A Step-by-Step Guide to Adult Daycare for Someone With Alzheimer's

Seven Key Steps to a Valuable Service

Adult daycare offers valuable respite to caregivers of patients who have Alzheimer's or other dementia, while also providing the patient with important cognitive and social stimulation that may slow the disease's progress. Here's how to line up care.


Step 1: Find out if the person is eligible for adult daycare services.

Adult daycare services are typically available to people with Alzheimer's who are living in their own homes (or with a caregiver) and who:

  • Are in the early- to mid-stage of the disease
  • Don't require constant one-on-one assistance
  • Have some mobility (most programs allow a self-propelled wheelchair)
  • Are continent (sometimes just bowel, sometimes bowel and bladder)
  • Are not physically or verbally abusive
  • Do not wander excessively

Depending on the program, you may need:

  • Documentation of a doctor's diagnosis of dementia or Alzheimer's
  • Proof the person lives within the community (for state-sponsored programs)
  • An intake examination by the staff to determine eligibility according to its own requirements

Step 2: Look into what daycare services are available

Canvass local resources to determine programs in your area. Make a list of the possibilities so you can systematically check them out. You'll probably want to look at several, because no two programs are identical.

Shortcuts to finding programs:

  • The Yellow Pages (try "adult daycare" and "senior care," but the listings may be imprecise)
  • An eldercare consultant
  • Friends, colleagues, and neighbors

Step 3: Gather information about the program

Call first to obtain brochures and ask questions (or visit websites; not all programs have them) and learn basic information. What to evaluate:

  • Eligibility: Does the person you're caring for meet the program's requirements for age and functional status? (Not all programs accept people with Alzheimer's, or people in the later stages of the disease. On the other hand, some programs handle only Alzheimer's patients.) Is a physician's certification of health status required, or does the center require an exam? At what point in the disease would he become ineligible?
  • Location: Where is the program located? How far is it from you? Is it convenient to your work or home?
  • Transportation: Is transportation available? What kind? Is there an extra charge for it?
  • Hours: When is the program open? Do these hours mesh with your schedule? Is it open early mornings, evenings, or weekends, if you need that? Determine which hours you most need care-giving relief.
  • Cost: What is the cost per day (or other fee structure)? Are fees payable weekly, monthly, or on a different schedule? Are there discounts for frequent attendance? Are transportation and meals included in the cost, or are they extra?
  • Reimbursements: What types are accepted -- Medicaid , others? What's the filing procedure?
  • Activities: What is a typical day like? What sorts of activities are offered? Are there activities specifically designed for people with Alzheimer's and, if so, what are some examples?
  • Other services: Is there physical therapy or other medical support? Counseling support? Caregiver support and training? You may or may not need additional services, but they're good to know about (and you may want them later). What's the program's protocol for reacting to medical emergencies?
  • Food: Is lunch provided, and what are typical offerings? Are snacks provided or must they be brought from home?
  • Staff: What's the staff-to-client ratio? (There's no industry stand ard, but six clients per staffer is considered good.) What are their credentials? Who's the director and what is her background? What's the proportion of paraprofessionals to trained staffers, such as a geriatric nurse, an occupational therapist, a recreational therapist, a social worker? (Not all are necessary, but the better trained the staff, the more likely that is to reflect on the quality of services offered.)
  • Background: How long has the program been operating? Who owns or sponsors it? Is it licensed by the state? (Not all states require this.)

Step 4: Narrow your choices and visit the sites

To make the decision process less overwhelming, winnow your list down to a handful of candidates and make appointments to visit them in person. (These initial visits should be made by you alone, without the person in your care.)

NADSA recommends asking yourself these questions:

  • Did you feel welcomed?
  • Did someone spend time finding out what you want and need?
  • Did someone clearly explain what services and activities the center provides?
  • Did someone present information about staffing, program procedures, costs, and what is expected of caregivers?
  • Was the facility clean, pleasant, and free of odor?
  • Were the building and rooms wheelchair accessible?
  • Was the furniture sturdy and comfortable? Were there loungers for relaxation? Chairs with arms? Was there a quiet place for conferences?
  • Was there a place to isolate sick persons?
  • Did the staff and participants seem cheerful?
  • Were volunteers helping?
  • Were participants involved in planning activities or making other suggestions?

