One of the Foundation's priorities is to help communities improve their capacity to deliver services to chronically ill people, including those with Alzheimer's disease and the frail elderly. The Foundation's strategy is to promote the use of both formal services and, perhaps more important, informal services provided by families and friends. Adult day care, the topic of this chapter, provides formal services that do not supplant informal services. Instead the services provided by adult day centers allow chronically ill people to continue living at home. The centers help informal caregivers by providing services during work hours, when many family members are not able to look after their loved ones.
Since 1987, the Foundation has supported a series of programs to test the usefulness of adult day care and then to promote its replication. This chapter presents a history of the three distinct investments made by the Foundation on this topic. In many ways, this cycle represents the archetype of the Foundation's approach to grantmaking: A Phase I program, in this case the Dementia Care and Respite Services Program, runs a demonstration to test a new idea. A Phase II program, Partners in Caregiving: The Dementia Services Program, expands the program to other locations, and a Phase III program offers technical assistance and guidance to an even wider set of communities.