Help your loved one age safely and comfortably at home anywhere on Hawaiʻi Island. Compare verified Big Island hourly home care costs ($41/hr state median), understand Hawaii Department of Health (`HRS § 321-14.8`) licensing standards, and check availability by district with state-licensed Home Care Agencies serving East Hawaiʻi (Hilo, Keaʻau, Pāhoa, Hāmākua) and West Hawaiʻi (Kailua-Kona, Captain Cook, Waikōloa, Waimea).
-HCA or HHA- licenses under HRS § 321-14.8 with TB-cleared, background-checked caregivers.-HCA agencies provide the official care documentation required by Long-Term Care Insurance and VA Aid & Attendance.-HCA) under HRS § 321-14.8 / HAR Title 11, Chapter 700 and Home Health Agencies (HHA-).
Select your Big Island district below to get matched with a Hawaii DOH-licensed home care agency serving Hilo/Puna, Kailua-Kona/South Kona, or Waimea/Kohala.
Select your Big Island district (East Hawaiʻi / Hilo & Puna vs. West Hawaiʻi / Kona, Waimea & Kohala), preferred schedule, and daily tasks needed.
Get matched with vetted Hawaii DOH state-licensed Home Care Agencies (`-HCA`) that dispatch caregivers in your specific district.
Review transparent hourly rates ($37–$41/hr Hawaii median), verify LTC insurance or VA benefits, and begin care on your schedule.
Hawaiʻi County has the highest senior share in the state—26.0% of its 210,043 residents are aged 65 and older (~54,611 seniors)—spread across 4,028 square miles. Families rely on state-licensed Home Care Agencies (`-HCA`) in both East and West Hawaiʻi to keep aging parents safe at home.
Dignified assistance with bathing, showering, dressing, grooming, restroom routines, safe bed-to-chair transfers, and nutritious island meal preparation.
Warm island conversation, lanai walks, KTA or Foodland grocery errands, accompanied rides to Hilo, Kona, or Waimea clinics, and dependable relief for family caregivers.
Calm, familiar routines in your loved one’s own home, wandering prevention, sundowning reassurance, and overnight or 24-hour multi-shift care.
Under Hawaii Administrative Rules HAR Title 11, Chapter 700, licensed Home Care Agencies provide hands-on assistance with Activities of Daily Living (ADLs): bathing, personal hygiene, dressing, feeding, ambulation, and fall-prevention mobility support.
Explore Big Island (Hawaiʻi Island) personal care services →
Ideal for kūpuna across Hilo, Kailua-Kona, Waimea, Waikōloa, or Puna whose adult children work full-time or coordinate care from Oʻahu or the mainland. Includes fresh meal preparation, light housekeeping, laundry, linen changes, hospital/clinic transportation, and pharmacy pickups.
Multi-generational caregiving is a cherished Hawaiʻi Island tradition, but family caregivers need time to work, rest, and care for keiki. Flexible respite shifts (from 12 hours/week to weekend or mainland-travel coverage) prevent caregiver burnout.
Moving a senior with Alzheimer’s or memory loss out of their longtime Big Island (Hawaiʻi Island) home can increase confusion. In-home memory support keeps surroundings familiar while providing structured redirection, safety monitoring, and daily engagement.
Transitioning home after a stay at Hilo Benioff Medical Center (Hilo), Kona Community Hospital (Kealakekua), Queen’s North Hawaiʻi Community Hospital (Waimea), or Hale Hoʻola Hāmākua / Kaʻū Hospital requires reliable household setup, fall prevention, and meal/hydration reminders.
For seniors who wake frequently at night, are at high risk of falls getting to the bathroom, or have adult children living on Oʻahu or the mainland, licensed Big Island (Hawaiʻi Island) agencies coordinate awake overnight shifts or 24/7 rotating caregiver teams.
Verified benchmarks from the CareScout / Genworth Cost of Care Survey and Hawaiʻi County agency data show why keeping kūpuna at home in Big Island (Hawaiʻi Island) is far more cost-effective than facility care.
