Caregiving without breaks leads to burnout, and respite is the planned, paid-for break that lets you keep going. Here is how to find it and who pays.
If you're caring for an aging parent, a spouse with dementia, or an adult child with a serious disability, you've probably reached the point where you can't remember the last time you had a full uninterrupted night of sleep, or a meal you ate sitting down, or an afternoon that belonged just to you. That feeling has a name, caregiver depletion, and the way out is not "trying harder." It's respite. A real, planned, paid-for break. Sometimes for an afternoon. Sometimes for a week.
This guide is a practical map of every respite option available in Tennessee in 2026: who pays for it, what it costs, where to find it, and the underused state grants that exist precisely so you don't have to fund this out of your own savings.
You're Not Alone, and You're Not Failing
Before we get into the program details, one thing worth saying out loud: needing respite care in Tennessee is not a moral failing. It's not a sign you don't love the person you're caring for. It's not weakness. Decades of research on family caregivers shows the opposite: caregivers who take regular breaks have better physical health, lower rates of depression, fewer ER visits of their own, and most importantly, are able to keep their loved one at home longer than caregivers who try to do it alone.
In other words: respite is not the thing that takes care away from your loved one. It's the thing that lets you keep providing care without burning out.
If you're reading this in a moment of crisis, skip ahead to the Emergency Respite section near the bottom. If you're planning ahead, the rest of the guide walks through your options in order from most affordable to most flexible.
The Four Types of Respite Care
1. In-Home Respite
A paid caregiver (or sometimes a trained volunteer) comes to your home for a few hours, a full day, or occasionally overnight. You leave, rest, run errands, or simply close a door. They handle whatever your loved one needs: meals, medication reminders, supervision, light personal care.
Typical duration: 2–8 hours, occasionally overnight or for a multi-day stay.
How it's funded in Tennessee:
- TennCare CHOICES (Groups 2 and 3): covers up to 216 hours/year of in-home respite. Available through Consumer Direction so the family can hire a specific worker. Talk to your MCO Care Coordinator.
- NFCSP grants through your AAAD: typically $300–$500 as one-time grants toward private respite.
- Family-Directed Respite Voucher through DDA/AAADs: up to $2,500/year per beneficiary for in-home care, adult day, or facility respite. Caregiver chooses the provider.
- VA in-home respite for enrolled veterans: up to 30 days/year, copay up to $97/day.
- Private pay home care agencies: Tennessee statewide median is roughly $23–$27/hour for personal care / home health aide and $19–$26/hour for companion care, with Nashville running higher at roughly $24–$30/hour.
- Privately hired caregivers: if you hire someone directly rather than through an agency you typically pay below the agency rate (Tennessee's TennCare CHOICES Consumer Direction wage range is $11–$15/hour as a public benchmark), but you handle taxes, scheduling, and backup coverage yourself.
2. Adult Day Services
A structured daytime program at a community center, typically 4–10 hours per day, that includes meals, activities, social engagement, and (at most TN centers) some level of nursing oversight, medication administration, and personal care. For people with dementia, adult day is often the single biggest difference-maker: the structure, the social contact, and the daytime activity often improve sleep, mood, and behavior, while giving the family caregiver consistent hours back during the workday.
Typical duration: 4–10 hours per day, multiple days per week.
Cost in Tennessee (2026): Approximately $85–$100/day private pay. Tennessee's adult day cost is roughly aligned with the national median ($95/day per the Genworth/CareScout 2025 Cost of Care report).
How it's funded:
- TennCare CHOICES Group 2: covers up to 2,080 hours/year of adult day care through MCO-contracted providers. The most generous public funding source for adult day in Tennessee.
- Family-Directed Respite Voucher: the $2,500/year DDA voucher can pay for adult day services.
- NFCSP grants: the smaller per-grant amounts can offset a few weeks of adult day cost.
- Private pay: $85–$100/day, or roughly $1,800–$2,200/month for a 5-day-per-week schedule.
- Long-term care insurance: many policies cover adult day; check the policy's HCBS rider.
Where to find a center: Tennessee has approximately 30+ TDHS-licensed Adult Day Services centers in 2026, concentrated in Davidson, Knox, Shelby, Hamilton, and Rutherford counties. The Tennessee Association of Adult Day Services (TAADS) maintains a directory. The TDHS public roster is also available at tn.gov/humanservices.
A note on terminology: Tennessee uses a single licensure category for adult day, so the social-model vs medical-model distinction familiar from other states isn't a regulatory line here. Most TN centers blend social activities with health-related services (medication administration, basic nursing oversight) under the same license.
