What is in-home care?

What is in-home care?

In-home care — also called home care, at-home care or care at home — is practical help that lets someone keep living where they already live instead of moving to a facility. It covers the tasks that get hard with age, illness or disability, and it supports daily living. Home care help includes getting washed and dressed, getting to the bathroom, making meals, keeping the house safe and getting to appointments.

Most older adults want to stay at home. Home care is what makes that possible for people who can no longer manage every part of daily life. Home care at home costs far less than a nursing home, and care in the home keeps people near family, neighbours and routines they know.

The words vary. Some people type "in home home care" into a search bar, and in Britain the same service is called home help or domiciliary care. Whatever the label, it means one thing: care in home, not in a building run by someone else.

Home care services: the kinds of help you can get

Home care services fall into three groups. Most families need some of each, and a good care plan mixes them.

Personal care

Hands-on help with bathing, dressing, grooming, toileting, moving from bed to chair and eating. This is the core of in-home care assistance and the part families find hardest to do alone. Medicaid calls it personal care; see personal care services.

Home help and homemaker services

Light housekeeping, laundry, meal preparation, shopping and errands. These in-home help services keep a house running when someone can't. Home help care services are often the first thing families arrange, long before anyone needs help in the shower.

Companionship and supervision

Conversation, walks, hobbies and simply being there — especially for someone with memory loss who shouldn't be alone. Much of the job is simply helping. Home carers who show up on a schedule also notice when something is wrong.

Put together, these care services at home are sometimes sold as in-home assistance, at-home assistance or home assistance services. They're the same thing: assistance at home with the tasks of daily life, sometimes called in-home care and assistance or at-home care assistance. The help in-home care provides doesn't have to be a big package — at-home care services and other care-at-home services can start with one visit a week.

Who provides in-home care: home carers, aides and attendants

The person who shows up has many titles — in-home caregiver, home care worker, home care attendant, home help aide, personal care aide, caregiver aide or, in older usage, care takers. Some people still write "home help aid". The job is the same: an in-home care aide who helps with daily living.

• Agency aides. A home care agency hires, trains, insures and schedules the caregiver. You pay the agency. See how to choose a home care agency.
• Independent caregivers. You hire a home care caregiver directly, often for less per hour, and you take on the employer's role. See private pay home care.
• Home health aides. Aides with extra training who work under a nurse, often through a home health agency. See what a home health aide does.
• Family members. A son, daughter, spouse or friend who gives care — and who can often be paid for it through Medicaid.

Medicaid programs often call the worker a personal care attendant, so you'll see the phrase PCA caregiver on forms. A home care taker, an in-home care taker and an at-home caregiver are all the same role. Whether you hire at-home carers or other caregivers for home care from an agency or on your own, and whatever the care in-home caregivers give, the home care person you choose matters more than the label on their badge.

Caregiver duties: what an in-home caregiver does

A written care plan lists a caregiver's duties so everyone knows what to expect. A typical day for a caregiver at home might include:

1. Helping the person get up, use the bathroom, wash and dress.
2. Making breakfast and giving medication reminders.
3. Tidying the kitchen, doing a load of laundry and changing the bed.
4. A walk, a card game, a drive to the doctor or pharmacy.
5. Lunch, rest, and a check that the home is safe before leaving.

Non-medical caregivers usually can't give injections, change sterile dressings or adjust medications. Those tasks belong to a nurse. Each state draws the line a little differently, which is why care and help home care workers can give depends on your state's rules. Our non-medical home care guide covers the details, and in-home nursing care covers the medical side.

Home-based care vs. home health: which do you need?

Both are home-based care, but they solve different problems. Home health is skilled, short-term care ordered by a doctor after a hospital stay or illness: visiting nurses and therapists who come for an hour or so. Visiting home care services from a non-medical agency are about daily living, and they can continue for years.

Many people need both at once. Read the full comparison in home health vs. home care.

From a few hours to long-term in-home care

Not all home care is the same size. Most families start small and add hours as needs grow.

• A few hours a week — a bath, a clean kitchen, a ride to the doctor. See part-time and short-term home care.
• Daily visits — mornings and evenings, the times people most need hands-on help.
• Round the clock — shifts of aides covering day and night. See 24-hour home care.
• Live-in care — one caregiver who lives in the home and sleeps there. See live-in caregivers.

Long-term in-home care is where costs add up and where Medicaid matters most. If the goal is stay-at-home care, or stay-home care for years, plan the money early — see how families pay below.

In-home care vs. assisted living

Many families compare home care with a move to assisted living. Some want in-home assisted living services — the help an assisted living caregiver gives, without the move. There's no licensed category called assisted living at home services, but that's essentially what in-home care is: assisted in-home care, built around the person rather than the building.

Assisted home care services make the most sense when someone needs help with specific tasks, has a safe home and has family nearby. Assisted living makes more sense when someone needs supervision all day and lives alone. CareScout's 2025 survey put the national median for assisted living at $6,200 a month. Whether you call it in-home living assistance or in-home living care, the question is the same: can the right amount of help come to the house?

