Category Archives: Research

19 March 2014

Adult day services boosts beneficial stress hormones in caregivers

Posted March 19, 2014 in Research in Uncategorized

Family caregivers show an increase in the beneficial stress hormone DHEA-S on days when they use an adult day care service for their relatives with dementia, according to researchers at Penn State and the University of Texas at Austin. DHEA-S controls the harmful effects of cortisol and is associated with better long-term health.

“This is one of the first studies to show that DHEA-S can be modified by an intervention, which, in our case, was the use of an adult day care service,” said Steven Zarit, Distinguished Professor of Human Development and Family Studies, Penn State. “The study is also one of the first to demonstrate that interventions to lower stress on caregivers, such as the use of adult day care services, have an effect on the body’s biological responses to stress. We know that caregivers are at increased risk of illness, because of the long hours of care they provide and the high levels of stress.  These findings suggest that use of adult day care services may protect caregivers against the harmful effects of stress associated with giving care to someone with dementia.”

The researchers studied 151 caregivers of family members with dementia who attend an adult day care service at least two days a week. For eight consecutive days, the caregivers collected their own saliva five times each day and kept a diary of the times at which they collected the saliva. They kept these saliva samples refrigerated until they could be shipped back to the laboratory. During the evenings of each of the eight days, interviewers from the Penn State Survey Research Center called the participants and asked them about the daily stressors they had encountered as well as their mood.

The team’s results suggest that caregivers of family members with dementia who use adult day care services at least two times a week have increased DHEA-S levels on the day following the adult day service visit. The results appear on-line in the American Journal of Geriatric Psychiatry.

“Prior research has found that higher DHEA-S levels are protective against the physiological damaging effects of stressor exposure and may reduce risks of illness,” Zarit said. “We have found that regular use of adult day care services may help reduce depletion of DHEA-S and allow the body to mount a protective and restorative response to the physiological demands of caregiving. These results suggest the value of broadening the focus of caregiver interventions to include their impact on relevant biological risk factors associated with chronic stress and disease.”

The National Institute on Aging supported this research.  Steve Zarit is a member of the Board of Directors for the National Adult Day Services Association.

Other authors on the paper include Courtney Whetzel, research associate in biobehavioral health, Penn State; Kyungmin Kim, postdoctoral fellow, University of Austin at Texas; Elia Femia, research associate in human development and family studies, Penn State; David Almeida, professor of human development and family studies, Penn State; Michael Rovine, professor of human development and family studies, Penn State; and Laura Cousino Klein, associate professor of biobehavioral health, Penn State.

13 December 2013

Federal Study Releases Findings on Adult Day Service Centers

Posted December 13, 2013 in Research

CDC’S National Center for Health Statistics (NCHS) today released the first in a series of reports from the National Study of Long-Term Care Providers (NSLTCP).  Long-Term Care Services in the United States: 2013 Overview includes general, descriptive information on the supply, organizational characteristics, staffing, and services offered by providers of long-term care services; and the demographic, health, and functional characteristics of users of these services.  You can access the report here:

  • The report shows that in 2012, about 58,000 paid, regulated long-term care services providers served about 8 million people in the U.S.
  • Each day in 2012 there were 273,200 participants enrolled in adult day services centers, 1,383,700 residents in nursing homes, and 713,300 residents in residential care communities.
  • In 2011, about 4,742,500 patients received services from home health agencies, and 1,244,500 patients received services from hospices.

Selected summary highlights from the report include:

  • Provider sectors differed in ownership, and average size and supply varied by region.  In all sectors except adult day services centers, the majority of long-term care services providers were for profit.  The largest share of adult day services centers, home health agencies, hospices, and nursing homes was in the South, while the largest share of residential care communities was in the West.
  • Provider sectors differed in their nursing staffing levels, use of social workers, and the types of services offered.  The majority of nursing employee full-time equivalents (FTE) in residential care communities, adult day services centers, and nursing homes were aides, while the majority of nursing FTEs in hospices and home health agencies were registered nurses (RN).
  • Rates of use of long-term care services varied by sector and state.  Users of long-term care services varied by sector in their demographic characteristics and functional status.  Hospices, nursing homes, and residential care communities served more persons aged 85 and over, and adult day services centers served more persons under age 65.  Adult day services centers were the most racially and ethnically diverse among the five sectors.