3. Short-Term Facility Respite
A few days to a few weeks in an assisted living, memory care, or nursing facility while you take a vacation, recover from your own surgery, attend a family event, or simply collapse for a week. Some facilities have dedicated respite suites; others fit respite stays into open beds as availability allows.
Typical duration: 3 days to 30 days. CHOICES caps inpatient respite at 9 days/year per member.
Cost (private pay, 2026 TN): Tennessee assisted living runs roughly $4,200–$5,300/month for long-term residency, which works out to about $140–$177/day; respite stays typically carry a per-day premium over that long-stay rate, and nursing-facility and memory-care respite price even higher. Most facilities quote respite as a daily rate that includes meals, lodging, and basic care; ask each facility directly for its respite pricing.
How it's funded:
- TennCare CHOICES Groups 2 and 3: covers up to 9 days/year of inpatient respite (no PASRR required).
- VA Respite Care: up to 30 days/calendar year for enrolled veterans, including stays at VA Community Living Centers, VA-contracted residential care, or community facilities. Copay up to $97/day.
- NFCSP / Family-Directed Respite Voucher: can offset a portion of a facility respite stay.
- Long-term care insurance: some policies cover short-term facility respite.
- Private pay: the most common funding source for stays beyond the 9-day CHOICES cap.
4. Emergency Respite
For caregivers in crisis: sudden illness, hospitalization, a car accident, a family death, or simply hitting a wall. Emergency respite is harder to access on short notice but it does exist.
Where to start in a crisis:
- Your AAAD at 1-866-836-6678 (statewide): sometimes can arrange emergency respite or refer to a local crisis program.
- Alzheimer's Association 24/7 Helpline at 1-800-272-3900 if the crisis involves dementia.
- Alzheimer's Tennessee (independent state nonprofit) at 1-888-326-9888, Knoxville-based, statewide reach.
- VA Caregiver Support Line at 1-855-260-3274 for veteran families.
- Adult Protective Services at 1-888-277-8366 if the situation involves immediate risk to your loved one's safety.
- Local hospice agencies sometimes provide respite even when the care recipient isn't on hospice, call any local hospice and ask.
If your loved one is on Medicare hospice, the hospice benefit includes up to 5 days of respite per benefit period in a Medicare-certified facility. This is one of Medicare's only direct respite benefits.
The Underused Funding: NFCSP and the Family-Directed Respite Voucher
Tennessee has two state-level respite funding sources that almost no one talks about and far too few families use. Both run through your local Area Agency on Aging and Disability (AAAD).
NFCSP Grants
The National Family Caregiver Support Program (NFCSP) is federally funded through the Older Americans Act and delivered locally by Tennessee's 9 AAADs.
Eligible caregivers include:
- Caregivers of people age 60+ who need help with at least one ADL.
- Caregivers of people with Alzheimer's or related dementia regardless of the care recipient's age.
- Grandparents or other relatives age 55+ raising children (separate eligibility category).
NFCSP services at most TN AAADs include:
- Respite vouchers or grants (typically $300–$500 as one-time grants).
- Caregiver training classes including Powerful Tools for Caregivers, Stress-Busting for Family Caregivers, and Creating Confident Caregivers.
- Support groups (in-person and virtual).
- Individual care consultation with a counselor.
- Supplemental services: transportation, legal consultation, emergency supplies.
No income test. Many TN families assume programs like this are means-tested and don't bother applying. NFCSP is not.
Family-Directed Respite Voucher
Separate from NFCSP, Tennessee's DDA (through the AAADs and the TN Caregiver Coalition) administers a Family-Directed Respite Voucher Program that provides up to $2,500/year per beneficiary for in-home care, adult day services, or short-term facility respite. The caregiver chooses the provider, the voucher reimburses the cost.
This voucher is one of the strongest publicly funded respite supports in the state. Combined with TennCare CHOICES respite hours (for members) or used standalone (for non-CHOICES households), it can cover a meaningful portion of yearly respite cost.
How to Access Both
Call the statewide AAAD line at 1-866-836-6678. The intake worker will route you to your regional AAAD based on your county. When you call, ask for:
- NFCSP caregiver support services and current respite grants.
- The Family-Directed Respite Voucher Program (sometimes called the FDRP voucher).
- A care consultation to walk through your situation.
- Powerful Tools for Caregivers or Stress-Busting classes if available locally.
Tennessee's 9 AAADs cover all 95 counties: First Tennessee (Johnson City), East Tennessee (Knoxville), Southeast Tennessee (Chattanooga), Upper Cumberland (Cookeville), Greater Nashville Regional Council, South Central Tennessee, Northwest Tennessee, Southwest Tennessee (Jackson), and the Memphis-area AAAD.
