In-Home Dementia Care in Nashville: Who Provides It, Who Licenses It, and Who Pays

What does in-home dementia care in Nashville actually include?

In-home dementia care in Nashville is mostly hands-on, non-medical help: a trained caregiver who supervises, prompts and assists a person with Alzheimer's or another dementia with bathing, dressing, toileting, meals and getting through the day safely. Families usually start with a few shifts a week and add hours as the disease progresses.

The care splits into two very different services. Personal support services cover the daily-living help above, plus homemaker tasks and in-home respite so a spouse or adult child can rest. Home health is skilled care, such as a nurse or physical therapist, ordered by a doctor for a medical need. Most families searching for Alzheimer's in-home care in Nashville, Springfield, Gallatin or Mt. Juliet need the first kind, often for many hours a week.

That distinction drives everything else in this guide: who licenses the agency, what Medicare will and will not pay, and whether TennCare CHOICES can help. For an overview of local options, see our Nashville in-home care page and the Nashville Alzheimer's care page.

Who licenses in-home dementia care agencies in Tennessee?

Two different state agencies license the two kinds of home care. Under Rule 0940-05-38, an agency providing personal support services needs a license from either the Department of Mental Health and Substance Abuse Services or the Department of Intellectual and Developmental Disabilities. An agency whose client base is 50 percent or more older adults, or people with a mental illness diagnosis, goes to Mental Health and Substance Abuse Services.

Home health agencies are a separate category. The Tennessee Health Facilities Commission, which took over facility licensing from the former Board for Licensing Health Care Facilities, sets standards for home care organizations providing home health services in Rule chapter 0720-27. The same commission licenses assisted-care living facilities under chapter 0720-26.

	Personal support services agency	Home health agency
Typical dementia help	Supervision, bathing, dressing, meals, toileting, companionship, in-home respite	Skilled nursing and therapy visits ordered by a doctor
Tennessee licensing	Department of Mental Health and Substance Abuse Services (Rule 0940-05-38) when most clients are older adults	Tennessee Health Facilities Commission (Rule chapter 0720-27)
Does Medicare pay?	No, when personal care is the only care needed	Can, when Medicare home health conditions are met
Can TennCare CHOICES pay?	Yes, for eligible members (personal care visits, in-home respite)	Through regular TennCare medical benefits

Before hiring anyone, ask the agency which license it holds and from which department, then confirm it. An individual caregiver hired privately is not an agency, which means you take on the screening, scheduling and backup coverage yourself.

How much does in-home Alzheimer's care cost in Nashville and Middle Tennessee?

No published survey gives a Nashville-only figure. The best current benchmark is CareScout's 2025 Cost of Care data for Tennessee, which puts the statewide annual median for a non-medical home caregiver at $70,928, based on 44 hours a week for 52 weeks. That works out to roughly $31 an hour and about $5,900 a month.

For comparison, the same release lists Tennessee medians of $67,140 a year for assisted living, $20,800 a year for adult day health care at five days a week, and $113,150 a year for a semi-private nursing home room. In other words, 44 hours a week of home care already costs more than the statewide assisted living median, and dementia care often needs more hours than that.

Rates vary by agency, shift length and overnight coverage, so get written quotes. Ask each agency whether weekend or overnight shifts cost more, whether there is a minimum shift length, and what dementia-specific training its caregivers receive. A lower hourly rate with a four-hour minimum can cost more each month than a higher rate with shorter visits. Our Nashville in-home care cost page walks through how to compare them.

Can TennCare CHOICES pay for dementia care at home in Nashville?

Yes, for people who qualify. TennCare CHOICES Group 2 covers seniors 65 and older who qualify for nursing home level of care but choose to receive care at home. Group 3 covers seniors who do not need nursing home care yet but need help to avoid it soon, and they must also receive SSI. Home services listed by TennCare include personal care visits, in-home respite care, home-delivered meals, a personal emergency response system and enabling technology.

To qualify, a person must show they need help with daily activities such as moving around, eating, toileting or communicating, and must meet TennCare's financial rules, which are set each calendar year. The health plan must also be able to meet the person's needs safely at home.

In Davidson and the surrounding counties, the Greater Nashville Regional Council (GNRC) Area Agency on Aging and Disability screens applicants. Call its Information and Assistance line at 615-255-1010 or 866-836-6678. GNRC also runs the state-funded OPTIONS for Community Living program, though it notes a multiyear waitlist, and a Family Caregiver Support program that can include respite. Read more on our TennCare CHOICES home care page.

In-home dementia care vs. memory care in Nashville: when does home stop working?

Home care works best while one or two caregivers can cover the hours that matter and the person is safe between visits. Memory care, which in Tennessee operates as a specialty inside an assisted-care living facility license, makes more sense when supervision is needed around the clock. Neither option is automatically cheaper, so compare a full monthly memory care quote against the paid hours your parent actually needs at home, including the hours family members are covering for free today.

Three signs usually mark the turning point: night-time wandering or getting up unsafely, a family caregiver who is exhausted, and paid hours climbing past 40 or 50 a week. Medicare will not pay for 24-hour care at home, so round-the-clock coverage is nearly always private pay or CHOICES-funded.

If you are not ready to move a parent, short respite stays and adult day programs can stretch home care further. Our guide to respite care in Nashville covers those options, and the Alzheimer's Association's 24/7 Helpline at 800-272-3900 can talk through next steps any time. Last verified: October 2026.

Frequently Asked Questions

What is in-home dementia care in Nashville?

It is mostly non-medical help at home for someone with Alzheimer's or another dementia, including supervision, bathing, dressing, meals and respite for family caregivers. It is provided by personal support services agencies, while skilled nursing visits come from separate home health agencies.

Who licenses dementia home care agencies in Tennessee?

Personal support services agencies serving mostly older adults are licensed by the Tennessee Department of Mental Health and Substance Abuse Services under Rule 0940-05-38. Home health agencies are licensed by the Tennessee Health Facilities Commission under Rule chapter 0720-27.

How much does in-home Alzheimer's care cost in Nashville?

There is no Nashville-only figure. CareScout's 2025 Tennessee median for a non-medical home caregiver is $70,928 a year at 44 hours a week, roughly $31 an hour. Actual quotes vary by agency, hours and overnight needs.

Does TennCare CHOICES pay for dementia care at home?

It can. CHOICES Groups 2 and 3 cover home services such as personal care visits and in-home respite for eligible seniors. In the Nashville area, start with the GNRC Area Agency on Aging and Disability at 615-255-1010 or 866-836-6678.

Is in-home dementia care or memory care better for my parent?

Home care fits while supervision can be covered in shifts and the person is safe between visits. Memory care, a specialty within Tennessee assisted-care living facilities, usually fits better once your parent needs supervision around the clock or the family caregiver is worn out.