Fred Archie, 73, was diagnosed with Alzheimer's disease four years ago. To help care for him, two of his daughters stay with him during the week. On the weekends, they return to their families while a third daughter takes over. When the daughters are at work, Archie spends his days at The Ivey, an adult day care center in his hometown of Charlotte, NC.
Archie, a former fire captain, has no long-term care insurance, so his daughters pay the $125 daily fee out of pocket. It's a struggle, they admit, but it's worth it. Archie eats lunch at The Ivey and is pleasantly occupied by the activities. Each week, a singer performs at the center, and Archie loves to get up and sing with him.
The cost of Archie's care is more than the national average of $60 a day, and slightly less than the cost of eight hours with a home health care aide, which is about $152 per day, according to the National Adult Day Services Association in Fairfax, VA. But both are much less expensive than a nursing home, notes Brendan J. Kelley, MD, a neurologist at the Ohio State University Wexner Medical Center in Columbus, who specializes in treating patients with dementia, Alzheimer's disease, and memory problems.
Still, the cost of day care can put a crimp in the budget. We spoke to several experts for tips on how to ease the financial burden.
1. WORK WITH THE DAY CARE CENTER. “Some facilities get private or public funds they can use to defray costs,” says Amy Goyer, a family and caregiving expert with AARP in Washington, DC. Center directors are also usually up-to-date on local, state, and veterans resources, and may be able to advise you on how to use employee benefits to pay for care.
2. LIMIT THE HOURS. Some centers let seniors come for part of a day instead of the whole day and may even let you change the schedule as needed. At the Miami Beach Senior Center in Miami Beach, FL, for example, options include four hours a day for $40 or six-and-a-half hours a day for $60, with breakfast, lunch, and snacks included for both schedules. Charges are typically fixed, but some places may have a sliding scale, says Ruth Drew, director of family and information services at the Alzheimer's Association in Chicago.
3. RESEARCH MEDICAID. At least some Medicaid assistance is available in all 50 states, although not in Washington, DC, and is tied to a person's income. Plus, the center has to be one approved by Medicaid in your state. Call your local Area Agency on Aging (AAA) or check the website of the National Association of Area Agencies on Aging at http://n4a.org to ask about Medicaid funding through a Home and Community-Based Waiver. Or ask the AAA about caregiver respite funding covered by the Older Americans Act. Information specialists at the AAA may be able to help you find other financial resources, such as http://eldercare.gov, says Goyer.
4. CHECK THE VA. The US Department of Veterans Affairs runs its own adult day care programs for veterans in most states. While some centers are free to any veteran, others operate on a sliding scale and may require a copayment. Find more details at http://bit.ly/VA-AdultDayCare.
5. ASK YOUR LONG-TERM CARE INSURER. Many policies cover some portion of adult day care costs, although you must use a center approved by the insurer. Policies have a maximum amount per day, so if you already employ a home health aide, for example, there may be no funds left to cover adult day care. If so, ask specialists at the AAA about other funding sources, says Goyer.
6. EXPLORE EMPLOYEE BENEFITS. Check with the human resources department to see if your employer offers any discounts with local adult care centers. Many employers have a dependent care spending account that lets employees allocate pre-tax dollars to pay for care for dependents, including spouses and even parents if they live with you. The IRS limit is $5,000 per employee, but some companies may cap that at a smaller amount. Some employers also pay for several hours with a geriatric case manager, says Sherri Snelling, a care-giving consultant to employers in Newport Beach, CA, and author of A Cast of Caregivers (Balboa Press, 2012).