Additionally, you may want to look for:

  • A garden or outdoor area
  • Clean, accessible bathrooms
  • Security measures to prevent clients from wandering away
  • The quality and atmosphere of the activities (watch some)
  • A menu or sense of the food offered

Steps 5 and 6: Check references and involve the person

Step 5: Ask for references.

By now you probably will have zeroed in on one or two programs that seem right for you. Ask for the names of caregivers who've had relatives in the program. Contact them and find out what did they like and dislike?

Step 6: Inform the person in your care.

Once you've selected a program, it's time to get the patient on board. (There's no real need to do so sooner.) Have realistic expectations; he may not be as open to the idea as you are. He may feel anxious, insecure, or uncomfortable about meeting new people, being in a new place, or being separated from his primary caregiver(s). He may be put off by the term "daycare," thinking he'll be treated like a child.

To ease the way:

  • Explain why the program is a good idea: "It will give us a little break from each other and let you be with other people. There will also be a lot of activities there that can keep you busy. Doctors think these kinds of programs can possibly slow down the Alzheimer's."
  • Try pitching the center as a club -- this may help remove some of the stigma of the "daycare" association while emphasizing the camaraderie and opportunities that the center makes possible. Or, for a patient who's focused on therapies for slowing the disease, it might be easiest to think of adult daycare for its therapeutic value.
  • Enlist a third party, such as a doctor or a geriatric care manager, to discuss the benefits if you sense or expect resistance. This approach can also help lessen feelings of guilt or stress associate d with leaving him at a center. (These feelings are common, and a neutral party also can help you see the value of taking advantage of available services.)

Adult Daycare Trial Run

Enroll the person in your care for a few sessions and see how it goes. Start small, with just a few hours per day or week, rather than diving into full-time daycare. It's common for new participants to express some stress or hesitation about a center -- but it's also common for them to overcome this pretty quickly.

If the transition proves difficult and he protests or expresses his dislike of his first visits, talk about his concerns. You and/or the director may be able to overcome specific objections. If he has problems with the daycare center that don't resolve after several weeks, you'll probably want to look into a different program for a better fit, or for an in-home care or companion service.

Paula Spencer Scott

Paula Spencer Scott is the author of Surviving Alzheimer's: Practical Tips and Soul-Saving Wisdom for Caregivers and much of the Alzheimer's and caregiving content on Caring. See full bio

over 1 year ago, said...

do you recommend a program that has patients with several medical diagnosis? not all Alzheimer. ...jerry

almost 3 years ago, said...

We are maybe trying out a adult day care my mother in law sits all day long watching tv. When I take her places she can on walk a few steps because she has arthritis in her back. We do use her push wheel chair. She can walk beside my husband long enough to get her hair cut. If he gets out of site she crys , only because she thinks her son is her husband. My father in law died 8 years ago. Since he passed she kind of lost all of her being of herself. This may be a tough challenge for us . We still want her t o live as much as she can. She needs to be with people her own age and maybe meet some friends. She does have alhimers and she does wander. About 4:00 that's when it starts . Not saying this will be full time . One day at a time. No rush , no hurry.

over 3 years ago, said...

Hello, Just a reminder, Caring.com has Family Advisors willing to assist you in your search for housing options for your loved ones. They will be able to tell you what amedities they have, such as an on site day care and help arrange a tour. To reach our Family Advisors, 7 days a week, call (800) 325-8591.

over 3 years ago, said...

I am looking for a caring facility where my Uncle will have adult day care. He has Alzheimer's but he is a sweet and kind person who is very sociable.

over 3 years ago, said...

The article confirmed that I was on the right path. 99% of suggestions have bee covered by the director and/or staff member. The staff seems eager to meet him.

about 4 years ago, said...

I would really like to get my mom involved in something but she dont like to be without me,Does anyone have any suggestions for me? It is getting to much for me to do everything! I feel like it is effecting my health and I have a new grandson that I am missing out on because of this terrible disease!

almost 5 years ago, said...

