Compare in-home dementia care by matching safety supervision, health and medication needs against what each agency offers, staffs, and charges. Shortlist only licensed agencies with dementia training, supervised caregivers, and clear hourly rates. In-home dementia care means paid support at home with supervision, personal care, and daily routines for a person living with dementia. The need is urgent because nearly 13 million Americans provided unpaid dementia care in 2025, delivering more than 19 billion hours valued at over $446 billion, according to the Alzheimer's Association in its 2026 Facts and Figures report.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- Start with the care needs you must cover
- What should you ask every agency?
- How do hourly rates compare?
- What will Medicare and Medicaid actually pay?
Start with the care needs you must cover
List what a day actually requires. Note wandering risk, nighttime supervision, bathing, meals, toileting, medications, and medical tasks. Note what family caregivers already do and where gaps appear.
Use that list to rule options in or out. In-home care fits when the person wants to stay home and needs personal supervision plus daily help. Consider adult-day or residential care when safety needs exceed what one caregiver at home can cover.
What should you ask every agency?
Ask the same questions of each agency so answers can be compared. The Alzheimer's Association advises asking every in-home agency whether it is licensed or accredited, whether criminal background checks were conducted, what dementia training caregivers receive, and who supervises care, as detailed in its checklist for choosing an in-home care professional.
Ask for the plan in writing. Confirm who will visit, how changes are communicated, and how concerns reach a manager after hours.
- License or accreditation status and how to verify it
- Background checks, dementia training hours, and continuing education
- Supervisor name, visit frequency, and backup plan for callouts
- Tasks covered, tasks excluded, hourly minimums, and cancellation terms
How do hourly rates compare?
Get itemized quotes for the same schedule from at least three agencies. Compare base hourly rate, evening and weekend rates, minimum hours, and fees for holidays or short shifts. Ask what triggers a rate increase, such as higher care needs.
Use a national benchmark to test quotes. The national median rate for non-medical in-home caregiver services was $35 per hour in 2025, or about $80,080 yearly at 44 hours weekly, according to CareScout and Genworth in the 2025 Cost of Care Survey results. A quote far above that figure should include clearly stronger staffing, training, or supervision.
What will Medicare and Medicaid actually pay?
Separate skilled home health from long-term custodial care. Medicare covers only part-time skilled home health, not 24-hour custodial dementia supervision, while Medicaid Home and Community-Based Services waivers can fund in-home personal care but vary by state and generally exclude room and board, according to the National Institute on Aging in its guide to getting help with Alzheimer's caregiving.
Ask each agency which payer each service will bill. For Medicaid waivers, confirm state eligibility rules, covered hours, waiting lists, and any costs the family must still pay.
