
  • Consider hiring a professional service to conduct a background check. You may be able to get referrals from your local police department or from the Internet.

If you are considering an out-of-home respite or adult day care program, here are some questions to ask the program director:

  • What is the ratio of caregivers to elders?
  • Can we meet and interview the caregivers in the program?
  • Do you keep a file on the elder's medical conditions and other needs? Is there a written care plan?
  • What training and experience do the caregivers have? Have you run background checks on the caregivers? Have you spoken with caregivers' references?
  • What training do you provide to the caregivers?
  • How do you supervise and evaluate the caregivers?
  • What is your method for evaluating the program?
  • Do you ask family members for feedback? Can I see that feedback?
  • Can I speak with the families of elders that have attended or are currently attending this program?

To understand all the alternatives to nursing facilities -- including a comprehensive discussion of how to get and pay for home care -- get Long-Term Care: How to Plan & Pay for It, by Joseph Matthews (Nolo).

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