Thursday’s edition of the Wall Street Journal, Personal Journal section (Jan. 10, 2008) contains an interesting article about day care - for elderly adults (”Finding Day Care for Your Parents, by Jeff Opdyke).  The article describes the growing demand for adult day care facilities, to the tune of between 5 and 15 percent a year.  Opdyke cites the following statistics.

• Adult day care serves about 400,000 people on a national level
• For an 8 hour day, average cost in elder daycare is about $61/day, compared with $152/day for a home health aide
• Services range from basic care to physical therapy, medication management, grooming, and exercise.

According to the article, there is still some stigma attached to the idea of daycare for adults.  However, even the federal government is getting in on the action, starting up a three-year pilot program allowing a fraction of Medicare home health-care benefits to fund elder daycare.  Opdyke cites some successful statistics for the federal pilot program: in one of the five pilot sites, hospital admission rates for participants are less than half of those not participating.  At another pilot site, about half of the recepients of Medicare benefits in adult daycare reenroll, using private funds after the Medicare benefits run out.

I think this is an idea with tremendous potential.  The topic caught my eye because my mother-in-law was asking us for some advice on purchasing nursing home insurance.  The insurance is very costly, about $2,500/year for a 62 year old.  If my in-laws do not need to be admitted to a nursing home for another 20 years, which is entirely possible because they are both in very good health, the combined insurance premiums paid by my in-laws could total $100,000.  Moreover, the insurance would only cover three years of nursing home care.  Granted, nursing home care is more intensive and costly than adult daycare.  However, barring a catastrophic medical event, adult daycare may suffice, even for elderly relatives with chronic conditions like Alzheimer’s disease.

Another benefit is that adult daycare alleviates much of the pressure and guilt that adult children may face in deciding what kind of care to seek for their elderly parents.  The elder parents are looked after during the day, but still sleep under their children’s roof at night and not at a nursing home.  Adult daycare is also cheaper and provides more social stimulation for elder parents, verses a home health aide.

Opdyke provides some pointers for baby boomers looking for an adult care facility:

• Find a center through local Alzheimer support groups or state or local agencies for the aging
• Personally visit providers before signing up
• Ask questions about staffing ratios, services provided, the pricing structure, and whether they offer discounts
• Visit multiple centers
• Verify licensing and registration

Finding safe and adequate care for aging parents can be a stressful, heart-wrenching process.  A friend of mine represented an elderly lady who was suffering from alzheimers disease.  Her daughter petitioned the court for guardianship of her because the mother, who was still living at home, was hoarding thousands of items, including hundreds of empty milk jugs, that were stacked to the ceiling of the house.  The mother was ultimately moved to a county-approved home for the elderly.  While not a full-blown nursing home, the home was a private residence retrofitted to accommodate up to 10 elderly patients for long-term stays.  The monthly charge was $2,400 per person.  I visited the home with my friend: it was dark and depressing, and I would not put my own parents there.  There were some patients whose children lived in the area and came to visit them frequently.  If adult daycare does become more prevalent, adult children would not have to make the difficult financial choice of putting their parents in such a place.