Personal care is hands-on help at home with bathing, dressing, grooming, using the toilet, eating and moving around. An aide comes to the house, often by the hour, and does the physical tasks a person can no longer do alone. Medicare does not pay for personal care when it is the only care you need, so most people pay privately or use Medicaid, VA or insurance if they qualify.
This guide explains what personal care is, who it helps, what an aide does and does not do, how it differs from nearby services, how it is paid for and how to choose a provider. Carevo is a directory. It does not provide care or vouch for providers.
What personal care is
Personal care covers the body-focused tasks of daily life. Providers and insurers often call these activities of daily living, or ADLs. One state insurance regulator, Oregon's, lists them as eating, dressing, mobility, bathing, toileting and continence. The Alzheimer's Association describes personal care as help with bathing, dressing, toileting, eating and exercise.
Medicare.gov uses the term custodial or personal care for help with daily activities like bathing or dressing, and puts it in the same group as long-term care, which it says is mostly non-medical. The idea is that the aide helps with a task the person can no longer do safely alone, while the person stays in charge of their own day as far as they can.
Personal care is delivered by personal care aides or home health aides, depending on the agency and the program paying for it. Titles vary, so ask what training the person who will come to your home has had.
Who personal care helps
Personal care suits people who can live at home but need physical help with self-care. Typical situations:
- An older adult with arthritis, weakness or balance problems who finds showering or dressing hard or unsafe.
- Someone with a disability who needs regular help getting up, washed and dressed.
- Someone leaving hospital or a rehab stay who needs several weeks of extra help.
- A person with memory loss who needs prompting and help with self-care. See dementia care at home.
- A spouse or adult child who has been doing all the hands-on care alone and needs relief. See respite care.
If the person needs only company, errands and light meals, companion care may be enough and may be less expensive to book. If the need is medical, see home health care.
What a personal care aide does and does not do
An aide commonly helps with:
- Bathing and grooming. Showering, bed baths, washing hair, shaving, skin and nail care, oral care.
- Dressing. Choosing clothes, helping put them on and take them off.
- Toileting and continence. Getting to the toilet, using the commode, changing incontinence products.
- Eating. Preparing meals, setting up the table, helping with feeding if needed.
- Moving. Getting in and out of bed or a chair, walking with the person, and following the safety plan set for the person.
- Light household help tied to the person's care, such as changing bed linens and laundry.
Medicare.gov lists home health aide tasks such as help walking, bathing or grooming, changing linens and feeding. That is a fair picture of the daily work.
An aide is not a nurse. VA says its Homemaker and Home Health Aide aides are supervised by a registered nurse but are not nurses. Skilled work such as wound care, injections, IV or nutrition therapy and monitoring a serious illness is skilled nursing. Ask the agency what its aides may and may not do, and have the answer in writing. Ask also how an aide should respond if the person falls, refuses help or seems unwell, and who the aide calls.
How personal care differs from similar services
- Home care is the broader category. It includes personal care, companionship and homemaker help.
- Companion care has little or no hands-on care.
- Home health care is skilled nursing and therapy ordered by a doctor. A home health aide may help with personal care as part of a Medicare home health plan, but only alongside skilled services.
- Private duty nursing is nursing care in longer shifts, done by a nurse.
- Assisted living provides help with daily tasks in a residential community, with staff on site.
How personal care is paid for
Medicare. Medicare.gov says Medicare does not pay for custodial or personal care when it is the only care you need, and does not pay for long-term care generally. It covers part-time or intermittent home health aide care only while you also get skilled nursing, physical therapy, speech-language pathology or occupational therapy from a Medicare-certified home health agency. See the Medicare guide and use the Medicare home health checker.
Medicaid. Medicaid can pay for personal care for people who qualify, and each state decides how. Federal rules at 42 CFR 440.167 define personal care services as services for someone who is not an inpatient or resident of a hospital, nursing facility or similar institution, authorized by a physician under a plan of treatment or, at the state's option, by a service plan the state approves, and provided by a qualified provider who is not a family member, with family member defined there as a legally responsible relative. Medicaid.gov also lists personal care among the services a 1915(c) home and community-based waiver can offer, and says states choose the maximum number of people a waiver serves. Some states let participants self-direct, hiring and supervising their own workers. Read Medicaid and long-term care, the state programs and how family members can be paid.
