- The Washington Times - Saturday, March 15, 2003

CHICAGO, March 15 (UPI) — More than half of U.S. counties lack enough adult day centers to meet current needs, a study released Saturday concludes.

"Fifty-six percent of the nation's 3,141 counties are underserved," lead researcher Nancy Cox, director of Partners in Caregiving, a national adult day services resource center at Wake Forest University Baptist Medical Center in Winston-Salem, N.C., told United Press International.

Cox presented the "National Study of Adult Day Centers" at the joint conference of the National Council on the Aging and the American Society of Aging.

"In order to meet the current need," Cox said, "5,415 new adult day centers are needed nationwide — 2,424 in rural areas and 3,991 in urban areas."

Most day center clients live with an adult child or spouse. The centers provide respite care, meals and appropriate activities Monday through Friday, usually during regular working hours.

"Adult day centers are serving a population similar to nursing homes but at less cost," Cox added.

The study indicated that 43 percent of adults in day centers require help with toileting, 37 percent with walking and 24 percent with eating.

"This first national study of adult day centers tells us that they keep people in need of chronic care at home, in the community, with family and friends for as long as possible, delaying or preventing institutionalization," Cox said.

The study, funded by The Robert Wood Johnson Foundation, concluded adult day centers can be part of an alternative cost-effective, long-term care strategy for the frail elderly and people with dementia.

"Adult day services are a key component in the continuum of care," Terry Stone Executive Director National Adult Day Services Association, told UPI. "This study will assist us in our efforts to educate public officials on the value of the services being provided."

The researchers found the average daily cost of providing adult care is $56, while the average daily cost of nursing home care in the United States is $120. However, they also found the average daily charge by day centers is only $46, suggesting many centers cannot function without subsidies.

Approximately half of the costs are covered by Medicaid and other public funds, and half by families. Less than 1 percent of costs are covered by long term care insurance.

Noting the financial burden this places on most families, Cox said, "right now the funding chooses the form of care, forcing the people into nursing homes for long-term care. Long-term care reform is needed, and adult day centers can be part of the reform as a cost-effective service option."

She added: "It would not be an expansion of Medicaid or Medicare to offer the choice of adult day services as a community-based care option. In fact it probably would be less costly for our tax dollars."

The study reported about one-quarter of all adult care centers have been opened within the last five years and many are underutilized due to lack of public awareness of the availability of services.

"The National Study of Adult Day Centers makes it very clear that we need to create a better public awareness and understanding of adult day services, what they are and how they are an important alternative to premature and costly nursing home placement." Jed Johnson, director of the Easter Seals adult day services network in Chicago and chairman of the National Adult Day Services Association, told UPI.

"This study truly underlines a growing need for adult day centers," he said, "not just for our aging population, but also for younger adults with profound disabilities."

(Reported by Bruce Sylvester, UPI Science News, in West Palm Beach, Fla.)

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