Many adults over the age of 60 in the United States live alone or with a spouse or partner, according to a recent Pew Research Center study. While remaining conscious of the costs, where do families turn for help when a loved one is faced with declining health or a condition such as dementia? One option to consider is in-home care, where trained caregivers can provide your loved one with the support they need to remain in their home longer.
Explore the cost of in-home care and how to pay for different home care services while determining the best options for your family.
What is in-home care?
In-home care is an umbrella term that covers different care options that are provided to seniors in their own homes.
Home care consists of nonmedical services that offer support for seniors and their family caregivers. Home care includes two common types of care:
- Companion/homemaker care offers social interaction and help with common household tasks, such as light housekeeping and meal preparation.
- Personal care provides hands-on assistance with activities of daily living (ADLs) such as bathing and dressing.
Home health care is typically prescribed by a doctor for individuals who require skilled nursing care or rehabilitative therapies at home.
How much does home care cost per hour?
The median cost of home care is between $26 and $27 per hour according to Genworth’s 2021 Cost of Care Survey. However, your loved one’s unique needs and location will determine the overall costs. Most families will pay for these services out of pocket, but health insurance plans will typically cover some home health care services.
Finding the right type of care that fits your loved one’s budget can be challenging. Being realistic about your loved one’s needs, and the time you have to dedicate to their care, can help you create an accurate estimate of what you will spend on home care.
Companion care
The national median cost of companion home care was $26 per hour in 2021. For example, if a caregiver were to visit your loved one for two hours, twice per week, it would cost approximately $450 each month.
For seniors who live alone and are still relatively independent, companion care can help reduce feelings of isolation or loneliness. A hired caregiver can visit a couple of times a week for an engaging conversation or to play a game of cards. They can also help with organization, light housework, and meal preparation. While companion caregivers don’t provide hands-on care, they can offer supervision and verbal reminders for seniors living with dementia who have a tendency to wander.
Personal care
The national median cost of personal care is $27 per hour as illustrated in Genworth’s 2021 Cost of Care Survey. The industry standard for someone who needs full-time personal care is around 44 hours per week, which would cost about $5,148 per month.
A personal care aide can provide assistance with daily activities such as toileting, bathing, and eating. They can also provide nonmedical support for elderly loved ones who have a chronic disease or condition such as dementia or incontinence.
Home health care
The cost of home health care depends on the amount of care a senior needs and their insurance coverage. Because home health services are typically prescribed by a doctor, Medicare, Medicaid, and private health insurance plans will usually cover at least some of these costs if certain eligibility criteria are met.
Durable medical equipment is often included in addition to services like injections, wound care, and physical and occupational therapy. Home health care providers may also assist individuals with ADLs and other homemaking tasks if these services are part of a senior’s care plan.
Factors that affect in-home senior care costs
The cost of home care can vary due to several factors, including the type and amount of care needed, how care is hired, and where a senior lives.
Type of care and frequency of care
The flexibility of paying for home care by the hour allows families to create a plan that best fits their loved one’s needs and budget. For example, six hours of companion care at $26 per hour would cost less than $200 a week. But a senior who needs personal care can usually expect to pay more due to the need for more hands-on care from a home health aide. However, for full-time family caregivers, hiring a companion or aide for a few hours per week may be an invaluable source of respite. It’s important to note that many home care providers require a minimum number of service hours each week.
For seniors who require round-the-clock care, the costs can be considerably higher. Hiring one live-in caregiver costs around $10,646 per month, according to proprietary data gathered by A Place for Mom, AgingCare’s senior living referral service counterpart. The median monthly cost of 24/7 care is $19,656. This rate is even higher since multiple caregivers must work in shifts to provide continuous care and supervision.
Hiring a caregiver through an agency versus hiring an independent caregiver
There is no standardized pay scale for private caregivers who aren’t affiliated with an agency. Often, hiring an independent caregiver will be slightly less expensive, but consider that in doing so, you will take on the responsibilities of being their employer. Home care agencies take care of tasks like hiring, background checks, scheduling, training, and payroll, so families aren’t burdened with them.
Read: Independent Caregivers vs. Home Care Agencies: Knowing the Differences and How to Choose
Where a senior lives
Location plays a role in how much a senior will pay for home care. For example, in cities with a higher cost of living, they can expect to pay more for care. Some states have regulations requiring specific training and certifications for home care providers, which can also impact home care costs.