If you have any questions or comments about the report, please contact Lauren Harris-Kojetin at or Manisha Sengupta at

The NSLTCP is a new initiative to monitor the diverse spectrum of paid, regulated providers of long-term care services and inform long-term care planning and policymaking to meet the needs of an aging population.  The NSLTCP uses data from the five major sectors of the long-term care services industry—adult day services centers, assisted living and similar residential care communities, home health agencies, hospices, and nursing homes—to produce representative national and state estimates.   NCHS plans to release state-level estimates on the topics in this report in spring 2014. To monitor trends, NCHS plans to conduct NSLTCP every two years.   The National Adult Day Services Association is one of many partners supporting NSLTCP.

To learn more about NSLTCP, please visit:

16 October 2013

ASPE Report Update Supports Adult Day Services Research

Posted October 16, 2013 in Research


RTI International received funding from the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation to update their report, Regulatory Review of Adult Day Services: Final Report that was published on August 26, 2005.  Co-principals Kristin Siebenaler, Janet O’Keeffe, Christine O’Keeffe, David Brown, and Beth Koetse are entrusted with the task of updating their research to improve utilization and reimbursement for adult day services.  The National Adult Day Services Association is an important consultant on the project.


The updated report will include:


  • Licensing, Certification, and Other Requirements.
  • Definitions of Adult Day Services.
  • Parameters for Who Can Be Served.
  • Required and Optional Services.
  • Provisions Regarding Medications.
  • Staffing Requirements.
  • Training Requirements.
  • Monitoring.
  • Relevant Medicaid Contracting Requirements.
  • State Regulatory profiles


This report will help state Medicaid directors, state and federal policy makers, managed care organizations and accountable care organizations determine best practices for the use of adult day services.


It will also provide information to guide future research and policy analysis on adult day services in general. The project end date is August 2015.


17 October 2012

Have you Participated in the National Study of Long Term Care Providers?

Posted October 17, 2012 in Research

The National Adult Day Services Association is proud to be collaborating with the National Center for Health Statistics to support the National Study of Long-Term Care Providers (NSLTCP) .  All adult day services centers should have received the National Study of Long-Term Care Providers (NSLTCP) questionnaire via FedEx by now. Your participation in this study is critical as the Centers for Disease Control and Prevention (CDC) gathers information nationwide in the first long-term care study funded by the federal government that has included adult day services. Your participation will affect whether or not the adult day services sector in your state is accurately represented in this national study. Every center counts!  If you received a survey and have not responded, please consider responding today to avoid receiving another copy of the survey via FedEx later this month.

How will the survey results be used?

  1. Estimate the supply of adult day services centers and other types of paid, regulated long-term care providers
  2. Estimate key policy-relevant characteristics and practices of adult day services and other long-term care providers
  3. Estimate the national use of these long-term care providers
  4. Estimate key policy-relevant characteristics of users of adult day services and other long-term care services
  5. Produce state estimates within  confidentiality  and reliability standards
  6. Compare adult day services and other long-term care providers and monitor trends over time.

By participating in this study, you can ensure that the voice and needs of your adult day center will be heard. The information you provide will be held in the strictest of confidence and only summary data will be made publicly available.

NSLTCP website:

Questions? Call (301) 458-4714 or (877) 745-1440

21 May 2012

Dissertation Fellowships Announced by National Association

Posted May 21, 2012 in Research in Uncategorized

The National Adult Day Services Association (NADSA) is pleased to announce the Beth Meyer-Arnold Dissertation Fellowships which are designed to encourage original scholarship in the area of adult day services by doctoral students. The award supports PhD Candidates in completing their dissertation work in areas of interest to adult day services.  NADSA will be awarding scholarships at their National Conference in Pittsburgh, PA, Sept .20-22, 2012.

Please distribute this information to your interested colleagues!

Please see more information posted here:  Deadline for submission of application is August 20,2012.

We value the strength of diversity and inclusion and encourage qualified individuals with disabilities and individuals of all backgrounds and cultures to apply.  For additional information, please contact Dr. Holly I. Dabelko-Schoeny at



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