Home Care in North Dakota: Top-Rated In-Home Care Agencies by City

Aging at home in North Dakota

North Dakota is home to roughly 800,000 people, and 17.3 percent of them are 65 or older. Nearly a fifth of the state lives in Fargo, which leaves the rest to Bismarck, Grand Forks, Minot, Williston and a great many small towns on the plains. The flat Red River Valley in the east, the Missouri River country around Bismarck and Mandan, and the Badlands in the west each present different settings. A parent in Fargo can often find several choices, while a parent in a county seat farther west may find one or two.

17.3% of North Dakota residents are 65 or older. Source: America's Health Rankings, citing U.S. Census Bureau Single-Race Population Estimates via CDC WONDER, 2024.

Cities, towns and neighborhoods we cover

Fargo's Roosevelt neighborhood, Horace Mann area and downtown sit near the Red River, and Grand Forks has its Near Southside Historic District and University Village. In central North Dakota, Bismarck's Cathedral District and Downtown Historic District lie close to the State Capitol, with Mandan across the Missouri River. Minot, Williston and Dickinson serve the north and west, where the Bakken oil region and Theodore Roosevelt National Park bring a different mix of residents. Lake Sakakawea and Devils Lake offer outings. Care needs differ most by distance, since some clients live a long drive from the nearest town.

• Fargo: Roosevelt, Horace Mann, Riverview, Downtown Fargo
• Bismarck: Cathedral District, Downtown Historic District, Northern Bismarck
• Grand Forks: Near Southside Historic District, University Village, Reeves Drive neighborhood, Downtown Grand Forks

Regions

• Red River Valley: flat eastern North Dakota on the bed of glacial Lake Agassiz, with fertile farmland and Fargo and Grand Forks
• Missouri Plateau: central region along the Missouri River, including Bismarck and Mandan
• Badlands: western half of the state, hilly Great Plains with Theodore Roosevelt National Park
• Bakken: oil-producing area in the western part of the state, around Williston

Familiar places

Theodore Roosevelt National Park, Badlands; North Dakota State Capitol, Bismarck; Fargo Theatre, Fargo; Lake Sakakawea, Missouri River; Devils Lake, eastern North Dakota; Ralph Engelstad Arena, Grand Forks; Geographic Center of the North American Continent marker, Rugby.

Planning care around North Dakota's seasons and geography

Cold and flooding set the calendar. Fargo's average January temperatures are 18 degrees F for the high and 0 for the low, and Grand Forks runs colder, so a heating plan and a safe walkway matter. Spring melt is the flood season in the Red River Valley: the river crested at 39.5 feet in 1997 and a record 40.84 feet in 2009, and Grand Forks was devastated in 1997. Families near the river should know their evacuation route. Summers are warm, and many rural clients live far enough from town that a late winter storm can interrupt a visit for days.

• North Dakota's statewide population was 799,358 in 2025, and Fargo alone accounts for nearly a fifth of it, so most of the state is sparsely settled.
• Average January temperatures run from 18 degrees F high and 0 low in Fargo to 16 high and minus 3 low in Grand Forks.
• The Red River Valley is flat and floods: the Red River reached a record 40.84 feet in Fargo in 2009 after 39.5 feet in 1997.
• The 1997 flood devastated Grand Forks, which later built levees and converted part of the floodplain into the Greater Grand Forks Greenway.

North Dakota resources for families

• Licensing. North Dakota licenses home health agencies that meet the statutory definition of skilled home health services, and secondary sources report that agencies providing only companion or personal care are not state licensed but must enroll as Qualified Service Providers to serve Medicaid clients; confirm with the state. North Dakota Health and Human Services, Health Facilities
• Aging services. Call the Aging and Disability Resource Link at 1-855-462-5465 (confirm number on the state site) to be connected to local services and long-term care options. North Dakota Health and Human Services, Aging Services Division
• Help paying. North Dakota's Medicaid home and community-based program for older adults is Medicaid Home and Community Based Services (HCBS) waiver, with the state-funded Service Payments for Elderly and Disabled (SPED) program. Eligibility is based on income and care needs.