America and other countries have adult day services programs serving hundreds of people per day. You can find some among clinical professionals who will criticize this model of adult day care. In this blog we have often provided both strategic and clinical advice aimed at program design that departmentalizes a program to ensure that person-centeredness is not lost in the numbers. This is especially important for larger programs.
Those who criticize often cite the advantage of using smaller, residential environments to serve demented populations. This is their preference over the larger adult day care programs where individualized care may be a greater struggle to provide. There is surely some wisdom in preferring smaller care environments. Here is where it gets tricky…
What if the demented person lives at home with family and this arrangement is the family preference and adult day care is needed for day-time care and supervision? After all you cannot leave a demented, incontinent person home unsupervised to threaten both their safety and skin integrity, not to mention personal sanitation?
What if the person is in that “in-between” crowd meaning they have too much income and/or assets to qualify for Medicaid or similar reimbursement of adult day care so it is being paid for out-of-pocket? This cost is normally significantly less expensive than quality, clinically competent assisted living services.
In each of these instances, regardless of the real or perceived advantage, serving them in a small, assisted living environment is likely not practical. Therefore, adult day care may be the best option and families simply have to locate a program that is complete with a rehabilitative mechanism and the required clinical acumen to serve the entire person.
So go large if you will, but not so large that you cannot focus on the individual. What are your thoughts? Sign-in to the blog and leave your comments. Contact the blogger: firstname.lastname@example.org.
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