Prevalence of Seniors With Dementia in Adult Day Shows Need for More Support

Providers of adult day and other services for older adults are playing an outsized role in caring for people with dementia, a new study has found.

A recent analysis of data from the adult day portion of the 2020 National Post-acute and Long-term Care Study has found that nearly a quarter of all older adults who receive some adult day services have dementia.

The report found that over 42% of participants in adult day service centers that specialized in providing dementia care were diagnosed with dementia, while over 22% of participants in adult day services without any dementia specialized care were diagnosed with some form of dementia.

The study’s findings indicate that adult day providers are caring for a significant number of older adults with dementia, indicating their important role in dementia care across the U.S. More than that, the study shows a need for broader partnerships between senior living providers and adult day care service providers, according to National PACE Association President and CEO Shawn Bloom.

PACE, which stands for Programs of All-Inclusive Care for the Elderly Benefits, was created with the intention of providing an alternative to institutional nursing home care for older adults. Providers of PACE services receive monthly Medicare and Medicaid capitation payments per enrollee.

While many for-profit adult day centers are not PACE providers, they can offer some of the same services. Through PACE centers, older adults have access to care from physicians, nurses, licensed and occupational therapists and other clinicians. They also typically get socialization, personal care and dining services.

Bloom and other stakeholder groups involved with senior care are champions of a pending bill in Congress known as the Part D Choice Act. The legislation, currently with bipartisan support, allows PACE enrollees that receive Medicare assistance to bring existing Medicare Part D coverage into PACE services.  

“It’s simple, and doing that our theory is that we emerge and expand as an affordable service option for people to afford,” Bloom said. “You pay one cost, everything is included regardless of what you utilize.”

Bloom said adult day services can provide a much needed assist for unpaid caregivers, like family members of those with dementia, but that these services must have specialized care due to the higher needs of those with cognitive impairments.

“We’re finding rates of impairment among individuals that are greater than what we’ve seen in the past,” Bloom said.

By examining social, environmental and health circumstances of an individual at adult day services, better more personalized care could be provided in the future.

“Through that three-part lens you really can identify what you can bring to bear to support that individual’s ability to remain living in the community and adult day centers could really amplify the access to nursing.”

By raising awareness about adult day services, Bloom noted that further progress could be made to bring more dementia-based services to older adults, while also supporting staff with new training and competencies on caring for those with dementia.

“Why not support and add services that support caregivers and give them the respite that they need and adult day is one of the most important types of respite for caregivers,” Bloom added.