The table below features hourly home care costs by state, including Washington D.C. in order from highest to lowest, according to Genworth Financial.
|
State |
Personal care |
Homemaker care |
|
Minnesota |
$36.25 |
$35.00 |
|
Washington |
$34.50 |
$34.34 |
|
Colorado |
$33.50 |
$33.50 |
|
New Hampshire |
$32.50 |
$31.50 |
|
California |
$32.00 |
$32.00 |
|
Oregon |
$32.00 |
$31.50 |
|
Rhone Island |
$31.25 |
$30.00 |
|
Massachusetts |
$31.00 |
$31.00 |
|
South Dakota |
$31.00 |
$31.00 |
|
Maine |
$30.00 |
$30.00 |
|
Hawaii |
$30.00 |
$30.00 |
|
Alaska |
$30.00 |
$30.00 |
|
Utah |
$30.00 |
$29.50 |
|
Vermont |
$30.00 |
$30.00 |
|
Wisconsin |
$30.00 |
$29.00 |
|
New Jersey |
$29.95 |
$29.00 |
|
North Dakota |
$29.84 |
$29.84 |
|
Iowa |
$29.25 |
$29.00 |
|
Washington DC |
$29.25 |
$29.25 |
|
Wyoming |
$29.00 |
$29.00 |
|
Michigan |
$29.00 |
$29.00 |
|
New York |
$29.00 |
$28.00 |
|
Arizona |
$28.50 |
$28.00 |
|
Idaho |
$28.50 |
$28.50 |
|
Delaware |
$28.00 |
$28.00 |
|
Connecticut |
$28.00 |
$27.50 |
|
Montana |
$28.00 |
$28.00 |
|
Nebraska |
$28.00 |
$27.00 |
|
Nevada |
$27.00 |
$27.00 |
|
Maryland |
$27.00 |
$27.00 |
|
Ohio |
$26.50 |
$26.00 |
|
Pennsylvania |
$26.00 |
$26.00 |
|
Virginia |
$25.98 |
$25.00 |
|
Oklahoma |
$25.50 |
$25.50 |
|
Florida |
$25.00 |
$25.00 |
|
Indiana |
$25.00 |
$25.00 |
|
Missouri |
$25.00 |
$25.00 |
|
Kentucky |
$25.00 |
$25.00 |
|
Kansas |
$24.50 |
$24.00 |
|
New Mexico |
$24.40 |
$24.15 |
|
Tennessee |
$24.00 |
$24.00 |
|
Texas |
$24.00 |
$24.00 |
|
South Carolina |
$23.50 |
$23.25 |
|
Georgia |
$23.00 |
$22.50 |
|
North Carolina |
$23.00 |
$23.00 |
|
Arkansas |
$22.00 |
$21.95 |
|
Alabama |
$20.20 |
$20.00 |
|
Mississippi |
$20.00 |
$20.00 |
|
Louisiana |
$19.50 |
$19.00 |
|
West Virginia |
$18.75 |
$18.50 |
Paying for in-home care
Determining how to pay for in-home care will depend on the type of care a senior needs. While Medicare and Medicaid will pay for medically necessary home health care, companion care and personal care are usually paid for out of pocket.
Fortunately, there are many options for funding a loved one’s care at home. Some veterans’ benefits cover in-home care for eligible veterans and their surviving spouses. Long-term care insurance is another way to pay for in-home care. A senior with life insurance may even be able to use their policy to offset some costs of care.
Read: How to Pay for In-Home Care
Comparing home care costs with other care types
For seniors who prefer to age in the comfort and security of their own homes, in-home care may seem like the perfect option. However, as they age, their health, emotional needs, and ability to safely live at home alone will likely change. Understanding how the costs of senior living compare to the costs of in-home care will help you prepare for future changes.
In-home care vs. assisted living
In-home care, at 44 hours per week, will cost approximately $5,148 a month, and the average median cost for assisted living is $4,500 each month.
Both care options will typically include assistance with some activities of daily living, transportation, and help with household tasks like laundry.
The main difference is that assisted living pricing includes rent, meals, and 24-hour staffing, while in-home care pricing only covers the cost of care. A senior living at home must still budget for their usual costs of living, such as a mortgage or rent, utilities, and food.
Read: Assisted Living vs. Home Care
In-home care vs. nursing homes
Nursing homes tend to be more expensive than home care with a median monthly cost of $9,034 for a private room.
Unlike in-home care, nursing homes offer round-the-clock care provided by licensed medical professionals. This high level of care is often necessary for seniors who have chronic medical conditions or need lots of assistance while recovering from an injury or illness.
Read: Cost of Home Care vs. Nursing Homes: Preparing for the Next Step
Find help understanding the costs of in-home care
In-home care can provide the assistance a senior needs to live at home safely, but keeping up with the changing care needs and associated costs as they age can be complicated. AgingCare’s Care Advisors can help simplify the search for home care by connecting you with local agencies that fit both your loved one’s needs and budget. In addition, by joining the Caregiver Forum you can connect with other family caregivers, get support, and find the answers you need.
Reviewed by senior care expert Leslie Fuller, LMSW, CDP.
Sources:
Older people are more likely to live alone in the U.S. than elsewhere in the world (https://www.pewresearch.org/fact-tank/2020/03/10/older-people-are-more-likely-to-live-alone-in-the-u-s-than-elsewhere-in-the-world/)
Home Health Services (https://www.medicare.gov/coverage/home-health-services)
Genworth Cost of Care Survey (https://www.genworth.com/aging-and-you/finances/cost-of-care.html)
Genworth Cost of Care Survey Median Cost Data Tables (https://pro.genworth.com/riiproweb/productinfo/pdf/282102.pdf)
A Place For Mom’s Proprietary Cost of Care Data; How Much Care Will You Need? (https://acl.gov/ltc/basic-needs/how-much-care-will-you-need)
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