Home Care Versus Adult Day Care

By Clare Absher RN, BSN  

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Elderly woman pushes husband in wheelchair

  Need help finding care?

Explore the good, the bad, and what's best for Mom and Dad!

Our nurses' side-by-side comparison of home care versus adult day care can help you choose which option is best for your family. If you're on the fence, consider hiring an in-home caregiver in combination with spending a few days a week at a day care center.

The GOOD About Home Care

  • More attention to individual needs when one-on-one with a caregiver
  • Flexible schedule tailored to accommodate personal needs and preferences
  • Formation of friendly, long-term bonds with their caregiver
  • Limited mobility or homebound status does not interfere with care
  • Early detection and subsequent reporting of health problems more likely with a one-on-one caregiver
  • Escort to shopping trips, restaurants, and other favorite outings of personal choice
  • Escort to medical appointments reduces family time off work
  • Enjoyment and comfort of being at home, surrounded by familiarity and family
  • Relief of housekeeping and meal preparation services for family
  • Senior’s illness or feeling “under the weather” does not prevent rendering of care or lead to missed work time for family
  • Avoidance of stressful morning preparations for departure and rushed returns for after work pick-up
  • Easy communications with in-home caregivers can alleviate worry of working family members

The GOOD about Adult Day Care

  • Less costly overall and more reasonable daily rates
  • More socialization with peers, making new friends, reduced loneliness, and decreased depression
  • Group activities for mental stimulation such as cards, puzzles, games, music, and pet therapy
  • Group exercise and wellness programs to enhance overall health
  • Professional staff trained to monitor medical problems and emergencies
  • Regular hours of operation to accommodate working families’ busy schedules
  • More accountability and support with multiple caregivers teaming together
  • Establishment of supportive relationships with other family caregivers who attend center
  • Daily prepared meals reduce workload on busy families
  • Time spent outside home reduces demand on housekeeping services
  • Facility design prevents wandering for those with Alzheimer’s disease and dementia
  • Facility design safely accommodates those with physical disabilities

The BAD about Home Care

  • Overall cost is substantially greater for one-on-one care at home
  • Increased isolation and loneliness when remaining at home for long periods
  • Loss of a regular or favorite caregiver may cause grief and feelings of abandonment
  • Less opportunity to participate in group activities may increase risk of social deprivation
  • Less exercise traveling outside home for care and lack of onsite exercise may cause deterioration in health
  • Less privacy in your home for family members when caregiver present
  • Dependency on back-up care when scheduled caregiver cancels
  • Reliance on one caregiver to be responsible and trustworthy
  • Less mutual support for family caregivers dealing with similar eldercare issues
  • Unscheduled hours of care may cause anxiety when left alone and/or safety concerns
  • Poor compatibility with caregiver and lack of replacement staff
  • Undetected and/or unreported neglect or abuse by caregiver

The BAD about Adult Day Care

  • Less attention to individual needs because caregivers are assigned to care for multiple clients
  • Hours limited to weekdays; no night, weekend, or holiday coverage is available for respite
  • Spreading of contagious illnesses
  • Reluctance to attend center can result in stress and logistical problems for working families
  • Embarrassing stigma of adult day services: perception that is like child day care and equivalent to babysitting
  • Morning preparations for departure and afternoon pickup may tax and stress busy family schedules
  • Health deterioration or advanced Alzheimer’s may cause termination of services resulting in need for new care arrangements
  • Reluctance to join in group activities limits the benefit of the center
  • Staff may be insensitive to individual needs, or even difficult to get along with, due to work load
  • Dislike or refusal to eat center’s food may pose nutritional problems
  • Other participants may be difficult to get along causing anxiety or fear

Consider a Combination of Home Care and Adult Day Care

Maximize the overall quality of your parent's care by hiring a part-time, in-home caregiver in conjunction with spending a few days a week at a day care center. This way, Mom and Dad can benefit from the social interaction that day care offers while also receiving some special, one-on-one attention at home. Your elderly loved one can benefit from the wellness programs, exercise, and mental stimulation at the day care center while the in-home caregiver more closely monitors changes in their health. It might be sensible for Mom or Dad to attend day care Monday through Friday and schedule in-home caregivers for respite at other times. Hiring in-home caregivers to cover evening, night and weekend shifts unavailable at adult day care makes the best use of both types of care. Take full advantage of employing in-home caregivers to escort Mom or Dad to appointments but set aside days at adult day care for Mom and Dad to enjoy music, art, and other stimulating events. Moreover, the financial demands of eldercare will be lessened by combining adult daycare and in-home care. Supplementing one-on-one, in-home care with less costly adult daycare helps to stretch the eldercare budget while reaping the positive benefits of both care options.

Clare Absher RN BSN

About the Author

Clare Absher is a Registered Nurse with 44 years of experience. Most of her experience is in home health serving as a caregiver, educator, patient advocate, and liaison between families and community resources. She has also worked in acute care, assisted living, and retirement settings. She is passionate about helping families care for their elderly loved ones at home.

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