How much does in home elder care cost?

If you are considering elder care for a loved one, a number a factors go into making the right choice for your family. For most people, cost is near the top of that list. So, how much does eldercare cost? There is not a one size fits all answer, and it depends on both the type of care and where you live. We’ve put together an overview of senior care services and residential living situations and their associated average costs.  

Elder Care Costs by Type of Care

Non-Medical Home Care

With this type of care, home care aides provide non-medical assistance to seniors, including:

• personal hygiene
• laundry
• cooking 
• transportation

Oddly enough, home care does not necessarily have to be provided in the home. It can also be made available to persons residing in assisted living. Note that location has no effect on the price. Typically, a home care aide will visit a home a few times a week for visits lasting between 2 – 8 hours. In 2019, the national average for non-medical, in-home care was $21 per hour, with different state averages ranging from $16 – $28 per hour. These are average costs from home care agencies. Private individuals can be hired to offer some of the same services with fees 20-30% lower. 

Home Health Care

Home health aides offer skilled care and perform care like checking patients’ pulse, temperature and respiration and helping with medical equipment like a ventilator. They will come to the home as much as medically necessary but usually for shorter periods of time than home care aide visits. In 2019, the national average was $22 per hour, with different state averages ranging from $16 – $29 per hour.

Adult Day Care

The average daily rate for adult day care is less than half that of assisted living, one third of home care and almost a quarter of nursing home care.

Adult day care centers offer the elderly supervision, meals and snacks, help with daily living activities, and social and recreational activities in a structured setting during daytime hours. Some adult day care centers also offer transportation to and from the facility at no additional cost. In 2019, the national average was $72 per day with different state averages ranging from $35 – $136 per day. Adult day medical care gives the supervisory and social aspects of adult day care and provides more intensive health and therapeutic services for those with serious medical problems and those at risk of requiring nursing home care. Families should expect to pay 5% – 15% more for adult day health / medical care than for regular adult day (social) care. 

Assisted Living & Memory Care

Assisted living residences help with activities of daily living, including:

• bathing
• dressing
• mobility
• toiletry
• medication management
• light housecleaning
• basic health services
• supervision
• recreational and social activities 

Cost is typically made up of monthly rent with additional costs based upon the level of attention the required by the resident. In 2019, the national average amount paid was $4,000 per month, and different state averages range from $2,844 to $9,266. Patients who need Alzheimer’s or dementia care in memory care homes, also called Alzheimer’s units, can expect to pay an additional 20 – 30% more each month on average.  

Nursing Homes

If you are looking for 24/7 care by licensed health professionals, a skilled nursing residence is the right choice. They include all housekeeping, medical, and social needs. In 2019, the average cost for a shared room was $245 per day with different state averages ranging from $153 per day to $963 per day.  A shared residence is typically 10-20% cheaper than a private one.  

Continuing Care Retirement Communities

These residences provide a spectrum of care ranging from independent living to assisted living to skilled nursing. These communities are designed to let seniors live in a single residential location. This is particularly appealing for the those with declining health conditions or couples in mixed health. While CCRCs offer many benefits for seniors, they are the most expensive long-term-care solution available. Be prepared to pay for a one-time entrance fee and monthly maintenance fees. Entrance fees typically cost between $80,000 – $750,000 and monthly maintenance fees from $1,300 to $5,400. The location and size of the residence and as well as the resident’s health with determine where you fit in the wide range in costs. In additional to location and health, there are three types of care contracts that impact fees.

 1. Extensive or Life Care Contract – this is the costliest option and includes all long-term care costs at no additional fees. This option provides a predictable monthly fee regardless of the needs of the individual. This contract allows families to create a payment plan for the remainder of the senior’s lifetime.

 2. Modified or Continuing Care Contract- this is a less expensive option but limits the total number of days one can receive long term care. If a senior needs additional care, it can be purchased for a discounted rate. While this contract is less costly, there may be unexpected future expenses.

 3. Fee-For-Service Contract – this is the least expensive monthly rate. Residents must pay separately for all long-term care separately. If extensive care is required, it will be very expensive. 

Care Planning & Management Costs

Geriatric Care Managers (GCMs) manage the coordination of care for an individual in need. They offer a variety of billing options, but their hourly rates are between $50-$200 per hour on average. A typical arrangement includes a needs assessment, care plan creation and implementation which may require 20-40 hours of work. Hiring a care manager can cost between $1,000 – $8,000. Medicare, Medicaid and health insurance seldom pay for these costs. Long term care insurance might cover a GCM, but typically this is an out-of-pocket cost. 

2019 Average Senior Care Costs by Type and Duration

Type of Senior Care Hour Day Month Year

Home Care Aide Cost $21 $168 (8 hrs / day) $3,696 (22 work days / mo.) $42,000 (250 work days / yr.)

Home Health Aide Cost $22 $176 (8 hrs / day) $3,873 (22 work days / mo.) $44,000 (250 work days / yr.)

Adult Day Care Cost n/a $72 $1,584 (22 work days / mo.) $18,000 (250 work days / yr.)

Assisted Living Cost n/a $132 $4,000 $48,000

Skilled Nursing Home Cost n/a $245 $7,441 $89,297