Medicaid
3
min read

What is Adult Day Health Care?

Adult Day Health offers daytime care under Medicaid for adults with certain health conditions, giving caregivers a much-needed break.
Published on
July 18, 2024
Presented by Givers
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As your loved one's needs evolve, you will need additional support for their well-being and quality of life. Fortunately, Adult Day Health Care (ADHC) programs offer a valuable solution. These programs provide structured daytime care for aging adults in a safe environment, offering a much-needed break for family caregivers.

What is Adult Day Health Care?

Adult Day Health Care (ADHC) is a structured program providing comprehensive health, social, and therapeutic services for adults, particularly those with chronic health conditions or disabilities. During daytime hours, ADHC supports individuals who need supervised care and often live at home with family caregivers. This service aims to improve the quality of life for participants while offering respite to caregivers.

The components of Adult Day Health Care include:

  1. Health services:
    • Skilled nursing care
    • Medication management
    • Physical, occupational, and speech therapy
    • Chronic disease management
  2. Social services:
    • Social activities and recreational programs
    • Counseling and support groups
    • Meals and nutritional counseling
  3. Therapeutic activities:
    • Art and music therapy
    • Exercise programs
    • Cognitive stimulation activities
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Benefits of Adult Day Health Care

ADHC offers a person-centered care model, a welcome alternative to nursing homes. These adult daycare programs provide many health care services beyond basic care, addressing social, physical, and emotional well-being.

For participants:

  • Enhanced physical and mental health through regular medical oversight and social interaction.
  • Maintenance or improvement of daily living skills through structured activities and therapies.
  • Prevention of social isolation and depression.

For caregivers:

  • Respite from caregiving duties, allowing time for personal needs, work, or rest.
  • Peace of mind knowing their loved one is in a safe and supportive environment.
  • Access to additional support and resources.

Adult Day Health Care and Medicaid Waivers

Medicaid waivers are state-specific programs that allow for the provision of home and community-based services (HCBS) to individuals who might otherwise require institutional care. ADHC is often included as an eligible service under these waivers, enabling participants to receive necessary care while living in their communities.

Eligibility and enrollment

Eligibility for ADHC under Medicaid waivers varies by state but generally includes criteria such as:

  • Age (typically 18 or older)
  • Chronic health conditions or disabilities
  • Functional limitations requiring a certain level of care
  • Financial eligibility for Medicaid

To enroll, individuals or their caregivers usually need to:

  1. Apply for Medicaid benefits through their state's Medicaid agency.
  2. Obtain a needs assessment to determine the level of care required.
  3. Select a participating ADHC provider.
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Choosing the ideal model of care

How can you find the right model of care for your loved one?

  • Needs assessment: Does your loved one require assistance with Activities of Daily Living (ADLs) like bathing or dressing? Do they manage chronic health conditions? Is social isolation a concern? Do they need occupational or physical therapy? Talk with their doctor.
  • Program exploration: Use the National Eldercare Locator or your state Department of Aging website to identify local Adult Day Services programs.
  • Ask questions: Ask about Adult Day Health Care staff qualifications, particularly experience with specific medical conditions. Ask about recreational activities to combat isolation.
  • Explore support services: Find out if Adult Day Services can assist family caregivers with transportation or social services referrals.

Resources for family caregivers

The next step is finding the right program. Here are some resources to get you started:

  • Contact your State Department of Aging: They can provide information on local ADHC programs, eligibility requirements, and potential financial assistance options.
  • National Eldercare Locator: This online tool can help you find ADHC programs in your area.
  • Area Agencies on Aging (AAA): These local organizations can connect you with ADHC programs and resources in your community.
  • Non-profit Organizations: National organizations like AARP or Eldercare Locator can offer resources and guidance on finding affordable ADHC programs.

Work with your AAA, a social worker, or legal aid for extra help completing the application process. Many programs have a long waiting list. Don't be surprised if your loved one has to wait several months for an answer.

And if they are rejected? What can you do? At that point, most social workers recommend hiring an attorney to help complete paperwork so your loved one can get help. It may be a long process, but the extra help will be worth it.

ADHC programs can be a valuable option for families considering affordable senior care by offering a stimulating social environment and essential healthcare services.

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