TennCare CHOICES Respite (For Enrolled Members)
If your loved one is already enrolled in TennCare CHOICES Group 2 or Group 3, respite is built into the benefit package. The challenge is that the benefit is routinely underused, usually because families don't know to ask, or because the MCO Care Coordinator didn't proactively raise it during care planning.
CHOICES respite includes:
- In-home respite: 216 hours/year. Available through Consumer Direction (you choose the worker, CDTN handles payroll) or through MCO-network providers.
- Adult day care: 2,080 hours/year, by far the biggest CHOICES respite benefit by total hours. Through MCO-contracted adult day centers.
- Inpatient respite: 9 days/year, in a TennCare-contracted facility. No PASRR required for stays under that cap.
How to activate CHOICES respite:
- Call your MCO Care Coordinator (BlueCare 1-888-747-8955; UnitedHealthcare Community Plan 1-800-690-1606; Wellpoint 1-833-731-2153). Ask for respite to be added to the Person-Centered Support Plan.
- Specify which type of respite you need (in-home, adult day, inpatient) and how often.
- If using Consumer Direction, name the worker you want to hire. CDTN at 1-888-444-3109 handles payroll and tax withholding.
- Request the maximum hours authorized by your loved one's care needs, the Care Coordinator may default to less than the cap.
If your CHOICES respite request is denied or reduced, you have appeal rights. See the How to Apply for TennCare guide for the two-track appeal process.
VA Respite for Veteran Caregivers
If your loved one is a VA-enrolled veteran, the VA offers respite as a covered benefit and offers significant separate caregiver support.
VA Respite Care benefit: up to 30 days per calendar year for enrolled veterans meeting clinical criteria. Settings include in-home respite, VA Community Living Centers, VA-contracted residential care, and adult day health care. Copay up to $97/day depending on Priority Group and disability status.
Program of Comprehensive Assistance for Family Caregivers (PCAFC): for primary family caregivers of veterans with a 70%+ service-connected rating who need 6+ continuous months of in-person personal care. PCAFC pays a monthly stipend to the caregiver and includes respite support. As of 2026, PCAFC is expanded to all veteran eras (post-9/11 AND pre-9/11). The September 29, 2025 final rule extended legacy participant transition protections through September 30, 2028.
Program of General Caregiver Support Services (PGCSS): open to caregivers of any veteran enrolled in VA health care, regardless of era or service-connection rating. No monthly stipend, but provides peer support, training, and self-care resources.
Tennessee VA Medical Centers (where to start):
| VAMC | Phone | Service Area |
|---|---|---|
| VA Memphis Healthcare System | 901-523-8990 | West Tennessee |
| VA Tennessee Valley - Nashville | 615-327-4751 | Middle Tennessee |
| VA Tennessee Valley - Alvin C. York (Murfreesboro) | 615-867-6000 | Middle Tennessee |
| VA Mountain Home (Johnson City) | 423-926-1171 | East Tennessee |
Each TN VAMC has a Caregiver Support Coordinator (CSC) who can arrange respite, evaluate PCAFC eligibility, and connect families to community resources. Call the facility switchboard and ask for the Caregiver Support Coordinator, or use the CSP Team Locator at caregiver.va.gov. The national VA Caregiver Support Line is 1-855-260-3274 (Mon–Fri 8am–10pm ET, Sat 8am–5pm ET).
Tennessee Dementia-Specific Respite
If you're caring for someone with Alzheimer's or related dementia, several Tennessee resources are specifically designed for your situation.
Two distinct organizations operate in Tennessee, and these are NOT the same group:
- Alzheimer's Association, Tennessee Chapter (alz.org/tn): the state affiliate of the national Alzheimer's Association. Offices in Nashville, Knoxville, Memphis, and Chattanooga. 24/7 Helpline: 1-800-272-3900 (English plus 200+ languages). Provides care consultations, support groups, training, and education programs.
- Alzheimer's Tennessee, Inc. (alztennessee.org): an independent state nonprofit founded in 1983, headquartered in Knoxville. Helpline: 1-888-326-9888. Operates the Howard Circle of Friends Adult Day Services in Knoxville.
Both organizations offer support; some families work with both. The two helplines are separate.
Tennessee state dementia resources:
- Family-Directed Respite Voucher Program (covered above) is dementia-friendly: many families with a dementia diagnosis use it for adult day services.
- DDA Statewide Dementia Coordinator: Keita Cole at 615-347-6890 (also serves as DDA's Nutrition Services Director).
- Alzheimer's Disease Program Initiative (ADPI), federal cooperative grant to DDA running through September 2026, funds statewide Dementia Navigators who provide live referral support to families newly facing a dementia diagnosis. No-cost first-line resource.
