According to the U.S. Department of Health and Human Services, informal care-giving is the dominant mode, by far, of providing long-term care services to the elderly. Changing demographics including a swelling elderly population, a simultaneous decline in fertility and mortality rates, a woman's accelerated entry into the labor force and the increasing obsolescense of a two-parent, stay-at-home wife, the June and Ward Cleaver scenario, have caused significant strain to this informal arrangement of elderly care provision.
Therefore, to maintain the family as primary purveyor of care for the elderly, the United States must consider substitute long-term care alternatives, like adult day care. "Achieving cost saving through community-based, long-term care depends on substituting community care for some institutionalized care. If alternatives supplement rather than substitute for institutional services, the additional service will add to the cost."
Adoption of long-term care alternatives, like Adult Day Care, could be cost-effective, would provide greater choice for patient and caregiver and would represent a movement toward long-term care which serves the medical, social and economic needs of the elderly; the acknowledgment and subsequent implementation of which is pivotal for effective and efficient long-term care policy.