Adult day care is a scheduled program with fixed open hours, fixed days, and a fee tied to the attendance you book. It is not the same thing as in-home hours, and it does not close the gap by itself. Before you enroll Dad, write down the hours when he cannot be left alone or cannot get through the day without another person. Then compare that list against the program's open hours, its transport window, and the days it runs. A program that opens at nine and closes at three leaves the early morning and the evening uncovered, and the family pays for those hours some other way.[1]

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

Write the gap as a list of hours

Build the list from a normal week, not from the best day. Mark the morning start, the midday stretch, the hours when the family member who helps is at work, and the end of the day. Note which of those hours need hands-on help and which need only someone in the room. Those two kinds of need are different, and a day program fits the second kind better than the first. Ask the program what staff-to-participant ratio it keeps and whether it provides personal assistance during the day, so you know whether the program covers the hours you marked.[1]

Check the transport and the return trip

Ask who drives Dad there and back, what the pickup window is, and what happens when the van is late or a trip is cancelled. Find out whether the program charges for a missed day, whether the fee is due on booked days or attended days, and what the notice period is for stopping. Get those answers in writing with the enrollment papers. A family that assumes a return trip is included often finds a second charge on the first bill.

Keep the program fee separate from the household bill

Keep the program's invoices, receipts, and attendance records in one folder. Do not assume a day program fee counts toward a VA pension claim. Whether an expense is counted as an unreimbursed medical expense is decided under VA's own rules, and a fee for supervision or company, as opposed to medical care, is not treated the same way.[2] Bring the question to the claims staff or an accredited representative before you list the fee, and keep the paperwork either way so the record is complete if VA asks.

Where to check next

If the program does not cover the early or late hours, the family has to decide how those hours are filled before the claim is sized. The Local Help page lists St. Louis offices that can explain the options in person.[3] The Sources page lists the VA.gov pages used for this briefing.[4]

Notes

  1. VA.gov, Aid and Attendance and Housebound benefits: https://www.va.gov/pension/aid-attendance-housebound/
  2. VA.gov, VA pension eligibility and income rules, including deductions for unreimbursed medical expenses: https://www.va.gov/pension/eligibility/
  3. Local Help: St. Louis Offices, https://aidandattendancestl.com/local-help.html
  4. Sources, https://aidandattendancestl.com/sources.html