Missouri family caregivers can find funded respite care through the Aged and Disabled Waiver and a federal caregiver program delivered by Missouri's 10 Area Agencies on Aging. That program is the National Family Caregiver Support Program (NFCSP). Consumer Directed Services (CDS) can pay a relative for hands-on personal care, but not for respite. Call 1-800-235-5503 to reach your local agency.

Caregiving without breaks is unsustainable. The research is clear: family caregivers who go without regular relief experience higher rates of depression, cardiovascular problems, and burnout than the general population. More practically, caregivers who build in respite keep their loved ones home longer than those who don't. A break isn't abandonment. It is what makes the long haul possible.

This guide maps every funded respite option in Missouri for 2026.

Why Respite Care Matters for Missouri Caregivers

Missouri has hundreds of thousands of unpaid family caregivers providing daily care without formal support or scheduled relief. The toll is real: elevated rates of anxiety, physical illness, and social isolation compared to non-caregiving peers.

Respite care addresses that directly. In-home respite gives the care recipient companionship and skilled attention while the caregiver rests. Adult day services provide structured programming, meals, and social connection during the day, freeing caregivers to work, sleep, or simply breathe. Short-stay facility respite gives families a longer window for travel or recovery from illness.

Not every option depends on Medicaid. Missouri's Senior Resource Line lists caregiver respite under family caregiver support, and separately lists in-home personal care, homemaker and respite services for non-Medicaid older adults.

Funded Respite Care Options in Missouri

1. Consumer Directed Services (CDS): Personal Care, Not Respite

What it is: Consumer Directed Services (CDS) is Missouri's Medicaid State Plan personal care benefit, offered through the Department of Health and Senior Services (DHSS), Division of Senior and Disability Services (DSDS). It lets a Medicaid-eligible adult (18 or older) with a physical disability who can direct their own care and can live independently, and who meets a nursing facility level of care, do the hiring, training, supervising, and directing of their own personal care attendant. The participant is the attendant's employer-of-record. People living in a nursing facility, or in a Residential Care Facility or Assisted Living Facility licensed by DHSS, are not eligible.

What it does not pay for: CDS is not a respite benefit. The HCBS manual states that CDS provides "hands-on" assistance with physical tasks, and that no time can be authorized for respite care or for stand-by assistance, prompting, or cueing. So a relative cannot be paid under CDS for time spent on stand-by assistance, prompting, or cueing.

Who can be the attendant? Missouri regulation 19 CSR 15-8.100 defines the CDS attendant as "a person, other than the consumer's spouse," and the attendant qualifications in the same chapter require the attendant to "Be a person other than the consumer's spouse or guardian," not be a consumer, and not have been involved in Medicaid fraud previously. The DHSS HCBS Policy Manual states that the attendant may be a family member, so an adult child, sibling, or other relative may be hired and paid. These rules are specific to CDS, Missouri's self-directed model, and are not statements about the state's agency-model personal care.

If someone holds a guardianship or power of attorney: The manual and the regulation pull apart here. The HCBS manual states that a person with a guardian or conservator cannot be rejected for CDS solely for that reason, but the regulation's definition of "consumer" leaves out anyone with a guardian or conservator, or with an effective power of attorney covering the CDS duties. Ask DSDS how these apply before counting on CDS.

How to access: The Missouri DHSS Division of Senior and Disability Services (DSDS) handles the intake of Home and Community-Based Services (HCBS) referrals. The participant, family, friends, or informal supports may submit a referral by phone at 866-835-3505, or you can contact your local Aging and Disability Resource Center (ADRC). Financial eligibility is determined by the Family Support Division (FSD); functional eligibility by DSDS.,

Best for: Medicaid-eligible adults with physical disabilities who need hands-on personal care from an attendant they hire, including a family member other than a spouse or legal guardian.

2. Aged and Disabled Waiver (ADW)

What it is: Missouri's Aged and Disabled Waiver (ADW) is a Medicaid home and community based services waiver administered by DHSS's Division of Senior and Disability Services. Its two government descriptions state the age test differently, so check both: myDSS describes in-home services for people aged 63 or over who would require nursing home care without them, while the CMS waiver factsheet describes people 65 or older and people with physical disabilities aged 63-64 who meet a nursing facility level of care. Covered services include homemaker, chore, respite, home-delivered meals and adult day care; the CMS factsheet lists basic respite and advanced respite separately.

Respite through the waiver: If your loved one is enrolled in the ADW, ask that respite be included in the care plan. Respite and adult day care are both among the waiver's listed services.

How to access: Your loved one, or a family member, friend, or informal support, may submit an HCBS referral to DSDS by phone at 866-835-3505. For someone not currently authorized for HCBS, DSDS's online HCBS referral form is the first point of contact. See also the Missouri DSS Aged and Disabled Waiver page.

Best for: Older adults who meet a nursing facility level of care and need respite arranged through a Medicaid waiver.

