Choosing an Adult Day Care Service

Over 10 million Americans are part of the “sandwich generation” – busy, working adults trying to care for their aging parents while also raising their own children.

“It’s really hard for families to make these decisions [about their loved ones],” says Beth Meyer-Arnold, who served as director at Luther Manor, an adult day service in Wauwatosa, WI for 25 years, and was the former chair of the National Adult Day Services Association (NADSA). “For working adults, it’s really hard.”

Arnold mentioned how she recently met with a young woman who struggled with the paperwork process. “She was finding it to be really difficult. One gate opens then there’s a whole other world of paperwork.”

So what options are available to the millions of individuals juggling parenting, caregiving duties, and careers? One rising trend is adult day care services.

What is adult day care?

“The primary goal of adult day is to keep seniors in their communities where they live,” says Dr. Merle Griff, CEO at SarahCare Adult Day Care Senior Solutions in Canton, OH, and past chair of NADSA. Instead of focusing on a 24-hour model of services (think nursing home or assisted living), adult day care services are only offered during the day, usually are in a center setting.

WHN TIP – Daycare Services for Younger Adults: Adult day care services are also available for younger adults who are in need of some type of assistance or social activities. Contact your state’s Health Department or Social Services Department to find a local center that finds your needs.

For adults day care, seniors are usually picked up in the morning, usually between 6-8 a.m., then they go home in the evening, between 5-7 p.m., says Griff. While at day care, seniors talk other, join group social activities, and receive assistance with daily tasks and general medical needs.

“Our health care system puts seniors in a place of dependence,” says Meyer-Arnold. “But when you ask seniors, they want something to do. They want to give back to the communities they live in, to do something that matters.”

What to know about selecting an adult care service

How do I select an adult day care service?

More than 3,500 adult day centers are providing care for 150,000 older Americans each day, but each center is different and the services might vary.

Meyer-Arnold stresses that the family’s job is to find the place for their loved ones that “feels the best.”

For example, “Mom needs nursing care, so she might benefit from a Skilled Nursing Technician’s services,” says Meyer-Arnold. “Or maybe Mom is more isolated, sitting alone all day, watching TV, so she might benefit from a group setting or a club activity.”

WHN TIP — Find a Senior Center Nearby: On the National Adult Day Services Association homepage, you can search by city, state or zip code.

What are some questions I should ask?

Hours and schedule

  1. What days/hours are they open? (Think about your schedule – will this work?)
  2. How many days can you use the service? Do you need it only on Mondays and Wednesdays, for instance, or every day?
  3. Do you offer transportation services? What are the pick-up and drop off times?


  1. What medical services do they offer?
  2. What social activities are available?
  3. How will the center meet any needs your loved one has (e.g. certain conditions – Alzheimer’s, diabetes or social, emotional, cultural, dietary needs)?
  4. Can you meet the staff? Visit during meal times?

Emergency care

  1. What would happen in an emergency?
  2. How would you be contacted?
  3. What local hospitals or clinics do they work with?

Licensing and certification

  1. Are you certified and licensed? At the state level? By NADSA? (This means they’ve developed their programs based on NADSA.)
  2. Who are the nurses? What are their backgrounds and certifications?
  3. Who else will be providing care to your loved one?


  1. How much is your service per day?
  2. What services are included in the base rate?
  3. What services are at an additional cost?
  4. Where can you get a price breakdown list of costs?
  5. What payment options/plans are available?
  6. What subsidies or scholarship funds are accepted to help you pay for services?

Always ask for explanations if you don’t understand the answers. NASDA has a downloadable checklist of more questions to ask.

WHN STAFF TIP – Additional Care: Thinking that your loved one might need more assistance than what is available at your nearby adult day care services? Visit our Get Prepared – Senior Living section for a descriptive list of other senior assistance options.

Financial Resources

  1. Services for senior day care average about $61 a day (NADSA).
  2. Both Medicaid and the VA pay for adult day services.
  3. Medicare does NOT cover adult day services.
  4. Other options include local and state assistance, Title 19 waivers and the adult day service itself might have assistance or scholarship programs.

Applying for day care

You will be asked to complete an application – the requirements vary depending on the service and the state. If your loved one needs medical assistance, generally you need a current assessment or physical from a physician. The physical must be recent (at least 30-90 days prior to the day you’d like to start services – this may vary depending on the state).

After day care begins

Within the first month, meet with the center’s director and the staff to assess the needs of your loved one. Develop a “plan of care” outlining the areas you feel assistance is needed (e.g. medical needs, social needs, emotional needs). An annual physical is also necessary for ongoing care.

Continue to ask questions and evaluate the experience and the care. Stop in to visit, ask your loved one about the services. (Additional “transitioning tips” can be found under our Senior Living – Articles and More section.