Good article. We are never prepared for the changes in our lives when we have to take care of a parent. Adult Day Care Centers are a blessing. We need more in all communities so that we are able to keep our parents home longer and allow them to live in dignity. Also the centers allows us, the caregiver time to take care of ourselves.

over 5 years ago, said...

Very good comments and question. My question in a situation I have as spouse, is: where do I look for and obtain the aid required to hire and pay for inhome care for completely disabled person, incontinent, etc.? However I am so lucky she can speak clearly, and feed herself (an already prepared meal), it takes a lot out of caregivers due to her inability to process and stop the not-so-great comments that come directly out of her mouth without edit!

over 5 years ago, said...

Good, common-sense guide with some important steps that can easily be overlooked by a stressed caregiver. Thank you for this helpful guide.

almost 6 years ago, said...

very helpful, I know I will refer to it again, and again in the future.

almost 6 years ago, said...

I had no idea where to start and no idea what to expect. Thank you so much

about 6 years ago, said...

Hi Deja, thank you for your comment. Unfortunately, we have no expertise or knowledge on how to start a care center, but I do wish you luck with this venture! Take care -- Emily | Community manager

about 6 years ago, said...

I want to start to care for healthy aging in my home. Were do I start?

about 6 years ago, said...

Wish there was more available in the rural areas where we live. Only thing listed is senior centers.

over 6 years ago, said...

Hi deescats, thanks for your comment. To answer your question: my guess is yes you would have to call, however I don't know why they wouldn't accept someone based on age unless it was some sort of payment issue. Either way, after a call or two I'm sure you'll get a better sense of what day care center will work best for you and your loved one. If you'd like to find Adult Day Care in your area, check our our local directory here: (http://www.caring.com/local/adult-day-care). I hope that helps! -- Emily

over 6 years ago, said...

Do I need to call individual Adult Day Care Centers to find out if they accept 56 yr. old dementia clients?

over 6 years ago, said...

Hi Circle Center, Thanks for the positive feedback and question! We share articles like this in our weekly e-newsletters, which you can sign up to receive here: http://www.caring.com/account/subscriptions Caring.com articles are also syndicated through a variety of leading online outlets, including The New York Times Company Regional Media Group, Yahoo! Health, MSN Health & Fitness, and EarthLink. If you have a blog or publication for which you'd like to include our contact, please get in touch via email to discuss further: http://www.caring.com/about/contact.html Thanks for asking!

over 6 years ago, said...

This article is perfect concerning day care. With the help of friends and family, I took those exact steps except for talking to my husband (the AD patient) because he has no more reasoning abilities. We tell him he's going to the club for lunch and to go on a trip (he can do day tripping). He loves the activity. I had to learn to take him in and turn around immediately and leave while someone came to take him into the room with the others. Otherwise he doesn't want to stay. He is very happy when I come back to get him and asks me how I knew he was there. I have found the Dr. and the Day Care director/employees extremely helpful. If anyone lives in the Denver area, I would be happy to recommend our day care facility.

over 6 years ago, said...

Great article. Do you have avenues for distribution? Best, Molly

over 6 years ago, said...

I am going to look into this tomorrow, beginning with the Area Agency on Aging, I have already talked with Tom, and after we talked about it for a while, he indicated that he would be willing to give it a try. He has been in physical, occupational, and speech therapy for the past month, 3hours, 3 days each week, and is now only having speech therapy, so I think we can arrange day care at this point. Thanks for the information.

over 6 years ago, said...

If you want to read first hand accounts on what happens at adult day care centers, read Debbie Stricoff's posts at http://blogs.vnsny.org/author/dstricoff/. She's the director of Adult Day Care Services at the Visiting Nurse Service of New York and has some great stories!

almost 7 years ago, said...

I have a brother who lives with me who is disabled. He is 63 and I am interested in getting him into an adult day care facility for 1 - 2 days a week. His disabilities include: hearing disability (hearing aids in both ears), had polio as a child so he walks with a limp and cannot do any distance walking. Cleft palate and mild paralysis of vocal cords . . . this means that he must eat slowly and he cannot eat any tough grades of meat like sirloin steak.