Not Enough Adult Care Centers to Go Around

More than half the nation's counties are underserved, survey finds

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HealthDay Reporter

MONDAY, March 17, 2003 (HealthDayNews) -- The first national head count of the number of adult care centers in the United States has found that more than half the counties don't have enough centers to serve a growing aging population.

This is despite the fact that such facilities provide the elderly a popular and less-expensive alternative to institutional care, health professionals say.

There are 3,407 centers throughout the country offering daily cultural activities, health care and a variety of other services, but with a growing elderly population, 5,000 more are needed, says the author of the survey.

"While there are large pockets of adult centers in the northeast, southern Texas, Florida, Chicago and California, 56 percent of the some 3,000 counties in the country are underserved," says Nancy J. Cox, who conducted the two-year survey. Cox is director of Partners in Caregiving, a resource center housed at the Wake Forest School of Medicine that focuses on increasing the number of adult care centers throughout the country.

A further problem is that many of the centers are under-utilized. "The utilization rate is only 66 percent, which means there's a lack of public awareness about the centers," Cox says.

Cox presented the results of her survey, which was paid for the Robert Wood Johnson Foundation, at a joint conference of the National Council on the Aging and the American Society of Aging in Chicago over the weekend.

"No one has known how many adult care centers there are. This is a very needed study, and it's very good that we've got it," says James Bergman, co-director of the Center for Social Gerontology in Ann Arbor, Mich.

Daily adult care centers are very popular with both the elderly and their families, he says, because they provide daily care while letting older people stay at home or with their grown children.

"Very few elderly people want to move into institutional care. They would rather stay home and have support services. Adult care is a very viable alternative," he says.

Indeed, Cox says, the survey found the two main reasons for leaving the centers after an average stay of two years were placement in an institutionalized setting or death.

"This says to me that adult care centers are delaying or preventing institutionalization. They are viable, cost-effective, community-based facilities that keep people at home with family and friends for as long as possible," she says.

The survey found that most of those attending the centers live with an adult child (35 percent) or a spouse (20 percent), and the average usage is three visits per week.

The centers provide differing services, from facilities that provide health-related services such as vision screening, nutritional counseling and blood pressure monitoring to those that provide therapeutic activities such as exercise and pet therapy.

"People don't realize the level of sophistication at the centers. They are not babysitting services," Cox says.

Other survey findings:

  • The large majority of those using the centers are elderly people suffering from dementia or physical frailty, but the centers are also used by younger people suffering from mental retardation or from disabilities such as multiple sclerosis and Parkinson's disease.

  • Seventy-eight percent of the centers are not-for-profit, are open eight hours a day from Monday through Friday, and the average daily fee is $46 day, which is less than the cost of running the centers.

    There is growth in the adult care services industry: 26 percent of all adult care centers have opened in the last five years, but growth lags behind need -- 1,770 counties out of 3,141 don't have enough centers for the elderly population which could use it.

More information

For guidance in finding and choosing an adult care center, you can visit National Adult Day Services Association. To find an elder care facility, go to the U.S. Administration on Aging.

SOURCES: Nancy J. Cox, M.S.W., director, Partners in Caregiving, Wake Forest University, Winston-Salem, N.C.; James Bergman, J.D., co-director, Center for Social Gerontology, Ann Arbor, Mich.; Executive Summary, National Study of Adult Day Services, 2001-2002; March 15, 2003, presentation, National Council on the Aging and the American Society of Aging joint meeting, Chicago

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