It often starts with something small: a missed medication dose, a pot left on the stove, or a fall. For many families, these are the signs that it’s time to explore affordable home care or adult day services. Especially for adult children juggling jobs and kids of their own, that’s the moment the question changes from “How can we help?” to “How can we keep them safe without burning out?”
You are not alone in asking that. The U.S. is in a caregiving surge, with an estimated 63 million Americans providing care to a family member or friend.1 And while nursing homes and assisted living get most of the attention, many people want something else: support that lets their loved one stay connected to home, community, and dignity.
Two options can be game-changers, and they’re often more affordable than people assume: in-home care and adult day services.
This guide breaks down what they are, why they matter, what they typically cost, and exactly how to find trustworthy, budget-conscious options in your metro area.
What “in-Home Care” Actually Means
“In-home support” is a broad phrase. In practice, it usually means help that makes everyday life safer and more manageable inside the home.2 It can include assistance with bathing, dressing, using the bathroom, meal preparation, light housekeeping, medication reminders, errands, or getting to appointments. Some families need a few hours a week. Others need daily coverage, especially after a hospitalization or as dementia progresses.2
One important distinction: not all in-home care is medical care. A personal care aide may help with daily tasks, while home health services may include skilled nursing or therapy.
Medicare does cover certain home health services for people who qualify, but it’s typically part-time or intermittent and tied to a medical need, not long-term “custodial” help. That’s why so many families end up piecing together support from multiple places: a mix of family caregiving, community services, and paid help when possible.2
What Adult Day Services Are, And Why They’re Underused
Adult day services (also called adult day programs or adult day health) are community-based centers that provide supervised care during the day. Many offer meals, social activities, exercise, health monitoring, and support for people living with dementia or chronic illness.3
They can also provide transportation in some areas, which matters when a loved one can’t drive safely anymore.3
The overlooked point is this: adult day services are not just “daycare for seniors.” Done well, they reduce isolation for the participant and give caregivers something many don’t get enough of: time to work, rest, attend appointments, and recover.3
Nationally, adult day services centers serve about 182,000 participants on any given day. That’s a meaningful number, and still small compared to the scale of caregiving in the U.S., which tells you how many families either don’t know about these programs or assume they’re out of reach.3
What These Services Typically Cost
Costs vary by city and provider, but having a baseline helps you plan. Adult day services are often one of the more affordable paid care options. The Genworth/CareScout Cost of Care Survey has reported a national median annual cost for adult day care around $26,000 (often translating to roughly $100/day depending on schedule and location).4
In-home care services are typically priced hourly, and the national median has been around the mid-$30s per hour in recent Cost of Care reporting.4
These numbers can feel overwhelming, but they’re also why it’s so important to understand payment pathways, sliding scales, and public programs that can bring costs down.4
Why Black and Brown Communities Often Face Bigger Barriers
The need is real across all communities, but access is not equal. Research on long-term services and supports shows that Black and Hispanic older adults often need care sooner and for longer periods, receive more unpaid care, and report more adverse consequences from unmet needs compared with white counterparts.5
In plain terms: our families are carrying more of the load, with fewer reliable supports.
At the same time, Black communities face higher rates of conditions like Alzheimer’s (dementia) and chronic conditions, which can increase care needs.5 The Alzheimer’s Association notes that older Black Americans are about twice as likely as older White Americans to have Alzheimer’s or another dementia, while also reporting barriers to getting excellent care and support.5
Structural realities add another layer: fewer nearby high-quality services, transportation barriers, job constraints (including less paid leave), and the lived experience of not being listened to when advocating for a loved one’s needs.5
This is why practical information is power. Knowing what exists, how to ask for it, and how to qualify can prevent months or years of avoidable strain.
Your Guide: How to Find Options in Your Metro Area
Step 1: Start with a “needs snapshot” before you call anyone
Before you search, write a quick, honest snapshot of what support is needed. This keeps you from getting overwhelmed or sold services you don’t need. Include:
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What your loved one can do independently (bathing, dressing, cooking, walking)
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Safety concerns (falls, wandering, leaving appliances on)
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Cognitive changes (memory, confusion, getting lost)
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Medical complexity (diabetes, dialysis, oxygen, recent hospitalization)
- Your coverage gap (days/times you can’t be there)
This snapshot becomes your script when you contact programs.
Step 2: Use the most reliable “front door” for local services
If you only do one thing, do this: contact your local aging network. The Eldercare Locator, a public service of the Administration for Community Living, connects you to local support by zip code and phone.
