Home care agencies in Washington DC became increasingly prevalent as family members could not adequately care for their disabled loved ones. Decades ago, it was more likely that one spouse did not work full-time, or even part-time, and could provide the necessary daily living care that would allow a disabled relative to avoid moving to a nursing home. It also was more common for immediate family members to spend most or all of their lives in the same area or even the same community. Extended families often lived in the same neighborhood or even the same household. Times have changed, and a professional caregiving service helps families who do not fit these characteristics.