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Day Care

By Barbara Resnick, PhD, CRNP, Professor, OSAH, Sonya Ziporkin Gershowitz Chair in Gerontology, University of Maryland School of Nursing

Day care may involve

  • Treating a problem

  • Maintaining the person's condition

  • Providing social activities or mental health care (such as group therapy)

People can go to day care facilities for several hours a day for several days a week. These facilities may also provide a place where family members who care for an older person full-time can take the older person and get a break from care (a service called respite care). By doing so, they may help delay or avoid placement in a nursing home.

In the United States, there are only about 2,900 day care programs compared with more than 16,000 nursing homes. Most day care programs are small, serving about 20 people.

Day hospitals are a type of day care facility. They provide complex tests and treatments, rehabilitation services, and intensive skilled care. They are designed for people who are recovering from a recent problem such as a stroke, an amputation, or a fracture. The primary care practitioner or a hospital may send a person to a day hospital. These facilities usually provide care for a limited time (6 weeks to 6 months) and are expensive because the ratio of staff members to patients is high.

Maintenance day care programs provide limited skilled care (such as screening for and monitoring of chronic disorders) and physical exercise. The goals are to prevent deterioration of the person's mental and physical condition, to maintain or improve the person's ability to function for as long as possible, and to prevent chronic disorders from worsening. Also, these programs include activities to improve the person's self-image, provide stimulation, and prevent loneliness, isolation, and withdrawal. Maintenance programs can provide long-term care and are less expensive than day hospital programs.

Social day care programs provide counseling, group therapy, activities to maintain or improve mental function, strategies to compensate for losses, and social and recreational activities. They may resemble a senior center or a mental health care center, providing care for older people with dementia or psychiatric disorders.

Financial issues

Medicare does not cover day care services. Funds usually come from the Older Americans Act (which funds services to help keep older people functional and independent—see the National Council on Aging web site), Medicaid waiver programs, long-term care insurance, and/or private funds.