3. NFCSP Caregiver Services Through Missouri's 10 Area Agencies on Aging

What it is: The National Family Caregiver Support Program (NFCSP), authorized by Title III-E of the Older Americans Act, makes federal grants to states based on their share of the population age 70 and over. Its services are provided by an area agency on aging or an entity it contracts with, and Missouri has 10 Area Agencies on Aging covering every county. The five service categories are information about available services; help gaining access to them; individual counseling, support groups and caregiver training; respite care; and supplemental services on a limited basis.,

Who qualifies: ACL lists adult family members or other informal caregivers of people 60 and older; caregivers of people of any age with Alzheimer's disease or a related disorder; relatives (not parents) age 55 and older caring for children under 18; and relatives, including parents, age 55 and older caring for adults 18-59 with disabilities. Federal law adds conditions for the two older-relative groups: the older relative caregiver must live with, be the informal provider of in-home and community care to, and be the primary caregiver for the child or the adult with a disability. For a child, the caregiver must also be a relative other than the parent, be the primary caregiver because the parents are unable or unwilling to serve, and have a legal relationship to the child, such as legal custody, adoption, or guardianship, or be raising the child informally.

The respite condition: Respite and supplemental services carry a condition the first three categories do not. For a family caregiver, they are available only where the person cared for is an older individual who is "frail" under federal law: unable to perform at least two activities of daily living without substantial human assistance, or needing substantial supervision because a cognitive or other mental impairment leads them to behave in a way that poses a serious health or safety hazard. Ask your AAA what respite it offers and whether there is any cost.

How to access: Call the Missouri Senior Resource Line at 1-800-235-5503, a DHSS service; you are prompted to enter your ZIP code, which connects you with your local Area Agency on Aging. You can also find your local AAA by visiting the Eldercare Locator website or calling 1-800-677-1116.

Best for: Family caregivers who fit one of the groups above and meet its conditions.

4. Adult Day Programs

What they are: Adult day and adult day health centers offer structured daytime programming, typically 4 to 8 hours a day, with meals, activities, social engagement, and varying levels of nursing support. For caregivers of people with dementia, consistent adult day attendance often reduces behavioral symptoms and makes sustained home care more manageable.

Finding programs: Call the Missouri Senior Resource Line at 1-800-235-5503 and enter your ZIP code to reach your local Area Agency on Aging. The line provides information and assistance on services including family caregiver support and caregiver respite.

Who pays:

Best for: Caregivers who need consistent weekday relief and care recipients who benefit from structured activity and peer engagement.

5. VA Respite for Veterans

What it is: Veterans enrolled in VA health care can access respite through their local VA medical center, including in-home aide services, adult day health, and short-term placement in VA Community Living Centers or contracted facilities.

PCAFC: Primary Family Caregivers in the Program of Comprehensive Assistance for Family Caregivers receive respite care as part of the benefit package; confirm authorized services and any cost-sharing with the VA Caregiver Support Coordinator.

How to access: Call the VA Caregiver Support Line at 1-855-260-3274, Monday through Friday, 8:00 a.m. to 8:00 p.m. ET. Its team provides information on support services and can connect you directly to your local VA Caregiver Support Program team. You can also contact the Caregiver Support Coordinator at the Kansas City VA Medical Center, the St. Louis VA Medical Center, or your nearest VA facility.

If you are in crisis: The Caregiver Support Line keeps the weekday hours above. If you are in crisis or having thoughts of suicide, call 988 (press 1), text 838255, or visit VeteransCrisisLine.net for more resources.

Best for: Families of veterans enrolled in VA health care.

How to Start Respite Care in Missouri

1
Step 1

Call the Missouri Senior Resource Line at 1-800-235-5503

Enter your ZIP code when prompted and you are connected with your local Area Agency on Aging. The line provides information and assistance on family caregiver support, including caregiver respite, support groups, and training.

2
Step 2

Ask DHSS about CDS if your loved one has Medicaid

If your loved one has Medicaid and a physical disability, you or another family member may submit a Home and Community-Based Services referral to the DHSS Division of Senior and Disability Services by phone at 866-835-3505. CDS can pay a family member other than a spouse or legal guardian for hands-on personal care, but it does not pay for respite.

3
Step 3

Ask about the Aged and Disabled Waiver if your loved one is 63 or older

Through the same DHSS phone line (866-835-3505), submit an HCBS referral and ask about the Aged and Disabled Waiver if your loved one meets a nursing facility level of care, and ask that respite be written into the care plan. myDSS gives the age as 63 or over, while the CMS factsheet says 65 or older, or 63-64 with a physical disability, so ask DSDS which applies.,

4
Step 4

Call the VA Caregiver Support Line at 1-855-260-3274 if your loved one is a veteran

It is staffed Monday through Friday, 8:00 a.m. to 8:00 p.m. ET, and can connect you directly to your local VA Caregiver Support Program team.

5
Step 5

Dial 211 for local referrals

The 211 line connects you to local social service referrals and county adult day program directories.

