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The state should support elderly adults who want to age in place

Heidar Ali Khoshvaghti (left) and Masoud Ansari dance to Persian music at Loving Care Adult Day Care in Gaithersburg, Md., in 2013.
Heidar Ali Khoshvaghti (left) and Masoud Ansari dance to Persian music at Loving Care Adult Day Care in Gaithersburg, Md., in 2013. (LINDA DAVIDSON/THE WASHINGTON POST)

In honor of National Adult Day Services Week (September 17-23), medical adult day services providers across Maryland have been welcoming local and state legislators to their facilities to tour and learn just how important these programs are to our communities. Medical adult day services are community-based programs that allow the elderly and adults with physical and/or mental disabilities to remain in their homes and receive health monitoring, socialization, daily meals and nursing care in a safe and structured environment during the day. There are more than 126 medical adult day centers located throughout the state caring for nearly 5,000 clients per day. Without medical adult day services, many clients would need to be in nursing facilities at a much higher cost to the state.

Keswick's Medical Adult Day program for older adults, for example, serves clients daily with a focus on individualized memory care. We offer an interdisciplinary team that includes a registered nurse, social worker, dietitian, activities specialist and physical, occupational and speech therapists with expert knowledge of geriatric and dementia care. Our program and others like it provide resources to each client that they would receive no other place than a full-time nursing facility. Adult day services help seniors in our community get the resources they need during the day — like medicine administration, a healthy lunch and snacks, socialization with others, stimulating activities and diverse therapies — while allowing them to still reside in their homes. Additionally, adult day programs are a respite service for caregivers, helpful in reducing the level of stress that they may encounter. Arguably most important, it preserves independence as much as possible for as long as possible for clients. It is clear that adult day services benefit the client, their families and our community.

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Centers have seen significant increases in transportation, food and medical supply costs. Most notable has been the significant increases in labor and employee benefits. Over the last four years, minimum wage rates and premiums for family coverage for employer sponsored health insurance have increased, far exceeding state reimbursement levels. Unlike other businesses that can pass on costs to consumers, centers do not have this option because many clients are either on Medicaid or receive subsidies through the state grant program. Many centers across the state are already struggling to stay open as the cost to operate per day increases and the state reimbursement rate remains the same.

Our goal is to ensure medical adult day services remain viable in these uncertain times. Adult day programming is a beneficial community health resource not only to the clients we serve, their families and caregivers but also economically for the state.

By 2030, 25 percent of Maryland's projected population of 6.7 million will be 60 years or older. Health, safety and caregiver needs are all challenges that adult day programs help alleviate, and we know that the programs are invaluable to families that want to ensure their loved ones are safe when they cannot be there with them. Medical adult day rates to cover the cost of providing care must be properly funded and reimbursed by the state for these day programs to survive, particularly as more people wish to age at home.

Carmel Roques (RoquesC@ChooseKeswick.org) is the CEO of Keswick Mutli-Care and Keswick Community Health Services; the latter oversees the organization's Medical Adult Day programming. Keswick's Medical Adult Day program is celebrating 30 years in operation this month.

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