In-home personal care

It’s hands-on help with daily living from a trained caregiver, sometimes called a personal care aide or attendant. That includes bathing, dressing, grooming, toileting, eating and moving around safely, plus help with things like light housekeeping, laundry, meals and errands. The goal is to help someone stay safely in their own home.

Utah’s rule describes personal care as help with daily living that doesn’t need a licensed health professional to perform or supervise directly. Aides can help hands-on or with reminders and cueing. Skilled tasks such as wound care, injections or adjusting medicines belong to nurses and therapists, and if a client’s needs go beyond personal care, the agency is required to refer them to a licensed professional or another appropriate service.

Home health is skilled medical care, like nursing or therapy, ordered by a doctor and usually covered by Medicare for a limited time. Personal care is non-medical, can continue as long as it’s needed, and is usually paid privately or through Medicaid, VA or long-term care insurance. Many families use both at once.

Companion care usually means company, conversation, supervision and outings. Homemaker or chore services cover housekeeping, laundry, shopping and meals. Personal care adds hands-on help with the body, such as bathing and toileting, so ask any agency exactly which of these its caregivers are trained and allowed to do.

When you pay privately, it depends on what the agency can staff and what you can afford, anywhere from a few hours a week to around-the-clock shifts. Many agencies have minimum visit lengths, so ask. When Medicaid, the VA or another program pays, the hours are set by an assessment of the person’s needs.

Generally no. Medicare doesn’t cover long-term help with bathing, dressing or using the bathroom when that’s the only help someone needs. The exception is a home health aide during a Medicare home health episode, which is short-term and only while the person is also getting skilled nursing or therapy.

It can, in a few ways. Utah Medicaid covers personal care services through home health agencies and licensed personal care agencies when a physician orders them and a registered nurse sets up and supervises the care plan. For people who need a nursing-home level of care, Medicaid waiver programs can also pay for attendant, homemaker and related services at home, and eligibility depends on income, assets and an assessment of need.

It’s a Utah Medicaid program for people 65 and older who need a nursing-home level of care and meet Medicaid’s financial rules, so they can get help at home instead. Services can include personal attendant care, homemaker and chore help, respite, adult day services, meals and emergency response systems, based on what the person is assessed as needing. There’s a waiting list, so contact your local Area Agency on Aging or the Division of Aging and Adult Services early.

It’s a Utah Medicaid program that helps people who currently live in a nursing facility, assisted living or another qualifying facility move back to a home or community setting with supportive services. Applicants must meet a nursing-facility level of care and must already be living in a qualifying facility for a minimum length of stay. Call Utah Medicaid’s long-term care line for the current rules.

Utah’s Alternatives program, run through local Area Agencies on Aging, helps frail older adults stay home with services that can include personal care and homemaking. Eligibility depends on income, assets and a risk assessment, a small fee is usually charged, and what’s available varies by area. The Utah Caregiver Support Program, which has no low-income requirement, can also help family caregivers with respite and some supplies.

The VA’s Homemaker and Home Health Aide program sends a trained, nurse-supervised aide to help enrolled Veterans with personal care and daily tasks, through agencies under VA contract. A copay may apply, and the Veteran’s VA social worker decides eligibility and arranges it. Veterans and surviving spouses who receive a VA pension may also qualify for an added monthly payment called Aid and Attendance if they need help with daily activities.

Many policies do, but each one is different. Most start paying when the insurer confirms the person needs help with two or more of six basic daily activities, or has a cognitive impairment like dementia, and then a waiting period you chose when buying the policy (often 30, 60 or 90 days) must pass. Call the insurer before hiring, and ask whether the caregiver must come from a licensed agency.

Rates vary by agency, location, hours, and whether care involves nights, weekends or dementia. Agencies usually charge by the hour, with higher rates or different pricing for overnight and live-in care. Get the rate, any minimums and the cancellation policy in writing, and Utah’s rule requires a licensed agency to give 30 days’ notice before raising its base charges.

Yes. Utah’s Office of Licensing licenses personal care agencies under a specific state rule, separate from home health agencies and hospices. You can look up an agency’s license and recent compliance history on the Office of Licensing’s public search, and it’s fair to ask any agency to show you its license.

Under Utah’s rule, aides must be at least 18, trained in first aid, and able to show competency in every area of their personal care training. They must be supervised by a licensed nurse or an experienced certified nursing assistant, with an in-person check of their work at least every six months. Staff need yearly training that covers recognizing and reporting abuse, neglect and exploitation, plus health and tuberculosis screening and a criminal background screening authorization on file.

An agency screens, trains, supervises and schedules caregivers, sends a backup when someone is sick, and handles payroll and insurance, which usually costs more per hour. Hiring privately can cost less, but you take on screening, scheduling, backup care and possibly the legal duties of an employer. If you control what the caregiver does and how, the IRS generally treats them as your household employee, and for 2026 you generally owe Social Security and Medicare taxes once you pay one worker $3,000 or more in cash wages.

Sometimes. Some Utah Medicaid waiver programs include self-directed attendant services, and long-term care insurance policies set their own rules about who can be paid. The rules about who can be hired, including relatives, differ by program and policy, so ask the waiver case manager or insurer before anyone starts.

Ask to see their Utah license and how they screen, train and supervise caregivers. Ask whether you’ll have a consistent caregiver, what happens if a caregiver doesn’t show up, and how quickly they can add hours or change the schedule. Ask for the service agreement and all charges in writing, and how they handle complaints.

Watch for missed or short shifts, unexplained bruises or injuries, sudden changes in your loved one’s mood, or a caregiver who discourages family visits. Missing money, new “gifts,” or a caregiver asking about bank accounts, wills or property are serious red flags for financial exploitation. An agency that can’t show a license or won’t put charges in writing is a warning sign too.

Write down routines, preferences, medicines, emergency contacts and anything that upsets or calms your loved one. Visit or call often during the first few weeks, and ask the agency to review the service plan after a short trial. Speak up early about small problems, since they’re easier to fix than big ones.

Yes, and it often helps people with dementia stay home longer. Ask whether the agency’s caregivers have dementia training and how they handle confusion, wandering or resistance to bathing. The Alzheimer’s Association helpline can offer tips on what to look for.

Utah’s rule gives clients the right to be free from mental and physical abuse and exploitation, to privacy and confidential records, to take part in planning their care, and to see proper identification from the caregiver. Clients also have the right to be told how to make a complaint. The agency must have a signed service agreement describing the services and charges.

Start with the agency’s owner or administrator. If that doesn’t resolve it, you can file a concern with Utah’s Office of Licensing, which licenses personal care agencies. For problems with a long-term care insurance claim, the Utah Insurance Department takes consumer complaints.

If someone is in immediate danger, call 911. Otherwise, report it to Utah Adult Protective Services, and also tell the agency and the Office of Licensing if an agency caregiver is involved. You don’t need proof to make a report, and you can keep notes, photos and bank statements to share.

If medical needs grow, the agency should tell you and refer you to licensed health professionals, such as a home health agency. When care at home is no longer safe or affordable even with help, assisted living, memory care or a nursing home may be the next step. A doctor, a hospital social worker or your local Area Agency on Aging can help you weigh options.

Yes. Hospice and home health visit on a schedule and don’t provide round-the-clock help, so many families add personal care for bathing, meals, overnight supervision or simply giving family members time to rest. Let each provider know the others are involved so they can coordinate.