Home Care in Texas: Licensed In-Home Care Agencies by City

Aging at home in Texas

Texas has a younger population than most states, with 14.0 percent of residents 65 or older, but with roughly 31 million residents that still adds up to millions of older adults. The largest groups live in the Houston, Dallas-Fort Worth and San Antonio areas, while Hill Country towns include growing retirement developments. Older Texans in Houston's Montrose, Dallas's Lakewood or San Antonio's King William district live in very different places from a parent in El Paso, Lubbock or McAllen. For families, the state's size, more than any single rule, shapes what in-home care looks like.

14% of Texas residents are 65 or older. Source: U.S. Census Bureau Population Estimates, Vintage 2024, July 1, 2024 (civilian population, computed from single-year-of-age file; the Vintage 2025 file puts it at 14.9).

Cities, towns and neighborhoods we cover

Houston's Midtown, Heights, Third Ward and Museum District neighborhoods sit near Space Center Houston and the Gulf Coast. In North Texas, Dallas stretches from Oak Lawn and Uptown to Oak Cliff and Lakewood, with Fair Park to the south. San Antonio's River Walk, the Alamo, King William and Stone Oak cover another large market, and Austin and the Hill Country lie nearby. Corpus Christi and McAllen lie on the coast and border. Far to the west, El Paso is a separate world in the desert, and Lubbock and Amarillo serve the Plains and the Panhandle, far from the Gulf Coast. Families outside the metros should ask how far agencies travel.

• Houston: Montrose, Houston Heights, Midtown, Third Ward, Museum District
• San Antonio: King William Historic District, Monte Vista Historic District, Stone Oak
• Dallas: Oak Lawn, Uptown, Deep Ellum, Oak Cliff, Lakewood, Bishop Arts

Regions

• Gulf Coast: The Houston and Galveston area, humid and exposed to hurricanes and flooding
• Texas Hill Country: Central and South Texas region, rugged karst terrain with growing suburbs and retirement developments
• Texas Panhandle: The northernmost 26 counties, semiarid and snowier than the rest of the state, centered on Amarillo
• Rio Grande Valley: The far southern tip around McAllen and Brownsville, with a seasonal influx of Winter Texans
• Trans-Pecos (Big Bend Country): West Texas Chihuahuan Desert, canyons and isolated mountain ranges, including El Paso

Familiar places

The Alamo, San Antonio; San Antonio River Walk, San Antonio; Space Center Houston, Houston; Fair Park, Dallas; Palo Duro Canyon, near Amarillo; Big Bend National Park, West Texas; Padre Island National Seashore, South Texas coast.

Planning care around Texas's seasons and geography

Texas weather risks depend entirely on where a client lives. Along the Gulf Coast, hurricane season and flooding are the big concerns, and families near Houston remember Harvey in 2017. Summer heat is severe statewide, with humidity making it feel worse in the east. Texas also ranks first among states for tornadoes. Winter is the surprise: the February 2021 freeze showed that a long outage in cold weather can be serious. Ask any agency what its plan is for storm days, power outages and extreme heat, and who checks on a client when a caregiver cannot get to the house.

• Texas ranks first in tornado occurrence with an average of 139 a year, and its climate runs from humid subtropical in the east to semiarid in the west and arid in the far west.
• Flooding is a recurring problem around Houston, from Tropical Storm Allison in 2001 to Hurricane Harvey in 2017, and humidity amplifies the feeling of summer heat in the eastern half of the state.
• Winter Storm Uri in February 2021 caused the largest power crisis in the U.S., with an estimated 700 deaths, so a long outage in winter is a real planning risk even in a hot state.
• The state is huge and varied: El Paso lies in the Chihuahuan Desert at 3,740 feet, the Panhandle gets 15 to 30 inches of snow a year in places, and the Rio Grande Valley is a target for hurricanes.

Texas resources for families

• Licensing. Yes. HHSC licenses Home and Community Support Services Agencies, and the Personal Assistance Services category covers routine, ongoing non-medical help with daily living and respite in a person's residence. Confirm current requirements with the state before you hire. Texas Health and Human Services Commission (HHSC), Home and Community Support Services Agency (HCSSA) licensing
• Aging services. Texas has 28 Area Agencies on Aging serving people 60 and older. Call the AAA toll-free line at 1-800-252-9240 or use the Find Services page at resources.hhs.texas.gov/pages/find-services to reach the one for your county. Texas Health and Human Services Commission (HHSC), Area Agencies on Aging
• Help paying. Texas's Medicaid home and community-based program for older adults is STAR+PLUS Home and Community Based Services (STAR+PLUS HCBS) program. Eligibility is based on income and care needs.