This page introduces common care options and explains how people can learn more, hire help, or explore programs in their community. Some people pay privately for care, but most of the information here is for people who receive Medicaid Long‑Term Services and Supports or want to learn how it works. The right option depends on the person’s needs, preferences, and daily routine.
In-Home Support
Many older adults and people with disabilities want to stay in their home as long as possible. In‑home caregivers can help with daily tasks, personal care, and health‑related needs so people can remain safe and independent.
- Home Care Aides and Individual Providers
Home Care Aides and Individual Providers are caregivers who help people with daily tasks so they can stay independent at home. Support can include bathing, dressing, meals, housekeeping, and other personal care tasks. Some caregivers also help with transportation, shopping, or reminders.
Finding a Caregiver
People who receive Medicaid Long‑Term Services and Supports can hire an Individual Provider through Consumer Direct Care Washington. This program helps people find caregivers, complete hiring steps, and manage timesheets.
You can also work with a licensed home care agency. Agencies recruit, train, supervise, and pay the aides they send to your home. Some agencies offer both in-person and remote caregiving.
Working With Your Case Manager
Once you are approved for long-term care services and supports, a case manager or care coordinator will help you find the best support that fits you.
They can help you:
- Choose the type of caregiver you want.
- Understand what tasks your caregiver can help with.
- Update your care plan when your needs change.
- Connect with other programs such as meal delivery, transportation, or adult day services.
If you hire an Individual Provider, your case manager will help you with the steps to get started. If you choose a home care agency, your case manager can help coordinate services with the agency.
Your Role in Care
You can take part in choosing your caregiver, setting routines, and explaining what works best for you. Many people work directly with their caregiver to plan daily tasks, talk about preferences, and build a schedule that supports their independence.
- Nurse Delegation Program – Medicaid Only
Nurse Delegation allows certain health care tasks to be safely done by a trained caregiver instead of a licensed nurse. This program is available to people who are eligible for Medicaid Long‑Term Services and Supports and receive support in their home or in a community residential setting.
Under Washington state law, credentialed and trained Nursing Assistants and Home Care Aides can perform specific nursing tasks after they are trained and supervised by a registered nurse. Examples include giving medications and checking blood glucose. These tasks are normally done only by licensed nurses, so the training and oversight are important.
How Nurse Delegation Works
If you have nursing care needs, your case manager or care coordinator can refer you to a registered nurse who works with DSHS to provide Nurse Delegation services.
The nurse meets with you to understand your health needs. Your condition must be stable and predictable, and the nurse must feel confident that your caregiver can learn the tasks safely.
Training Your Caregiver
The nurse works directly with your caregiver and provides training. To take part, your caregiver must:
- Be credentialed as a Nursing Assistant or Home Care Aide.
- Complete the required delegation training.
- Be approved by the nurse before doing any delegated tasks.
Ongoing Support
The nurse will check in regularly to:
- Make sure delegated tasks are being done correctly.
- Confirm your condition remains stable and predictable.
- Update the nurse delegation plan if your needs change.
Getting Started
If you receive Medicaid Long‑Term Services and Supports and want to learn more about Nurse Delegation, talk with your case manager or care coordinator. They can explain your options and help connect you with a delegating nurse.
- Assistive Technology
Assistive technology includes tools and devices that help people stay independent with daily tasks. These items can make eating, dressing, bathing, taking medications, and other activities easier and safer. Some items replace the need for another person to help with a task.
How to Get Assistive Technology
Many DSHS Medicaid programs include assistive technology in their service package. Programs such as Community First Choice, New Freedom, and Roads to Community Living may cover certain items.
Your case manager or care coordinator can help you understand whether your Medicaid program includes assistive technology and what items may be available.
They can help you:
- Learn which items are covered.
- Request an evaluation.
- Add assistive technology to your care plan.
- Explore other supports if your needs change.
Read our Technology Support Services Brochure (DSHS 22-2033 PDF)
- Personal Emergency Response System
A Personal Emergency Response System, often called PERS, is a device that helps someone call for help quickly during an emergency. PERS can support people who live alone, have health concerns, or want extra safety at home.
A PERS device can be worn as a button or placed in the home. When the button is pressed, the device connects to a response center. Staff follow the plan you set ahead of time, which may include calling 911, contacting a caregiver, or notifying a family member.
How to Get a Personal Emergency Response System
Many DSHS Medicaid programs include PERS as part of their service package. Your case manager or care coordinator can help you understand whether your Medicaid program covers PERS and how to request one.
Other Ways to Access Personal Emergency Response System
People who are not eligible for Medicaid can still explore PERS through community providers, private companies, or local senior programs. Your case manager or care coordinator can help you find options in your area.
- Other Assistive Technology Resources
There are also programs outside Medicaid that help people learn about or try assistive technology.
- Division of Vocational Rehabilitation Assistive Technology Services
Supports people who receive DVR services and need assistive technology for work or daily life. - Washington Assistive Technology Act Program
Helps people find, try, and borrow assistive technology. They also share information about low interest loans for certain items. - National Assistive Technology Act Technical Assistance and Training Center
Offers information about assistive technology tools and solutions.
Please note that not all items listed on national websites are covered by DSHS Medicaid programs.
- Division of Vocational Rehabilitation Assistive Technology Services
Residential Settings
For information on nursing homes, adult family homes, and assisted living facilities, visit Long-Term Care Residential Options. Your case manager or care coordinator can help you choose the best setting for you.
Community Programs
Community programs offer support outside the home and can help older adults stay connected, active, and healthy.
Adult Day Centers
Adult day centers provide daytime support for people who need some care but do not need skilled nursing. Programs often include personal care, activities, meals, health monitoring, and transportation coordination.
Adult Day Health
Adult day health centers provide skilled nursing or rehabilitative therapy along with the services offered at adult day centers.
Companion Services
Companion services offer regular visits or phone calls for people who live alone. Some programs also help with transportation or shopping.
Home Delivered Meals
Nutritious meals are delivered to people who have difficulty leaving their home. Many senior centers also offer meals in a group setting.
Senior Centers
Senior centers offer meals, activities, classes, and social connection for older adults.
Transportation
Transportation programs help people who can no longer drive or do not have access to a car.
Program of All-Inclusive Care for the Elderly
PACE provides coordinated health care and social services to help older adults remain in the community. Participants receive medical care, therapies, social services, and support with daily activities. Learn more about the program.
- Respite Care
Respite care gives caregivers a break by having another person or facility provide temporary care. This support can last a few hours, a day, or longer, depending on the situation. Respite helps caregivers rest, attend appointments, or take care of personal needs while knowing their loved one is safe.
Respite care can happen in many settings, including:
- At home
- Adult family homes
- Assisted living facilities
- Adult day centers
- Adult day health programs
- Nursing homes
- Through family, friends, or volunteers
Finding Respite Care
Your case manager or care coordinator can help you explore respite options and understand what is available through your Medicaid program. They can also connect you with the Family Caregiver Support Program, home health agencies, or community programs that offer respite.
- Hospice Care
Hospice care provides comfort and support for people who are nearing the end of life. A hospice team can include nurses, social workers, counselors, aides, and trained volunteers. Their goal is to help the person stay comfortable, manage pain, and receive emotional and spiritual support. Hospice care can happen at home or in other settings such as a hospital, assisted living facility, adult family home, or nursing home.
Hospice staff are available every day to help with care, answer questions, and support family members. They also help with medications, equipment, and planning.
Finding Hospice Care
You can explore hospice options in your community or ask your case manager or care coordinator for help. They can explain what hospice offers, how services are provided, and what costs may apply.
You can also contact: