Florida: ADRD for Spec Adult Day Care Level Two 2021Page 3 of 19

1. Adult Day Care

Adult day care centers were created to prevent isolation, depression, and undue cognitive and physical decline among community dwelling older adults. They help older adults to live at home or in the community as long as possible, by providing a supportive, professionally staffed environment which attends to nutritional, daily living, and social needs of adults with functional limitations within a group setting during the day (Ellen et al., 2017).

There are approximately 4,600 adult day service centers in the United States serving nearly 286,000 people (Caffrey and Lenden, 2019). In Florida, there are approximately 351 adult day care centers that provide therapeutic programs, social services, health services, and activities for adults in a non-institutional setting (AHCA, 2020). About one-third of regular adult day care clients have Alzheimer’s disease or a related disorder (Harris-Kojetin et al., 2016).

In Florida, there are approximately 15-20 specialized adult day care centers, which are specifically designated to treat clients with Alzheimer’s disease and other types of dementia. The specialized centers enroll a higher percentage of clients with dementia than do regular adult day centers and require specialized dementia training for their staff. A specialty license is also required to provide services as a Specialized Alzheimer's Services Adult Day Care Center (O’Keefe, 2014).

Adult day service centers provide non-residential coordinated services in a community setting for less than a day. There are three types:

  1. social,
  2. medical/health, and
  3. specialized (providing programs for people with dementia) (Siegler et al., 2015)

Did You Know. . .

Adult day care is a program of therapeutic social and health services as well as activities for adults who have functional impairments. Services are provided in a protective, non-institutional environment. Participants may utilize a variety of services offered during any part of a day, but for less than a 24-hour period.

The social model is designed for individuals who need supervision and activities but not extensive personal care and medical monitoring. The medical model provides more extensive personal care, medical monitoring, and rehabilitative services in addition to structured and stimulating activities (O’Keefe et al., 2014).

In general, adult day care clients are younger and more racially and ethnically diverse than users of other long-term care services. More than one-third of adult day care clients are non-white, about 17% are non-Hispanic black, and about 20% are Hispanic (Harris-Kojetin et al., 2016).

Most (about 2/3) of adult day care participants attend at least 3 days/week (Siegler et al., 2015) and most clients use transport services provided by the centers.

This course is for those of you who provide direct care to clients in a specialized adult day care center. It discusses Alzheimer’s disease and other common types of dementia from the perspective of both workers and clients and includes information on how Alzheimer’s and other types of dementia affect the brain. It describes tests that can be used for cognitive screening and the limitations of those tests.

It discusses the areas of the brain associated with speech and language comprehension and describes how brain deterioration affects behaviors you may see in people with dementia. The concept of person-centered care, creating a dementia-friendly physical environment, and common medications and their side effects are discussed. Assessing pain and identifying malnutrition and dehydration are described, along with strategies for addressing these important issues.

The course includes a discussion of the importance of meaningful activities and provides information on validation therapy, new technologies, and safety issues. We conclude with information about family issues and caregiver stress.