Adult day care

Adult day care is a group program where a person living with dementia spends the day in a safe, staffed place, then goes home at night. Most centers are open on weekdays during business hours. The person gets activities, meals, company and help with personal care. The family caregiver gets a break.^1,2

For many families, adult day care is the step between doing everything at home and moving to a care home. It can help a person stay at home longer. It can also let a caregiver keep a job, rest, or see a doctor of their own.

Who goes to adult day care

Adult day centers serve adults who should not be alone all day but do not need care around the clock. In 2025, there were about 4,450 adult day centers in the United States. They served about 227,000 people.³

People living with dementia are a large part of that group. About 28 out of every 100 people at adult day centers have Alzheimer's or another dementia. About 1 in 11 centers mainly serves people with dementia.³

Adult day care often fits best in the early and middle stages. Over time, the person may need more care than a center can give. That is why it helps to look at the fit again every few months.¹

What a day looks like

Every center runs its own schedule. Most are open on weekdays during business hours.² Some are open 7 to 10 hours a day, and a few have evening or weekend hours.¹ Some people go every weekday. Others go a few days a week. Here is an example of what one day might look like:

Staff also help with personal care during the day. This can include help with using the toilet, grooming and eating.^1,2 Many centers can help with medicines, and some check blood pressure. Some offer physical, occupational or speech therapy on site.¹

Good centers plan for dementia. Staff know how to respond to wandering, bladder and bowel problems, confusion and upsetting behavior.¹ Activities are matched to what each person can still enjoy. See meaningful activities for ideas you can also use at home.

Social centers vs. adult day health care

Adult day programs are often grouped into three kinds.²

The third kind is a specialized center. It serves a certain group, such as people with dementia.²

In real life, the line is blurry. In a 2025 national survey, about 1 in 6 centers met only social needs. About 1 in 3 mixed social and health care in equal parts. Only about 1 in 10 focused mainly on health needs.³ So ask each center what it does, rather than going by its name.

What adult day care costs

Costs depend on where you live, how many days the person goes, and how much care they need. In a large yearly industry survey, the national median cost of adult day health care was about $95 a day in 2025.⁴ At three days a week, that adds up to roughly $1,200 a month.

Ask each center about:¹

• The basic daily or half-day fee
• Extra charges, such as for rides, field trips, bathing or supplies
• The fewest days you must sign up for, and whether you pay for missed days
• Sliding-scale fees, which are based on income. Many centers offer these.

For a bigger picture of care costs, see what dementia care costs and tax help for caregivers.

Who pays: Medicare, Medicaid and the VA

Medicare

Medicare does not cover adult day care. It treats it as long-term care, which Medicare does not pay for. Medigap plans do not pay for it either.⁵ Learn more in what Medicare covers in dementia.

Medicaid

Medicaid pays for a large share of adult day care. About 3 in 4 centers can take Medicaid. More than half of centers get most of their fees from Medicaid.³ Each state sets its own rules. In general, Medicaid helps people with low income and few assets.¹ It often pays through a "waiver" program. These programs pay for care at home and in the community for people who would otherwise be at risk of moving to a nursing home.⁷

In Virginia, adult day health care is a service of the Commonwealth Coordinated Care Plus (CCC Plus) Waiver. The center must be licensed by the Virginia Department of Social Services and enrolled with Medicaid.⁷ To qualify, a person must meet nursing home level of care. A screening team checks this with a form called the Uniform Assessment Instrument (UAI). The person must also qualify for Medicaid financially.⁷ Read more in Medicaid and long-term care.

The VA

The VA has an Adult Day Health Care program for enrolled veterans. It is for veterans who need help with daily tasks like bathing or dressing, who are lonely, or whose caregiver is under strain.⁶ Veterans may go for a half day or a full day, often several times a week. The program can be at a VA medical center, a State Veterans Home or a community center.⁶

A copay may apply. It depends on the veteran's service-connected disability status and income. To start, talk with a VA social worker or case manager. They can help you fill out VA Form 10-10EC, the Application for Extended Care Benefits.⁶ See VA benefits for dementia.

Other ways to pay

• Long-term care insurance may pay for some respite and day care. Read your policy.¹⁰ See long-term care insurance.
• PACE (Program of All-Inclusive Care for the Elderly) is another option in some areas. See PACE.
• Local respite programs may have help to offer. See respite care.

How to find and choose a center

Start by gathering names. Good places to ask include your local Area Agency on Aging, the Alzheimer's Association, a senior center, and other caregivers.¹ The Eldercare Locator can connect you to local services at 1-800-677-1116.¹¹ The ARCH National Respite Locator also lists adult day centers.¹⁰

In Virginia, adult day centers are licensed by the Department of Social Services. You can look up licensed centers on its website and file a complaint about a center there.⁸ Virginia rules say a center must have at least one direct-care staff person for every six people in care, or part of six.⁹

Questions to ask on a visit

Visit at least once while the program is running. Bring the person with dementia on a later visit if you can.

1. Hours, fees and rules. What are the hours? What does it cost? How many days must we sign up for, and what happens if we miss a day?¹
2. Dementia skills. Is staff trained in dementia care? Are people with dementia in their own group, or mixed with everyone?¹
3. Health care. Is there a nurse? Who gives medicines? How do you assess each person's needs, and how often?¹
4. Safety. How do you keep people from leaving the building alone? What happens in an emergency? How will you reach me?¹
5. Rides. Do you offer transportation? How long is the ride? Does a staff member help at the door?^1,2
6. Daily life. What activities happen today? Can I see the menu? Is there a quiet place to rest?
7. Fit. Will my family member feel at home here? Are there people who share their language, culture or interests?

For a full tour checklist and red flags, see how to choose a care place.

Easing the first weeks

Many people push back at first. That is common. After a few weeks of meeting people and joining activities, many come to look forward to going.¹ These steps can help.

1. Use simple, positive words. Some families call it "the club," "the center" or "your day program." Pick words your family member will accept. Do not argue about whether they need it.
2. Start small. A half day or two days a week may be easier at first.
3. Go often enough. Try at least twice a week for about a month. Going now and then does not let a person settle in.¹
4. Share who they are. Tell staff about the person's past work, hobbies, favorite music, foods and what calms them. Staff can use this to connect.
5. Keep goodbyes short. A warm, quick goodbye is often easier than a long one. Staff can help with the hand-off.
6. Keep the rest of the day calm. A steady daily routine at home helps the center days fit in.
7. Check in with staff. Ask how the day went. Look at the plan again after a month or two.

What if my family member refuses to go?

Try again on a different day, with different words. Some people do better if a trusted doctor suggests it, or if the center is described as a place where they can help others. Talk with the center's staff. They have seen this many times. See talking with someone who has dementia.

I feel guilty using adult day care. Is that normal?

Yes. Many caregivers feel this way. But rest helps you keep caring for someone over the long run.¹ See caregiver stress and burnout.

When is adult day care no longer enough?

Look again if the person needs care at night, cannot travel safely, or needs more help than the center can give. The center may tell you too. Next steps can include in-home care, assisted living, memory care or a nursing home.

When to get help right away

You do not have to do this alone. For more ways to share the load, see caring for someone with dementia, caregiver training and support programs and your care circle.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.