Families who want home care living arrangements to work over the long term usually combine paid hours with family help and adult day programs. Those are the main homecare alternatives to a facility, and our assisted living vs. home care comparison walks through the numbers.

Signs it's time for in-home help

Families usually notice small changes before they ask for assistance. Home care often starts after small signs: unopened mail, spoiled food, missed pills, a fall nobody mentions. Any of these is a reason to look at in-home help.

• Trouble bathing, dressing or getting to the bathroom safely.
• Weight loss or skipped meals.
• Missed medications or doctor visits.
• A fall, or fear of falling, that keeps them in one chair.
• A growing need for hands-on personal care. Caregivers who spot this early can add hours before a crisis.
• A family caregiver who is exhausted — see respite care.

The aim is to protect daily life. Home care independence means doing what a person still can and getting help with the rest — not handing everything over. Starting early, with a few hours, is easier than starting in a crisis.

How to arrange home care services, step by step

1. List the needs. Write down what help is needed and when — mornings, nights, weekends.
2. Check how you'll pay. Private funds, Medicaid, the VA or insurance each lead to a different route. Check Medicaid eligibility first; it changes everything.
3. Decide who gives care. An agency, an independent caregiver, a family member, or a mix.
4. Interview and vet. Ask about background checks, training, backup staff and supervision.
5. Write a care plan. Tasks, schedule, emergency contacts, and who to call when a shift is missed.
6. Review after a month. Needs change. Adjust hours before problems grow.

Every state runs its home care system a little differently. The Medicaid home care program in your state may call it personal care, attendant care or a waiver, and each has its own intake. Our Medicaid home care guide explains the paths, and our state list shows yours.

Choosing a home care agency or an independent caregiver

Agency names tell you little. Many are built from the same words — home care solutions, at-home solutions, helping hands — and searches for names like "Because We Care" or "Help and Home" often turn up several unrelated businesses in different states. Every agency is some kind of business, often a home care LLC, so judge each one on what it does, not what it's called.

Ask any agency whether it is licensed in your state, how it screens caregivers, whether aides are employees or contractors, and what happens when a shift is missed. Our checklist for choosing a home care agency has the full list, and local home care agencies compared shows how small agencies stack up against franchises such as Home Instead and Right at Home.

Finding in-home care near you

Care at your home depends on who serves your area, so start local. Your Area Agency on Aging and county options are the best first call, and your state Medicaid office can tell you which agencies take Medicaid.

For care in your own home in a big county, look at the county page: Kings County (Brooklyn), Los Angeles County, Cook County, Harris County, Miami-Dade or Maricopa County. Our home care by city guide covers more.

If you're a stay-at-home caregiver for a relative, or arranging care in my home for yourself, the same steps apply — and you can be the employer who hires and directs the help. Help from home — calls, video check-ins and apps — can fill small gaps between visits; see caregiver apps.

What in-home care costs

CareScout's 2025 Cost of Care Survey put the national median for a non-medical caregiver at $35 an hour, or $80,080 a year at 44 hours a week. Homemaker and home health aide rates have converged so closely that the survey now reports them as one category.

Local prices vary widely. See the cost of in-home care for how to estimate your own.

How families pay for in-home care

Home care services in the USA are paid for in five main ways:

Medicare's home health benefit excludes 24-hour care, homemaker services unrelated to a care plan, and personal care when that's the only care needed, according to Medicare.gov. That surprises many families. Medicaid is the program that pays for ongoing home care, including care from relatives.

Family caregiver services: getting paid to give care at home

Many families already give care at home and care for a relative without pay. Medicaid in every state can pay a family member instead of an outside aide. Your relative qualifies, chooses you, and the program pays you for the hours an assessment approves. That makes you the provider of in-home caregiver services — and the person they trust most.

These family caregiver services go by different names: CDPAP in New York, IHSS in California, IRIS in Wisconsin, Structured Family Caregiving in several states. All are forms of consumer-directed care. Some home care agencies also hire family members to provide at-home caregiver services.

Home caregiver services from family also leave room for others: many households mix family help and home care hours from an agency, or bring in a home helper. Home care from outside fills the shifts family can't. Compare the trade-offs in agency care vs. a paid family caregiver.

In-home care by state

Programs differ by state. A few examples from our state pages:

• California home care for Medicaid members runs through IHSS, where the county sets the hours and relatives can be hired.
• For home care, Florida uses the Statewide Medicaid Managed Care long-term care program; see home care in Florida.
• For in-home care, Massachusetts has the PCA program and Adult Foster Care — see Massachusetts.
• For care at home, CT residents can use Community First Choice or Adult Family Living; Connecticut in-home assistance explains both.
• For home care, NJ residents can self-direct through Personal Preference; see New Jersey.
• For home care, Delaware offers self-directed attendant care — see Delaware.
• For in-home care, South Carolina runs Community Choices; see South Carolina.

New York and Pennsylvania have their own guides: home care in New York and home care in Pennsylvania.

Where to go next

In-home care works best when the help fits the person's daily life. Home comforts, familiar faces and a plan that grows with their needs matter more than any label.