According to AARP surveys, more than 3 out of 4 people say they hope to remain in their home or community as they age.  However, age may bring some challenges with remaining safely at home or in community and help may be needed in order to make that possible.  When in-home or supportive services are needed the following resources may be of assistance.  However, it is always best to plan for future needs if possible, as some resources may have waiting lists or specific eligibility or admission requirements. 

Most Older Americans Act (OAA) funded services we administer require that the applicant be age 60 or older, but some service providers may have other funding or resources available. 


Adult Day Services and PACE

Adult Day Services provide care, supervision, and/or health care services in a community group setting designed to promote social, physical, and emotional well-being.  In addition, these programs can help provide respite for family caregivers. These programs operate on a regular basis and are subject to state certification requirements.

Programs that provide primarily supervision and promote social interaction with peers are certified as adult day care programs, and those that offer nursing services are certified as adult day health programs.

PACE (Programs of All-Inclusive Care for the Elderly) is a special type of adult day program that provides comprehensive health care and services that allows individuals 55 years and older who qualify for skilled nursing to remain in the community and in their homes, rather than entering a nursing home.  PACE operates as a comprehensive managed care program, and participants agree to receive all of their health services through the PACE program.  PACE accepts Medicaid and Medicare for qualifying individuals, but these are not required for program enrollment.

Housing and Home Repair

Housing and home repair services are available through a myriad of organizations and specialized funding streams which can be quite confusing to navigate. Specialists at our region’s Information and Assistance programs can assist with identifying housing resources.

Heat and Cooling Programs

Energy assistance programs are also administered by many different organizations.  Most power companies offer an energy assistance program for individuals with difficulty paying for power.  County Departments of Social Services administer and take applications for the

During hot summer months, donations of box fans, and in some cases window air conditioning may be available for qualifying older adults through donations from local power companies.

To locate a program in Chatham, Durham, Johnston, Lee, Moore, Orange, or Wake counties contact CPAAA at 800.310.9777.

Consumer-Directed Services

Self-directed care programs, often referred to as  “consumer-directed” services provide an alternative way of receiving assistance in which the individual consumer has more control over who provides their care and how it is provided. Rather than being assigned to a service provider agency that controls selection, training, and scheduling of individuals providing care and assistance, the "consumer," or the family member, friend, or guardian directs his or her own care by performing the functions usually done by the agency.  Participating in a consumer-directed in-home assistance program and hiring staff is complex and subject to IRS requirements and labor laws.  In a self-directed program, the consumer becomes the employer of record and receives advice from a trained professional and has the assistance of a financial management company to assist with payroll and taxes.

Home Care Independence

In North Carolina, a self-directed service option called Home Care Independence is available in some parts of the state for the provision of in-home aide services and related support. 

For more information about Home Care Independence for those age 60 and older living in Chatham and Johnston counties, call CPAAA at 800.310.9777. 

Community Alternatives Program for Disabled Adults (CAP/DA)

NC Medicaid also offers an option for self-directed in-home care for adults who are disabled and would otherwise need institutional care, called the Community Alternatives Program for Disabled Adults.  As the employer, the individual consumer or a designated representative can choose  and hire caregivers and arrange for other needed community-based services and supports that allow for continued residence at home.  Eligibility for the program is determined by a thorough assessment process. 

Contact a CAP/DA Case Management provider in your county of residence to apply; a list of CAP/DA Case Management agencies is available here