How to choose an adult day program — what to look for

This article is for informational purposes only and does not constitute medical, legal, or financial advice. Please consult appropriate professionals for guidance specific to your situation.

Once you've decided an adult day program might work for your situation, you need to find one and then figure out whether it's actually right for your parent. There are probably not a ton of options in your area. You might have two or three programs to choose from. The question is: which one will work best for your parent, and how do you figure that out without just guessing?

The answer is to visit, to watch, to ask a lot of questions, and to trust your instincts about whether the people there actually care about the people attending. You're looking for a place where your parent could spend five days a week and actually benefit, not just be warehoused. You're looking for staff who remember your parent's name, who notice their moods, who try to engage them in the day. That matters more than fancy activities or expensive equipment.

Your parent's buy-in also matters, maybe more than you think. If you choose a program they hate and refuse to attend, it doesn't work. So you need to choose somewhere that feels right not just to you, but to them.

Evaluating Program Quality

Start with the basics. Does the program have proper licensing? Is the facility clean and safe? Are there bathrooms that are accessible and clean? Is there adequate space? Are the chairs comfortable? These aren't small things. Your parent is going to spend six, seven, eight hours a day here. The environment matters.

Look at the activities. Watch what's happening. Is there a program going on, or are people sitting around watching TV? Are residents actually engaged or are they just present? Are the activities age-appropriate or do they feel infantilizing? Are there choices, or is everyone doing the same thing? A good program has a balance of structured activities and more relaxed time.

Watch how staff interact with participants. Do they speak to them respectfully or talk down to them? Do they call them by name? If someone asks a question, does staff answer or ignore it? If someone needs help, is help provided quickly? Can you see staff actually knowing the people they're caring for? This is where you trust your gut. If it feels cold and institutional, it probably is. If it feels warm and personal, you're onto something good.

Ask about staffing ratios. How many staff members are there relative to how many participants? What's their training? Do they have certifications in dementia care or first aid? How long have they been there? High turnover is usually a red flag, because it means staff relationships are constantly starting over.

Ask about medication management. How do they handle people's medications? How do they keep track of who takes what? What's the protocol if someone refuses medication or has a medication error? This matters if your parent is on any medications that need to be taken during the day.

Look at the food. What kind of lunch and snacks are provided? Can they accommodate dietary restrictions? Is food fresh and actually appealing, or does it look institutional? For some people with dementia, eating becomes complicated. Your parent needs food that tastes good and looks good, not something that seems punitive.

Ask about their approach to people who are struggling. What do they do if someone is refusing to participate? If someone is agitated? If someone is having a hard day? Do they have strategies for that, or do they just wait it out? Do they call you? At what point would they say your parent is not a good fit for the program?

Your Parent's Fit

Beyond the program quality, you need to think about whether this particular program is right for your particular parent. Is there anyone there your parent might connect with? Does the program have people they might like? Would they have something in common to talk about?

Watch the mix of participants. If your parent is more cognitively intact, would they get bored around people who are more impaired? Or would they be comfortable in that mix? If your parent is more significantly impaired, would they be able to participate in activities designed for the more intact group? The fit between your parent and the other participants actually matters.

What about transportation? Is pickup time convenient? Is drop-off time what works for you? Are the pickup and drop-off locations accessible? Can your parent physically manage the transfer to and from the van?

Does your parent meet the criteria for the program? Some programs won't accept people who are in too early stages of dementia because they'd be bored. Some won't accept people in too advanced stages because they can't provide the level of care needed. Some won't accept people with certain behavioral issues. You need to be honest about where your parent falls and whether this program accepts people at their level.

Most importantly, does your parent want to go? You can't force an adult to go to day program every day if they're determined to resist. Some parents warm up to the idea once they're there a couple times. Some never do. You need to at least try, to talk to your parent about it in a way that makes sense to them, to see if they can imagine themselves there.

What to Watch For

After your parent starts, pay attention to how they're responding. Are they coming home happy or angry? Are they talking about things they did? Are they mentioning staff by name or friends they've made? Or are they refusing to go, complaining the whole way, coming home miserable?

Some resistance is normal in the first weeks. People are settling in. But if after a month your parent still hates it and you're forcing them to go every day, that's not working.

Pay attention to the relationships between staff and your parent. Do the staff seem to know your parent? Do they ask you about your parent's preferences, their history, their interests? Do they try to adjust activities based on what your parent responds to? Good programs personalize the experience. Bad programs have a one-size-fits-all approach.

Notice if the program is actually engaging your parent's abilities or if they're sitting around doing nothing. Some days your parent will be tired or low energy, and that's fine. But if every day is unengaged passivity, that's a program issue.

Pay attention to your parent's physical health too. Are they eating enough? Are they coming home with accidents or injuries? Are they sleeping well? Sometimes shifts in physical health can indicate that the program isn't working out.

Talk to staff regularly. Ask how your parent's day was. Are there things you should be doing at home to support them? Are they noticing changes in your parent? A good program communicates with families about what's happening during the day.

A good fit means your parent is getting something out of the program. They're socially engaged. They're doing activities that matter to them, even if those activities are simple. They're somewhere safe. You can work without worrying about what they're doing. That's the goal. If the program is delivering that, you've found a good one. If it's not, keep looking or decide that day program isn't going to work for your situation.

How To Help Your Elders provides educational content for family caregivers. This is not a substitute for professional medical, legal, or financial advice. Every family situation is different — what works for one may not work for another.