About Adult Day Services

Adult day services is a professional care setting in which older adults, adults living with dementia, or adults living with disabilities receive individualized therapeutic, social, and health services for some part of the day.

Adult day service centers provide a coordinated program of professional and compassionate services for adults in a community-based group setting. Services are designed to provide social and some health services to adults who need supervised care in a safe place outside the home during the day. They also afford caregivers respite from the demanding responsibilities of caregiving. Adult day centers generally operate during normal business hours five days a week. Some programs offer services in the evenings and on weekends. Although each facility may differ in terms of features, these general services are offered by most adult day centers:

Social activities—interaction with other participants in planned activities appropriate for their conditions

Transportation—door-to-door service

Meals and snacks—participants are provided with meals and snacks, those with special dietary needs are offered special meals

Personal care—help with toileting, grooming, eating and other personal activities of daily living

Therapeutic activities—exercise and mental interaction for all participants.

In general, there are three types of adult day centers:

  • social (which provides meals, recreation and some health-related services)
  • medical/health (which provides social activities as well as more intensive health and therapeutic services) and
  • specialized (which provide services only to specific care recipients, such as those with diagnosed dementias or developmental disabilities.

Caregivers typically select the type of center a care recipient attends based on the care needed.

By 1978, adult day center owners/managers saw the need to establish national standardized criteria that would allow caregivers the ability to rate and fully understand what adult day centers would provide for their loved ones. Thus, the National Adult Day Services Association formed in 1979. Since then, NADSA has made great progress in promoting the concept of adult day services as a viable community-based care option for people with disabilities within the larger constellation of long-term care services.

The National Adult Day Services Association (NADSA) has identified 5,685 day programs operating in the United States in 2014.  The growth trend continues from previous censuses of 4,601 in 2010 (NADSA) and 3,407 programs counted in the research by Partners in Caregiving (funded through the Robert Wood Johnson Foundation).

NADSA was proud to partner with MetLife Mature Market Institute (MMI)1 and the Ohio State University College of Social Work2 researchers Dr. Holly Dabelko-Schoeny and Dr. Keith Anderson to present the 2010 national study. A random sample of the 4,601 centers identified were asked to complete a survey about their current operations, staffing, services, referral sources, and participants. The full report is available at www.MatureMarketInstitute.com.

Key Findings from the 2010 MetLife Study

Adult Day Services Are a Growing Source of Long-Term Care

  • There are more than 4,600 adult day services centers across the U.S. — a 35% increase since 2002.
  • More than 260,000 participants and family caregivers are serviced — an increase of over 100,000, or 63%, since 2002.

Adult Day Services Provide Comprehensive Skilled Health Care

  • A full range of interdisciplinary professionals meet the physical, emotional, and social needs of participants and family caregivers.
  • Nearly 80% of adult day services centers have a nursing professional on staff, nearly 50% have a social work professional on staff, and approximately 60% offer case management services.
  • Approximately 50% provide physical, occupational, or speech therapy.
  • There is one direct care worker for every six participants, facilitating individualized, person-centered care and enabling staff to care for increasingly complex needs.
  • Adult day services centers serve as an emerging provider of transitional care and short-term rehabilitation following hospital discharge.

Adult Day Services Are a Preferred Platform for Chronic Disease Management

  • There is an increase in disease-specific programs offered in centers to address chronic conditions.
  • More than ever, adult day services participants have higher levels of chronic conditions and disease, such as hypertension (46%), physical disability (42%), cardiovascular disease (34%), diabetes (31%), mental illness (25%), and developmental disability (20%).
  • There is a heightened focus on prevention and health maintenance — nearly 80% of centers offer physical activity programs to address cardiovascular disease and diabetes.

Adult Day Services Are Leaders in Community-Based Care for Individuals with Alzheimer’s Disease and Other Dementias

  • Adult day services centers provide an interactive, safe, and secure environment.
  • Nearly half of all participants have some level of dementia.
  • Approximately 90% of centers offer cognitive stimulation programs, almost 80% provide memory training programs, and more than 75% offer educational programs.
  • The care provided may allow these individuals to delay nursing home placement.

Adult Day Services Are an Essential Source of Support for Family Caregivers

  • Adult day services provide a reliable source of support, restore balance in times of crisis, and enhance overall quality of life for caregivers.
  • Adult day services provide respite to family caregivers.
  • Over 80% of participants attend full days and 46% attend five days per week, enabling family caregivers to remain in the workforce.
  • Most centers provide caregiver support programs, including educational programs (70%), caregiver support groups (58%), and individual counseling (40%).


National Study of Adult Day Services, 2001-2002. Winston-Salem, North Carolina: Partners in Caregiving: The Adult Day Services Program, Wake Forest University School of Medicine, 2002.

The MetLife Mature Market Institute® Established in 1997, the Mature Market Institute (MMI) is MetLife’s research organization and a recognized thought leader on the multi-dimensional and multi-generational issues of aging and longevity. MMI’s groundbreaking research, gerontology expertise, national partnerships, and educational materials work to expand the knowledge and choices for those in, approaching, or caring for those in the mature market.

MMI supports MetLife’s long-standing commitment to identifying emerging issues and innovative solutions for the challenges of life. MetLife, Inc. (NYSE: MET), through its subsidiaries and affiliates, is a leading provider of insurance, employee benefits and financial services with operations throughout the United States and the Latin American, Europe and Asia Pacific regions. For more information about the MMI, please visit: www.MatureMarketInstitute.com.

The Ohio State University College of Social Work The Ohio State University is one of the largest and most comprehensive institutions of higher education and consistently ranks in the top 20 public universities in the U.S. First accredited in 1919, The Ohio State University College of Social Work is the oldest continuously accredited public social work program in the country. Dr. Holly Dabelko-Schoeny and Dr. Keith A. Anderson served as co-principal investigators for the study. Dr. Dabelko-Schoeny’s practice and research interests focus on improving the delivery of community-based services for older adults and their caregivers through collaboration with community agencies. Dr. Anderson’s practice and research centers on well-being and quality of life for older adults and their caregivers across the long-term care spectrum. www.csw.osu.edu