In-home care

In-home care: how to find, compare and choose an agency

In-home care is non-medical help that lets an older adult keep living at home: bathing and dressing, meals, errands, medication reminders, company and safety. It is the kind of home care most families mean when they search for "home care near me". Here is what it includes, what it costs and how to check an agency.

The types of in-home care

What in-home care costs

The national median is about $35 an hour (CareScout 2025), roughly $3,000 a month for 20 hours a week, and it varies a lot by state. Most families pay privately. Medicaid waivers, VA benefits, long-term care insurance and local Area Agency on Aging programs can help. See rates in your state on our cost of care page and the programs on paying for care.

How to check an in-home care agency

Ask for the agency's state license or registration number and look it up on your state health department's website. Most states license or register home care agencies, but the rules vary, so ask what your state requires. Then ask: Are caregivers employees of the agency, or independent contractors from a registry? (Employees are trained, supervised and covered by the agency's insurance.) Are they background-checked, bonded and insured? Who supervises them, and how often does a nurse or care manager visit? What happens when a caregiver is sick? Is there a written care plan, and how are changes made? What is the minimum number of hours, and how much notice do you need to cancel? A good agency answers all of these in writing. Our guide to senior home care services has a longer checklist.

Signs it may be time to look for help

Most families do not decide in one day. They notice small changes first: unopened mail and unpaid bills, spoiled food in the refrigerator, a stack of laundry, missed medication reminders, new bruises or a fall, weight loss, or a parent who stops going out. Another sign is the caregiver, not the parent: a spouse or adult child who is worn out, missing work or sleeping badly. Care does not have to start at full time. Many families begin with a few hours twice a week for meals, bathing help and errands, and add hours as needs grow.

What a first visit looks like

A good agency starts with a free in-home assessment, usually with a care manager or nurse supervisor who meets your family member and anyone who helps with decisions. They look at the home for trip hazards, ask about routines, meals, sleep and what the person wants to keep doing, and write a care plan that lists tasks by day. You should receive the hourly rate, the minimum hours, the cancellation terms and a written service agreement before care begins. Ask to meet or at least speak with the caregiver who will be sent, and ask what happens when that person is sick or on vacation.

How hours and schedules work

Agencies bill by the hour, and most have a minimum visit of two to four hours. Companion and homemaker help is often scheduled in a few blocks a week. Personal care such as bathing is often placed in the morning or evening. Overnight, 24-hour and live-in care are priced differently, usually as a flat shift or daily rate, and are covered in their own guides above. Weekend, holiday and overnight hours can carry a higher rate, so ask for the full rate sheet.

In-home care compared with other options

In-home care keeps a person in familiar surroundings and lets families pay only for the hours needed, which is often the lower-cost choice when help is needed part of the day. Moving to a community with meals and daily help can be a better fit when someone needs support around the clock and prefers company, or when the house itself has become unsafe. Families often use both over time: in-home care first, then a move. Our cost of care page shows hourly rates by state so you can compare hours at home against a monthly community fee.

Making the home safer

Small changes help whether or not paid care is in place: good lighting on stairs and hallways, grab bars and a non-slip mat in the bathroom, loose rugs removed, a phone within reach, and the walk to the mailbox or front steps kept clear. A caregiver can reinforce these habits, keep the kitchen and refrigerator in order and notice changes early, then pass them on to the family.

Memory care at home

Memory care at home is in-home care from caregivers trained to support someone with Alzheimer's disease or another dementia. It keeps a person in familiar surroundings, which often eases confusion, and lets the schedule grow as needs change. Ask any agency how many hours of dementia training its caregivers have and whether it is ongoing, how it keeps the same caregivers week to week, how caregivers handle wandering, sundowning and refusals of care, and whether it can provide overnight or awake care when needed. Our dementia care guide covers what to ask before you hire.

In-home care listings by state

Our city lists come from two kinds of data, and every page says which. In 19 states we start from the state license roster, check each license against the state record and show the license number and the date we checked it. In the other 32 states there is no usable public roster of non-medical home care agencies, so we rank the agencies with the best public reviews and say plainly that we have not verified their licenses: ask each agency for its license or registration number if your state requires one. Either way, a listing does not mean we have reviewed an agency's care, and any paid placement is labeled. Browse every state below, or apply if your agency isn't listed.

Find an agency near you

Enter a city or ZIP code to see top-rated in-home care agencies, or pick a state above.

Questions about in-home care and memory care