Home Care in New York: Licensed In-Home Care Agencies by City

Aging at home in New York

New York is two states in one for older adults. The Downstate area and lower Hudson Valley hold about two-thirds of residents, so 18.9 percent of the population aged 65 or older is largely a story of high-rise apartments, walk-ups and long subway rides in places like Queens, Brooklyn and Riverdale. Upstate, the picture is of mid-size cities such as Buffalo, Rochester, Syracuse and Albany, plus mountain and lake country where homes are far apart. Families moving a parent between these settings should expect care to look very different, even when the hours of help are the same.

18.9% of New York 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

In New York City, neighborhoods such as Astoria, Flushing, Jackson Heights, Park Slope and Riverdale each have their own languages and building types, and getting a caregiver to a fifth-floor walk-up is a different problem from visiting a house. Upstate, Buffalo's Elmwood Village, Allentown and Black Rock and Rochester's Park Avenue, Corn Hill and South Wedge offer older housing close to services. Albany, Schenectady and Troy form the Capital Region, Syracuse anchors Central New York, and Niagara Falls, the Finger Lakes and the Adirondacks draw visitors and shape where care is easy to arrange.

• New York City: Astoria, Flushing, Park Slope, Riverdale, Jackson Heights
• Buffalo: Elmwood Village, Allentown, Black Rock, Larkinville, University Heights
• Rochester: Park Avenue, Corn Hill, South Wedge, Charlotte

Regions

• Downstate: New York City and Long Island; with the lower Hudson Valley it holds about two-thirds of the state's population
• Capital Region: Albany, Schenectady and Troy
• Western New York: Great Lakes region on Lakes Erie and Ontario, home to Buffalo and Rochester
• Finger Lakes: lake region between Central and Western New York
• Adirondacks: northeastern mountains, where Mount Marcy is the state's highest point

Familiar places

Central Park, New York City; Grand Central Terminal, New York City; Niagara Falls, Western New York; Peace Bridge, Buffalo; Darwin D. Martin House, Buffalo; Highland Park, Rochester; Mount Marcy, Adirondacks.

Planning care around New York's seasons and geography

Lake-effect snow is the defining season in Western and Central New York. Buffalo averages about 95 inches a year and Rochester just over 100, and the Blizzard of 1977 and the November 2014 storm are remembered for their depth and speed. Families should plan for snow removal, a safe entrance, and what a caregiver does when roads close. Downstate winters are milder and the climate is warmer and more humid, so summer heat in apartments without air conditioning is the bigger worry. Because the state is large, ask any provider which counties and boroughs they actually serve.

• Buffalo averages about 95 inches of snow a year and Rochester just over 100, mostly lake-effect snow from Lake Erie and Lake Ontario.
• Buffalo's November 2014 storm dropped more than 66 inches of snow, and the Blizzard of 1977 combined high winds with snow on land and frozen Lake Erie.
• Most of Upstate New York has a humid continental climate, while Downstate has a warmer humid subtropical climate.
• About two-thirds of the population lives in the Downstate area and lower Hudson Valley, so urban high-rise and walk-up access is a major factor there.

New York resources for families

• Licensing. Under Public Health Law Article 36, agencies providing nursing, home health aide or personal care services must hold a Licensed Home Care Services Agency (LHCSA) license, which is subject to a public need review. Ask whether a companion-only agency needs one and confirm it with the Department of Health. New York State Department of Health, Licensed Home Care Services Agencies
• Aging services. Find your local Office for the Aging or Area Agency on Aging through NY Connects or the NYSOFA site; NY Connects is run locally by AAAs, local social services departments and independent living centers. New York State Office for the Aging (NYSOFA)
• Help paying. New York's Medicaid home and community-based program for older adults is Medicaid Managed Long Term Care (MLTC). Eligibility is based on income and care needs.