VA. VA's Homemaker and Home Health Aide program sends a trained aide to a Veteran's home to help with daily activities such as eating, dressing, grooming, bathing, using the toilet and moving around. VA says all enrolled Veterans are eligible if they qualify for community care, meet the clinical criteria and the service is available, and a copay may apply. Ask a VA social worker. See VA benefits and VA Aid and Attendance.
Long-term care insurance. Oregon's insurance regulator describes the benefit trigger for long-term care policies there as being unable to do two or more activities of daily living, or having a cognitive impairment, with an elimination period chosen at purchase. What your policy pays is set by your policy. See long-term care insurance.
Private pay. Many families pay directly. See private pay.
What drives the cost
Carevo does not publish a price, because we cannot support one. What moves the bill:
- Hours per week. Personal care is usually billed by the hour.
- Time of day and visit length. Ask whether nights and weekends cost more, and what the agency's minimum visit is.
- Number of caregivers needed. Ask whether any task in the care plan needs two people, because that can change the hours billed.
- Experience and training. Ask whether the rate changes for dementia care or for lifting and transfers.
- Agency or independent aide. An agency's rate covers the aide's pay and the agency's costs, including supervision, scheduling and back-up. The Bureau of Labor Statistics reports a national median wage of $17.21 an hour for home health and personal care aides in May 2025. That is what aides are paid, not what an agency charges.
- Funding rules. A program that pays may approve a set number of hours and may pay only certain providers.
Starting personal care: the first weeks
Bathing and toileting help is private. Many people resist it at first, and that is normal to plan for rather than a reason to give up. A few practical steps make the start easier:
- Involve the person in the decision as far as you can. Let them say what they want done and what they want to keep doing themselves.
- Tell the agency about routines: when the person likes to wake, wash and eat, which products they use, and what they find upsetting.
- Start with the tasks that cause the most trouble, and add more once the person is comfortable with the aide.
- Ask for a short check-in call after the first week to adjust the plan. Agencies should expect to adjust.
- Keep a short written note of anything you observe, and share it with the person's doctor if you see a change in health.
If the person has memory loss, the aide's approach matters as much as the task. The Alzheimer's Association suggests asking about dementia-specific training and experience. If the person is seeing a doctor or therapist, ask them whether any equipment or home changes would make personal care safer, and check what a coverage plan will pay for before you buy.
How to choose a personal care provider
- List the tasks and times. Write down every task you want help with, how often, and what the person finds hard.
- Decide how the work will be paid for. If Medicaid or VA will pay, call the program first and ask which providers it can pay.
- Shortlist and call three. Browse home care agencies on Carevo by state and city. Our listings for this category show home care agencies, and we have not yet confirmed which of them provide personal care, so ask each one.
- Interview at home. The Alzheimer's Association suggests interviewing in the home with a third person present if possible, checking references and asking about criminal background checks.
- Meet the aide. Ask whether you can meet the aide before the first shift. Comfort matters for bathing and toileting.
- Agree a care plan in writing. Tasks, schedule, who to call, and what the aide does if the person refuses care.
Questions to ask
- Who employs the aides, and how are they screened?
- What training do aides have for personal care, safe transfers and incontinence care?
- Will the same aide come each time? Who covers a sick day?
- How do you protect privacy and dignity during bathing and toileting?
- Who supervises the aides, and does a nurse or manager visit the home?
- How do you respond to a fall or a medical concern?
- Are aides trained in first aid and CPR, and bonded and insured?
- What does a minimum shift look like, and what is your cancellation policy?
- Which payers do you bill directly?
Red flags
- The agency cannot explain who supervises its aides.
- Aides change every visit and there is no hand-over.
- Promises that Medicare will pay for ongoing personal care.
- The aide does tasks outside the written plan, such as moving the person alone when the plan calls for two people.
- Marks, bruises or changes in the person's mood or behavior that no one explains. Raise it with the agency and the person's doctor.
- No written plan, or no way to reach a person after hours.
Next steps
- Write down the tasks and times, and test the hours in the home care hours cost calculator.
- Check what coverage you have before care starts.
- Tell us what you need and we will show providers in your area. You decide who to call.