The future programs of adult day care seems to be in the hands of the 50 states in America. As I write applications for our clients to start adult day care, it has come to my attention that the states are regulating what clients are being taken for adult day care centers in order to maintain home based care instead of institutionalization.
One such example, is adult day care centers in Boston, MA. There are three levels of care and three levels of reimbursement for those levels of care. The lowest level of care includes clients who could be at a senior center and need some help with ADL's. The second level of care provides medication management reminders, help getting in and out of chairs, socialization, care plans and help with ADL's and IADL's. The third level would be a client who may have just come from the hospital with a stroke or other debilitating illness where they need more attention and physical care and rehabilitation.
When adult day care began in this country, one just needed help with ADL's and be on medicaid to be a client. It was easier on the center and the center's main goal was to socialize the client and watch for any signs of progressive illness.
Adult day care has come a long way and is a vital part of communities every where as a continuum of care for living at home as long as possible.