Adult day care is a community-based program designed to meet the needs of impaired adults through an individual plan of care. Adult day care is a structured comprehensive program that provides a variety of health, social, and related support services in a protective setting during any part of a day. Adult day care addresses the needs of family caregivers by providing a break from care giving while providing a stimulating group environment for the adult day care participant. The center’s staff provides care for the individual who cannot be left alone during the day, but does not require twenty-four hour institutional nursing care. Services may allow family members to return to work, to shop, or to have free time to themselves for various reasons.
Employed caregivers pass up opportunities for advancement, change jobs to be more available, and often feel tired on the job. Fifty percent made significant changes in job spurred by caregiving demands. Nearly forty-four percent of the caregivers depend on day care. Analysts forecasted that in 2000 there were nine million elders requiring long term care and that this number is projected to increase to twelve million by the year 2020. Elders overwhelmingly wish to remain in their homes or in the community regarding residential care as a last resort. For each person that turns twenty-one two people turn sixty-five. Ten percent of our nation’s senior citizens have children who are also senior citizens. Thirty seven million Americans are sixty-five or older by 2050 that number will be 86.7 million. The average age of a caregiver is forty-nine. The average duration of care giving is 4.5 years.
Day units for adults appear to have developed after the Second World War, although a few existed beforehand, mostly as occupation centers for the mentally handicapped and shelter workshops for the disabled. According to estimates the largest group catered for by the services is the elderly. Creation of day units for seniors in poor physical and mental health is one social alternative for diminished family care for its aging members. Social expectations of filial obligations to aging parents have altered. Until the opening years of this century provisions for old age was regarded as primarily a matter for the individual and his relatives. The Phillips Committee reported in 1954 on the economic and financial problems of old age. The Phillips Committee felt children should not sacrifice themselves to care for aging relatives, the committee endorsed that community services should help older people stay in their own homes. Rehabilitative services promised improvements in health and happiness.
There has been a sharp increase in the number of women employed in the workforce, particularly married women. Also the size of the average family has shrunk considerably. In the middle of the nineteenth century the average family had seven children in the mid twentieth century the number decreased to two leaving fewer children to cope with aging parents. At the same time the number of parents reaching old age increased considerably from fourteen percent in 1851 to forty-one percent in 1951. The pool of potential caretakers has reduced while the number of aging parents has increased. Five out of ten of the elderly confused come to the unit either for two or three days each week. Although three out of ten came for four or five days each week, these places tended to be as often taken by users who lived alone as users who lived with relatives. Since most users are confined to two or three day’s attendance what the day unit provides for the relative is a break rather than the possibility of leading an individual life.
Adult day care centers have been providing a form of respite for caregivers for more than twenty years. In 1978 there were only three hundred centers nationwide. By the 1980s there were twenty-one hundred centers and today there are about four thousand six hundred centers nationwide. The growth is due in part to new funding sources such as Medicaid waiver programs, which support alternatives to institutional long-term care and rehabilitation. Title Three Amendments to Title Three of the Older Americans Act of 1965 authorizes appropriations indefinitely for making grants relating to supportive services, senior centers, congregate nutrition services, home-delivered nutrition service, in-home services, and special needs. The Older Americans Act of 1965 also establishes grant programs for support services for family caregivers, education and training related to programs for older individuals, and pension counseling projects.