Pending legislation: The Tennessee Caring for Caregivers Act (sponsored by Rep. Renea Jones, passed both chambers Spring 2026, awaiting Governor Lee's signature as of May 2026) would establish a three-year DDA pilot grant program providing up to $6,000/year per family to reimburse dementia caregivers for home modifications, durable medical equipment, and respite care. Year-one appropriation is $600,000, divided evenly across East, Middle, and West Tennessee.
This article will be updated when the act is signed and the application opens.
What Each Respite Option Costs (Tennessee 2026)
| Type | Private-pay cost | Public funding available |
|---|---|---|
| In-home respite (private hire) | Below agency rate; CHOICES CD wage benchmark $11–$15/hr | NFCSP, FDRP voucher, CHOICES (216 hrs/yr), VA |
| In-home respite (agency) | TN statewide median $23–$27/hr (companion $19–$26/hr) | NFCSP, FDRP voucher, CHOICES (216 hrs/yr), VA |
| Adult day services | $85–$100/day | CHOICES (2,080 hrs/yr), FDRP voucher, NFCSP |
| Assisted living respite | Premium over $140–$177/day long-stay rate; ask each facility | CHOICES (9 days/yr), VA, FDRP voucher |
| Nursing facility respite | Daily rate; ask each facility | CHOICES (9 days/yr), VA, Medicaid (if NF-eligible) |
| Memory care respite | Daily rate; ask each facility | CHOICES (9 days/yr), FDRP voucher, VA |
| Hospice respite | Bundled into hospice | Medicare/TennCare hospice benefit (5 days/period) |
The pattern is clear: adult day services are by far the most cost-efficient structured respite option, and the AAAD-administered grants and vouchers stretch much further when paired with adult day than with facility-based respite.
Frequently Asked Questions
Generally no. Medicare's only direct respite benefit is bundled into the Medicare Hospice Benefit, which covers up to 5 days of inpatient respite per benefit period in a Medicare-certified facility, and only for someone who has elected hospice. For non-hospice respite, Medicare does not pay.
If your loved one has a Medicare Advantage plan, check the plan's "Special Supplemental Benefits for the Chronically Ill" (SSBCI), some MA plans now include limited respite. Plans vary.
Standard TennCare doesn't have a dedicated respite benefit. Respite is a CHOICES (or ECF CHOICES, or Katie Beckett) benefit. If your loved one is on Standard TennCare and would clinically qualify for CHOICES, the path is to apply for CHOICES, the How to Apply for TennCare guide walks through that process.
Several non-Medicaid options:
- NFCSP grants and Family-Directed Respite Voucher through your AAAD, neither requires TennCare enrollment.
- OPTIONS for Community Living, Tennessee's state-funded HCBS program for older adults at risk of nursing-facility placement. Also through AAADs.
- VA respite if your parent is a VA-enrolled veteran.
- Long-term care insurance if there's a policy with HCBS coverage.
- Private pay, adult day services at $85–$100/day are often the most accessible private-pay option.
Yes, in some situations. Through TennCare CHOICES Consumer Direction, family members (other than spouses) can be hired as paid CHOICES workers, including for respite. Through the agency-employed pathway opened by Public Chapter 182 of 2025, spouses and parents of minor children can also be hired by TennCare-contracted provider agencies. See the How to Get Paid as a Family Caregiver in Tennessee guide for the full landscape.
It's the most common worry families raise, and almost universally families report being surprised after a few weeks. Adult day services in Tennessee are usually warm, social, structured environments with meals, activities, exercise, music, and (for dementia centers) cognitive engagement specifically designed to slow decline. Most centers will offer a free trial visit so your parent can experience it first.
For people with dementia in particular, the structure and social contact often improve mood, sleep, and behavior, and give the family caregiver consistent hours back.
Call the AAAD line at 1-866-836-6678. It's free, the intake worker is paid to help you sort through options, and there's no pressure to enroll in anything. They can also connect you to a care consultation through NFCSP, a structured one-on-one conversation with a caregiver counselor, which is often the most useful single hour you'll spend.
The Tennessee Caring for Caregivers Act passed both chambers of the General Assembly in spring 2026 and as of early May 2026 is awaiting Governor Lee's signature. If signed, it will establish a three-year DDA pilot grant program providing up to $6,000/year per family to reimburse dementia caregivers for home modifications, equipment, and respite, with year-one funding of $600,000 split across East, Middle, and West Tennessee. We'll update this guide once the act is signed and the application process is published.
Learn More
Respite Care for Family Caregivers: The 50-State Guide Respite is one piece of caregiver support. The other pieces of Tennessee's caregiver landscape:
Find personalized help mapping Tennessee respite options to your family's situation 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.