| Big Island (Hawaiʻi Island) Care Option & Weekly Schedule | Verified Hourly / Monthly Median | Annualized Cost | When Big Island (Hawaiʻi Island) Families Choose This Option |
|---|---|---|---|
| Part-Time Companion / Respite Care (16 hrs/week) | $37–$41/hr • ~$2,840/mo | ~$34,080/yr | 4-hour shifts, 4 days/week for meal prep, bathing help, light housekeeping, grocery errands, and relief for working ʻohana. Saves ~$9,250/mo vs. Hawaii assisted living. |
| Half-Time Daily Personal Care (20 hrs/week) | $37–$41/hr • ~$3,550/mo | ~$42,600/yr | Weekday morning or afternoon routines (bathing, dressing, meals, mobility) while family members are working. |
| Standard Weekday Care (30 hrs/week) | $37–$41/hr • ~$5,330/mo | ~$63,960/yr | 6 hours/day, 5 days/week for kūpuna needing consistent daily ADL assistance, fall supervision, and clinic transportation. |
| Full-Time In-Home Care (44 hrs/week Benchmark) | $41/hr median • $7,817/mo | $93,804/yr | CareScout Hawaii full-time benchmark (Homemaker $7,627/mo; Home Health Aide $8,103/mo). Saves $4,279/mo ($51,348/yr) vs. Hawaii assisted living. |
| Hawaii Assisted Living Facility (1-Bedroom Median) | $12,096/mo (#1 Highest in U.S.) | $145,152/yr | Residential facility room & board in Hawaii (95% above the $6,200 U.S. national median), with limited bed availability on Hawaiʻi Island. |
| Hawaii Nursing Home (Semi-Private / Private Room) | $15,473 – $16,395/mo | $185,676 – $196,740/yr | Institutional 24-hour skilled nursing facility care for complex clinical needs that cannot be managed at home. |
In Hawaii, operating a Home Care Agency without a state license is unlawful under HRS § 321-14.8 and HAR Title 11, Chapter 700. Before hiring anyone to care for an aging parent in Big Island (Hawaiʻi Island), understand the difference between state-licensed agencies and unlicensed registries.
The Hawaii Department of Health — Office of Health Care Assurance (OHCA) inspects and licenses 20 Home Care Agencies (`-HCA`) and Home Health Agencies (`HHA-`) authorized to serve the Island of Hawaii across Hilo, Keaʻau, Kealakekua/Kona, and Kamuela/Waimea. State-licensed agencies must maintain:
Hawaii law distinguishes between two types of in-home licenses overseen by OHCA:
-HCA under HRS § 321-14.8 & HAR Chapter 11-700): Provide non-medical personal care (bathing, dressing, hygiene, mobility, continence), homemaker services (meal prep, housekeeping, shopping), companionship, and family respite care. Paid primarily via private pay, Long-Term Care Insurance, VA Aid & Attendance, or Hawaii County Kupuna Care.HHA- under HAR Chapter 11-97.1): Provide doctor-ordered intermittent clinical care such as skilled nursing, physical therapy, occupational therapy, and wound care after a stay at Hilo Benioff Medical Center, Kona Community Hospital, and Queen’s North Hawaiʻi Community Hospital.When a partner agency contacts you after submitting our form, ask for their Hawaii DOH OHCA License Number (for example, ###-HCA or HHA-##). Only 20 agencies hold active state licenses for the Island of Hawaii, and verifying their OHCA license ensures Long-Term Care Insurance and VA Aid & Attendance claims are accepted.
Because Hilo and Kailua-Kona are 75 to 90+ minutes apart across Saddle Road (Daniel K. Inouye Highway), our referral system routes your inquiry by district to agencies with caregiver teams on your side of the island.
View complete Big Island (Hawaiʻi Island) district & ZIP code coverage guide →
According to the CareScout / Genworth Cost of Care Survey and Hawaiʻi County agency data, non-medical in-home care in Hawaii averages $37 to $41+ per hour ($41/hr state median). Part-time companion or personal care (16–20 hours/week) typically costs $2,840 to $3,550 per month, while full-time 44-hour/week care averages $7,817 per month—saving Big Island families $4,200 to $8,500+ per month compared to assisted living ($12,096/mo median) or nursing homes ($15,473–$16,395/mo).
Hawaiʻi Island covers 4,028 square miles, and Hilo and Kailua-Kona are separated by Mauna Kea, Mauna Loa, and a 75–90 minute drive across Saddle Road. When you select your district on our form, we match you specifically with Hawaii DOH-licensed agencies that dispatch caregivers in your region—whether that is Hilo/Puna on the East side or Kailua-Kona, Captain Cook, Waikōloa, and Waimea on the West side.
Yes. Most private Long-Term Care (LTC) insurance policies and the VA Aid & Attendance pension benefit (supported via the Hilo and Kailua-Kona VA clinics) reimburse for non-medical personal care when delivered by a Hawaii DOH state-licensed Home Care Agency (-HCA).
No. BigIslandHomeCare.com is a free, independent consumer information and referral service in Hawaiʻi County, HI. We do not employ caregivers or provide medical or personal care services directly. We connect Big Island families exclusively with Hawaii Department of Health OHCA state-licensed Home Care Agencies (-HCA) and Home Health Agencies (HHA-).