Home care services in Palo Alto

Most older Palo Altans say they want to stay in their own homes. Many do so with some help. That help can be a caregiver who comes three mornings a week, a nurse who visits after a hospital stay or a family member paid through a state program. The words for these services overlap, which makes it hard to know who to call. This guide sorts them out.

This page is general information, not medical, legal or financial advice. It draws on the California Department of Social Services, Medicare and local nonprofits as their pages read in November 2026. We do not name or rank private home care agencies. Instead, we explain how to check any agency yourself. In an emergency, call 911.

Four kinds of help at home

Families often combine them. A parent home from the hospital might get Medicare home health visits for a few weeks, plus a privately paid aide for evenings. Hospice is covered on our hospice and palliative care page.

Checking a caregiver or agency

California's Home Care Services Consumer Protection Act took effect in January 2016. It requires home care organizations to be licensed and created a public online registry of home care aides who have passed a background check. The Home Care Services Branch (HCSB) of the Department of Social Services runs both. It also handles complaints and makes unannounced visits to licensed agencies.

1. Search the registry. The state's Home Care Aide Registry search lists registered aides and licensed home care organizations.
2. Confirm the agency license. Ask the agency for its license number and make sure it matches the registry.
3. Confirm each aide. Ask for the aide's registration number before the first shift. Aides apply through the state, pay a $35 fee and submit Live Scan fingerprints.
4. Ask questions. Call HCSB at (877) 424-5778 or email HCSB@dss.ca.gov with licensing questions.

Registration shows that an aide passed a background check. It does not certify skills, so still ask about training and experience. Aides you hire on your own, without an agency, can also choose to register. The state's licensed vs. unlicensed care fact sheet explains the difference.

If you suspect abuse, neglect or financial exploitation of an older or dependent adult, contact Adult Protective Services. In an emergency, call 911.

Medicare home health

Skilled home health is a medical service. A doctor or nurse practitioner orders it, usually after a hospital stay, surgery or a change in a chronic condition. Medicare pays for part-time skilled nursing and therapy at home for people who are homebound and need skilled care. It does not pay for 24-hour care or for help with daily activities when that is the only care needed. Medicare's Care Compare tool lists certified home health agencies by ZIP code with quality ratings.

Two agencies serving Palo Alto describe their programs on their own sites:

• Sutter Care at Home lists home health nursing, physical, occupational and speech therapy, infusion therapy, wound care and hospice. Sutter calls it the region's largest community-based, not-for-profit home health provider. Patients of the Palo Alto Medical Foundation are often referred here.
• Pathways Home Health and Hospice has a Sunnyvale office at 585 North Mary Avenue and lists home health, hospice and grief support. Its phone is 888-755-7855.

When a hospital discharge planner offers a list of agencies, you can choose any Medicare-certified agency that serves your address and takes your plan.

In-Home Supportive Services

IHSS is a California program that pays for personal care and domestic help so eligible people can stay safely at home. It serves people who are 65 or older, blind or disabled and who qualify for Medi-Cal. A county social worker visits to assess needs and set the authorized hours. Recipients choose their own provider, who can be a family member in many cases. The provider is paid through the program. In Santa Clara County, apply through the Social Services Agency at (408) 792-1600. Our health insurance guide explains Medi-Cal eligibility.

Local organizations that help families plan

• Avenidas, 450 Bryant Street, (650) 289-5400. Social work consultations for older adults and families, the Avenidas Village membership program, a medical equipment loan closet and Door to Door rides. Our resources for older adults page covers Avenidas in detail.
• Jewish Family and Children's Services. Its Seniors At Home program lists home care, care management, dementia care and palliative care. It also runs a free weekly online peer support group for family caregivers of people with dementia.
• Sourcewise, Santa Clara County's Area Agency on Aging, at (408) 350-3200, for referrals on in-home care, meals and case management.

Families caring for someone with memory loss should also read our memory care guide, which lists support groups and adult day programs.

Questions to ask a home care agency

1. What is your state license number? Are all your aides on the Home Care Aide Registry?
2. Are caregivers your employees, with payroll taxes and workers' compensation covered?
3. What is the hourly rate? Is there a minimum number of hours per visit or per week?
4. Who supervises the aides? How often does a supervisor visit?
5. What happens if the regular caregiver is sick or quits?
6. Can we meet the caregiver before the first shift?
7. How much notice do we need to give to change or cancel service?

Hiring an aide directly, without an agency, often costs less per hour. It also makes you responsible as an employer for wages, overtime, payroll taxes and insurance under California law. Get advice before you choose that route. Our legal help page lists free and low-cost options.

Paying for care at home

• Private pay. Most non-medical home care is paid out of pocket by the hour.
• Long-term care insurance. Policies often pay for home care after a waiting period. Call the insurer early, since claims take time.
• Veterans. Some veterans and surviving spouses qualify for VA help with home care. Ask the VA or a county veterans service officer.
• Medi-Cal. IHSS and some waiver programs pay for care at home for eligible residents.

Making the house work

Small changes make care at home safer: grab bars, a shower chair, better lighting and removing loose rugs. Avenidas lends medical equipment such as walkers and wheelchairs. Bigger projects, such as a ground-floor bedroom or a small cottage for a live-in caregiver, need planning and permits. Our guide to accessory dwelling units explains the city's rules. If home is no longer the right fit, our senior housing guide compares local communities.

Frequently asked questions