By Miami Senior Advisor Care Team · October 24, 2026
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Listen to this guide as a 5-minute podcast episode, or read on. Hosts Marcus and Dana are AI-generated voices.
Read the episode transcript
Marcus: Welcome to the Miami Senior Advisor podcast. I'm Marcus.
Dana: And I'm Dana. Today we're talking about in-home dementia care across Miami-Dade, Broward and Palm Beach.
Marcus: This is where a lot of families start. Mom's memory is slipping, she wants to stay home, and you just need some help in the house.
Dana: And that's often the right first step. But in Florida, who's allowed to help depends on a license most families never ask to see.
Marcus: So let's start there. What does in-home dementia care in South Florida actually include?
Dana: It's paid help that comes to your parent's home. Company and supervision, hands-on personal care like bathing, dressing and toileting, and, when a doctor orders it, skilled nursing or therapy.
Marcus: And it usually starts small?
Dana: Usually. A few hours a week so a spouse can get to the store, or a daily check that medication was taken and lunch was eaten. Then it grows: bathing help, longer shifts, then nights.
Marcus: So the plan in year one isn't the plan in year three.
Dana: Rarely. That's why it pays to pick a type of provider that can grow with your parent.
Marcus: Okay. Who is actually allowed to provide in-home memory loss care in Florida?
Dana: Three kinds of providers send caregivers into Florida homes, and all three answer to the Agency for Health Care Administration, AHCA: home health agencies, nurse registries, and homemaker and companion services.
Marcus: What's the difference between them?
Dana: Home health agencies and nurse registries are licensed, and they can send aides and nurses for hands-on personal care. Homemaker and companion services are registered, not licensed, and AHCA says that registration does not allow hands-on personal care.
Marcus: So a companion versus a home health aide: what's the real difference for someone with dementia?
Dana: A companion can sit with your mother all afternoon, make lunch, run errands. But if she needs help getting in and out of the shower, a companion-only service isn't allowed to do it.
Marcus: How do I know which one I'm talking to?
Dana: Ask which AHCA license or registration they hold, get the number in writing, and confirm it with AHCA before the first visit. AHCA even bars companion businesses from using names that imply personal care or nursing.
Marcus: Next one families type in: what dementia training do Florida home care workers have to have?
Dana: Under section 430.5025 of the Florida Statutes, caregivers from home health agencies, nurse registries and companion services take a 1-hour Department of Elder Affairs course within 30 days of starting.
Marcus: And that's it?
Dana: No. Staff who give personal care need 2 more hours within 7 months. The rule took effect July 1, 2023, and workers hired before that had until July 1, 2026 to finish.
Marcus: Which has now passed.
Dana: Right, so anyone working since before mid-2023 should already be done. And three hours is a floor, not a specialty. Ask the date each caregiver finished, and how the agency handles agitation, sundowning and wandering.
Marcus: Let's talk money. Does Medicare pay for in-home dementia care?
Dana: Not for ongoing care. Medicare covers part-time or intermittent skilled nursing and therapy for someone who's homebound, and aide help only while those skilled services are running.
Marcus: So no round-the-clock care at home.
Dana: Medicare lists 24-hour care at home, homemaker services, and custodial or personal care when that's the only care needed as not covered.
Marcus: Then where do families in Miami-Dade, Broward and Palm Beach find help?
Dana: Start with one number, the Elder Helpline: 1-800-96-ELDER. It connects you to your county's Aging and Disability Resource Center.
Marcus: And what can they offer?
Dana: Florida's Alzheimer's Disease Initiative funds respite for caregivers of adults 18 and older with probable Alzheimer's or a related dementia: at home, at adult day care, in an emergency, or as extended care of up to 30 days. Plus case management, counseling and support groups.
Marcus: What if there's no diagnosis yet?
Dana: Then start at a state memory disorder clinic. In South Florida those include the Wien Center at Mount Sinai, the University of Miami, Miami Jewish Health, Broward Health, St. Mary's Medical Center and Florida Atlantic University.
Marcus: Last big one. In-home care versus memory care in Florida: when does home stop working?
Dana: Usually when your parent needs someone awake through the night, when one relative is covering every gap, or when wandering and falls outpace the hours you can staff.
Marcus: And memory care handles that differently?
Dana: A Florida assisted living facility that advertises Alzheimer's care and has 17 or more residents must have an awake staff member on duty at all hours. Smaller ones need that, or safety monitoring.
Marcus: Is there a simple test?
Dana: Write down every hour last week when your parent was alone or watched by an exhausted relative. If that list keeps growing, start touring while you still have time to choose.
Marcus: The full guide, with the license comparison table and every source, is in the description. And talking with a Miami Senior Advisor is free. See you next time.
Dana: Take care, everyone.
What does in-home dementia care in South Florida actually include?
In-home dementia care in South Florida is paid help that comes to your parent's house or apartment: company and supervision, hands-on personal care such as bathing, dressing and toileting, and, when a doctor orders it, skilled nursing or therapy. Which of those a caregiver may legally do depends on the Florida license or registration behind them, not on the job title on a website.
Most families searching for memory loss care in Fort Lauderdale, Miami Beach or Homestead start small: a few hours a week of supervision so a spouse can get to the store, or a daily check that medication was taken and lunch was eaten. As the disease moves, the plan usually grows to bathing help, then longer shifts, then nights. The arrangement that works in year one rarely works in year three, so it pays to choose a provider type that can grow with your parent instead of one you will have to replace.