It’s designed to point you toward your Area Agency on Aging (AAA), which is the regional hub for many caregiver services, referrals, and sometimes subsidized programs.6
When you reach them, ask specifically for:
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Adult day services in your area (including dementia-capable programs)
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In-home personal care options
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Transportation assistance
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Caregiver respite funds or vouchers
- Benefits counseling (to figure out what your loved one may qualify for)
Step 3: Ask about Medicaid HCBS and waiver programs even if you “think you won’t qualify”
Medicaid’s Home and Community-Based Services (HCBS) are designed to help eligible people receive care at home or in the community rather than in institutions.
Even if your loved one isn’t currently on Medicaid, it can still be worth asking about:
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Functional eligibility (what level of help they need)
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Income/asset rules in your state
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Waitlists (many waiver programs have them)
- Whether adult day health, personal care, or respite services are covered
Because rules vary by state, your AAA or Medicaid office can help you navigate the local pathway.
Step 4: Check if PACE is available in your metro area
PACE (Program of All-Inclusive Care for the Elderly) is a major option many families miss. It’s designed for people 55+ who meet certain criteria (including needing a nursing-home level of care as certified by the state) and can live safely in the community with support.7
PACE often includes adult day health services, coordinated medical care, therapies, and transportation in areas where it operates. It can be especially helpful when someone has multiple conditions and care is fragmented.7
Step 5: Use a second search track for “real world” options
Once you have your official referrals, widen your net:
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Major hospital systems’ social work/case management departments
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Community health centers
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Faith-based caregiver ministries
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Local dementia organizations and caregiver support groups
- 211 referral services (common in many cities)
The goal is to identify both formal programs and community support that can reduce paid hours.
What to Ask Before You Choose a Program
Whether it’s in-home care or adult day services, the best programs welcome questions. You’re not being difficult. You’re being responsible.
For adult day services, ask:
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Who is the program best suited for (dementia, mobility needs, medical complexity)?
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What does a typical day look like (activities, meals, movement, rest time)?
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What health support is provided (med monitoring, nurse on site, therapy)?
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What’s the staff-to-participant ratio?
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Is transportation available and what does it cost?
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How do they handle emergencies, falls, or behavioral symptoms?
- Can you visit for a trial day?
For in-home care, ask:
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Is the caregiver employed by an agency or independent?
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Are background checks performed?
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What training do caregivers receive for dementia, mobility, transfers, hygiene?
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What is the backup plan if the caregiver cancels?
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What is the minimum number of hours per shift?
- How are care notes shared with family?
How to Make it More Affordable
Affordability often comes from combining strategies, not finding one perfect program.
Start by asking every provider the same direct question: “Do you offer a sliding scale, scholarships, or caregiver respite funding?” Then explore:
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Medicaid HCBS / waiver coverage (if eligible)
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PACE (if available and eligible)
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AAA-sponsored services (some regions subsidize adult day or in-home supports)
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Bundling adult day services 2–3 days/week with family coverage the other days
- Using adult day services as “caregiver coverage” during work hours so paid home hours can be reduced
Even partial support can prevent burnout and crisis spending later.
A Call to Action For Our Community
Caregiving is often framed as a private family issue. In many Black and Brown families, it becomes a quiet expectation: handle it, absorb it, figure it out. But when the system makes services hard to find, hard to afford, and hard to access, families end up paying with their health, sleep, and stability.
You deserve support that matches the love you’re giving.
In the NOWINCLUDED app, tell us what you’re navigating right now: Are you looking for adult day services, in-home care, or both? What has been the hardest part, and what kind of help would change everything for your family?
Your story can help another caregiver feel less alone and help our community share resources that actually work.
References
- AARP. (2025, July 24). New Report Reveals Crisis Point for America’s 63 million Family Caregivers. Retrieved from AARP: https://www.aarp.org/press/releases/2025-07-24-new-report-reveals-crisis-point-for-americas-63-million-family-caregivers.html
- CARE. (2025, January). What Do Home Care Providers Do? Retrieved from Care Homecare: https://carehomecare.com/what-do-home-care-providers-do/
- Alzheimer’s Association. (2026, January). Adult Day Centers. Retrieved from Alzheimer’s Association: https://www.alz.org/help-support/caregiving/care-options/adult-day-centers
- Clark, R. (2025, March 04). Genworth and CareScout Release Cost of Care Survey Results for 2024. Retrieved from Genworth Financial, Inc.: https://investor.genworth.com/news-events/press-releases/detail/982/genworth-and-carescout-release-cost-of-care-survey-results
- Scott, C. (2025, February). Caregiving in the Black Community. Retrieved from The Senior Alliance: https://share.google/RND2yhP98Kndzi4sD
- ACL. (2024, August 12). Area Agencies on Aging. Retrieved from Administration For Community Living: https://acl.gov/programs/aging-and-disability-networks/area-agencies-aging
- PACE. (2026). Program of All-inclusive Care for the Elderly (PACE) . Retrieved from PACE: https://www.medicare.gov/health-drug-plans/health-plans/your-coverage-options/other-medicare-health-plans/PACE