Where to Get Respite Help in Missouri

DHSS Division of Senior and Disability Services Takes Home and Community-Based Services referrals and care plan change requests. The phone line is reserved for participants and their supports; providers use the online options. Someone not currently authorized for HCBS can start with the online HCBS referral form. 866-835-3505 health.mo.gov/partners-providers/home-community-based-services-provider-information/hcbs-referrals-requests-eligibility-determination
Missouri Senior Resource Line A DHSS line: enter your ZIP code to reach your local Area Agency on Aging. The line provides information on family caregiver support, including caregiver respite, support groups, and training. 1-800-235-5503
VA Caregiver Support Line Monday through Friday, 8:00 a.m. to 8:00 p.m. ET. Information on VA caregiver support and a direct connection to your local VA Caregiver Support Program team. In a crisis, call 988 (press 1). 1-855-260-3274 www.caregiver.va.gov
Eldercare Locator Find your local Area Agency on Aging by visiting the Eldercare Locator website or calling 1-800-677-1116. 1-800-677-1116 eldercare.acl.gov

Not sure which Missouri respite program fits your family? Chat with Brevy's care navigator for a personalized list based on your loved one's Medicaid status, age, and care needs.

Frequently Asked Questions

Does Missouri Medicaid pay for respite care?

Through the Aged and Disabled Waiver, yes: respite and adult day care are among its listed services for people who meet a nursing facility level of care. CDS is different. It pays a hired attendant, who may be a family member other than a spouse or legal guardian, for hands-on personal care, and the HCBS manual states that no time can be authorized under CDS for respite care. Talk to DHSS or your regional ADRC to confirm eligibility.,

Can a spouse be the paid CDS attendant in Missouri?

Not under CDS. Missouri regulation 19 CSR 15-8.100 excludes a consumer's spouse from the definition of the CDS attendant, with no exception. Other relatives (an adult child, sibling, or extended family member) can be hired and paid, as long as they are not the participant's legal guardian, have not previously been involved in Medicaid fraud, and are not a current CDS participant themselves. Under CDS, a different family member would need to cover the paid personal care hours. Missouri's agency-model personal care also bars a spouse as the aide, and the Aged and Disabled Waiver bars a spouse from its homemaker, chore and respite services., The exception is dementia: Missouri's Structured Family Caregiving Waiver can pay a live-in spouse of a Medicaid participant with Alzheimer's disease or a related dementia, through an enrolled provider agency.

Is there respite in Missouri without Medicaid?

Yes, with conditions. Missouri's 10 Area Agencies on Aging deliver NFCSP caregiver services, and under federal law NFCSP respite for a family caregiver requires that the older person cared for is frail: needing substantial help with at least two activities of daily living, or, because of a cognitive or other mental impairment, needing substantial supervision because they behave in a way that poses a serious health or safety hazard. The Missouri Senior Resource Line also lists in-home personal care, homemaker and respite services for non-Medicaid older adults. Call it at 1-800-235-5503 to reach your local AAA and ask what it offers and whether there is any cost.,

What is the difference between CDS and the Aged and Disabled Waiver for respite?

CDS is a self-directed State Plan personal care benefit: the participant hires, trains, supervises, and directs their own attendant, who can be a family member other than a spouse or legal guardian, for hands-on physical tasks. It is not a respite benefit, because the HCBS manual states that no time can be authorized under CDS for respite care. The ADW is a Medicaid waiver administered by DHSS whose covered in-home services include homemaker, chore, respite, home-delivered meals and adult day care for people who meet a nursing facility level of care., The waiver has its own family rule: its respite aide must be an employee of an enrolled provider agency and cannot be an immediate family member (a parent, sibling, child or stepchild, spouse, grandparent or grandchild), and respite is limited to 49 hours a week, whether basic, advanced or a combination of both.

Can the Aged and Disabled Waiver and CDS be used together?

Ask DSDS, which administers the ADW and through which CDS is offered. Coordination depends on the specific services authorized in each program and the participant's assessment. One limit is stated in the HCBS manual: CDS shall not exceed 60% of the cost maximum, including when combined with agency-model personal care. Because CDS cannot pay for respite, respite would come through the waiver or another program. A DHSS case manager or ADRC can clarify how services can stack in your situation.,

Learn More

CaregiverRespite Care for Family Caregivers: The 50-State GuideWhat respite care is and how to pay for it in 2026: the main types, NFCSP respite with no income test, Medicaid and VA respite, and every state guide. CaregiverHow to Get Paid as a Family Caregiver in MissouriGet paid as a family caregiver in Missouri in 2026: Consumer Directed Services, the dementia caregiving waiver that can pay a spouse, pay rates, and VA options. CaregiverCaregiver Burnout: Signs, Stages, and How to Get SupportHow to recognize caregiver burnout, why it happens, and what actually helps, from respite care to evidence-based programs like REACH II and Powerful Tools. VA BenefitsVA Aid and Attendance in MissouriVA Aid and Attendance in Missouri for 2026: who qualifies, annual rates up to $34,488, how to apply, and free help from the Missouri Veterans Commission. Care TypesThe Cost of Senior Care in MissouriWhat senior care costs in Missouri in 2026: assisted living about $5,400 a month, a nursing home about $80,893 a year (CareScout 2025). See every setting. CaregiverCaregiver Programs in MissouriEvery caregiver program in Missouri: Consumer Directed Services paid pathways, the Aged and Disabled Waiver, respite, NFCSP grants, VA benefits, and taxes.

Find personalized help navigating respite care options in Missouri at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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