You can compare local providers in Miami in-home care and Fort Lauderdale in-home care. Before you call any of them, it helps to know the three provider types below.
Who is allowed to provide in-home memory loss care in Florida?
Three kinds of providers send caregivers into Florida homes, and all three answer to the Agency for Health Care Administration (AHCA): home health agencies, nurse registries, and homemaker and companion services. Only the first two can send someone to give hands-on personal care.
| Provider type | How Florida regulates it | Hands-on personal care? | Typical role in dementia care |
|---|---|---|---|
| Home health agency | Licensed by AHCA under Chapter 400, Part III, Florida Statutes, and Chapter 59A-8, Florida Administrative Code | Yes, through its aides and nurses | Personal care, plus skilled nursing and therapy when ordered |
| Nurse registry | Licensed by AHCA under s. 400.506, Florida Statutes, and Chapter 59A-18, Florida Administrative Code | Yes, through the nurses, certified nursing assistants and home health aides it refers | Private-duty shifts, including longer and overnight hours |
| Homemaker and companion service | Registered, not licensed, with AHCA; the registration lasts two years | No. AHCA says the registration “does not allow hands on personal care” | Supervision, company, meals, light housekeeping and errands |
That last row matters more with dementia than with almost any other condition. A companion can sit with your mother all afternoon, but if she needs help getting in and out of the shower, a companion-only service is not allowed to provide it. AHCA also bars companion businesses from using names that imply personal care or nursing. Ask every provider which AHCA license or registration it holds, get the number in writing, and confirm it with AHCA before the first visit.
What dementia training must Florida home care workers have?
Under s. 430.5025, Florida Statutes, caregivers sent by home health agencies, nurse registries and homemaker or companion services must complete state dementia training: a 1-hour Department of Elder Affairs course within 30 days of starting, plus 2 more hours within 7 months for staff who provide personal care.
The rule took effect July 1, 2023, through Chapter 2023-278, Laws of Florida. It also requires basic written information about dementia at hire, and it gave workers already employed before that date until July 1, 2026 to finish. That deadline has passed, so any caregiver who has been working since before mid-2023 should already be done. Completed training follows the worker from one employer to the next, and the provider must keep records of it.
Three hours is a floor, not a specialty. When you interview a provider, ask for the date each proposed caregiver finished the training, how the agency handles agitation, sundowning and exit-seeking, and whether the same small group of caregivers will be assigned so your parent sees familiar faces. Our guides to sundowning and wandering and Silver Alert cover the behaviors to plan around.
What does Medicare cover for in-home dementia care in Miami-Dade, Broward and Palm Beach, and what can Florida programs add?
Medicare does not pay for ongoing in-home dementia care. Its home health benefit covers part-time or intermittent skilled nursing and therapy for a parent who is homebound, and home health aide help only while those skilled services are running. Medicare.gov lists 24-hour care at home, homemaker services, and custodial or personal care when it is the only care needed as not covered.
Florida fills part of the gap through programs reached with one phone number: the Elder Helpline, 1-800-96-ELDER (1-800-963-5337), which routes you to the Aging and Disability Resource Center for your county. The state's Alzheimer's Disease Initiative funds respite for caregivers of adults 18 and older with probable Alzheimer's disease or a related dementia, at home, at adult day care, in an emergency, or as extended care of up to 30 days, along with case management, supplies, counseling, support groups and caregiver training through the Area Agencies on Aging. Members enrolled in Statewide Medicaid Managed Care Long-Term Care can get respite, caregiver training and in-home caregiver services through their case manager.
If your parent has no formal diagnosis yet, start with a state memory disorder clinic. In South Florida the Department of Elder Affairs map lists the Wien Center at Mount Sinai Medical Center, the University of Miami Center for Cognitive Neuroscience and Aging and the MIND Institute at Miami Jewish Health in Miami-Dade; the Broward Health Memory Disorder Center; and St. Mary's Medical Center and Florida Atlantic University's Louis and Anne Green Memory and Wellness Center in Palm Beach County. More in our Alzheimer's Disease Initiative guide.
In-home dementia care vs. memory care in Florida: when does home stop working?
Home usually stops working when your parent needs someone awake and close by through the night, when one relative is covering every gap, or when wandering and falls outpace the hours you can staff. A Florida assisted living facility that advertises Alzheimer's care is built for that stage: under s. 429.178, Florida Statutes, one with 17 or more residents must have an awake staff member on duty at all hours, and a smaller one must either do the same or have mechanisms in place to monitor residents' safety.
Those facilities must also offer activities designed for residents with cognitive impairment, keep a physical environment that protects residents' safety and welfare, and employ staff who complete the same state dementia training, with 3 additional hours instead of 2 for personal-care staff. Round-the-clock home care can match the staffing, but rarely the secured setting, and the shifts add up quickly.
A practical test: write down every hour last week when your parent was alone or was watched by an exhausted relative. If that list is growing month to month, start touring while you still have time to choose. See memory care vs. assisted living in Florida and memory care in Miami, or talk to our care team. The service is free, and hablamos español.
Last verified: October 2026.