Cost of home care for seniors up nearly 50% since 2019, a time bomb for many families
An older population, rising cost of living and shrinking incomes should be alarming
Home care and assisted living costs have surged nearly 50 percent since 2019, wiping out a decade of progress in long-term care affordability for middle-income older adults, a new report from AARP finds.
Additionally, findings show that affordability varies dramatically across states. Older adults in states with the least affordable long-term care can pay for about half the amount of care that older adults can afford in states with the most affordable.
The national median cost for home care is about $33 per hour in 2025, which means that a typical schedule of about 30 hours per week can exceed $50,000 per year, according to the Federal Long-Term Care Insurance Program. Full-time home health aide care averages roughly $77,000–$80,000 annually.
The alternatives are even more expensive. The median cost of assisted living is roughly $6,200 per month, or about $74,400 annually while nursing home care for a semi-private room costs about $315 per day or $114,975 per year, according to Genworth.
“Home care and other long-term care services have quickly become increasingly unaffordable in recent years,” said Alan Weil, Senior Vice President for Public Policy at AARP. “The result is a widening gap between what care costs and what older adults and their families can afford — and we’ve got to fix this, because the consequences can be life-threatening.”
Key findings
Additional key findings from the report include:
In recent years, long-term care costs grew faster than incomes. From 2019 to 2024, the annual median cost of home care services increased by close to 50 percent, while over the same period the median household income for someone age 65 or older grew by less than half that amount, making long-term care further unaffordable.
Typical incomes are not enough to pay for long-term care. In 2024, the median household income for someone age 65 or older was about $60,000, while the annual median cost of home care services exceeded $50,000.
Savings are often insufficient to cover long-term care needs. The median household age 75 and older has about $50,000 in financial assets, enough to cover roughly one year of home care or only a few months of nursing home care.
Why are costs increasing?
Experts say several factors are pushing costs higher:
1. Workforce shortages
Care providers face ongoing shortages of nurses, aides, and caregivers, forcing facilities to raise wages and compete for staff.
2. Aging population
About 70% of Americans turning 65 will need some form of long-term care during their lives. Demand is already rising rapidly as baby boomers enter their 70s and 80s.
3. Higher operating costs
Facilities face increased expenses for labor, insurance, housing, and regulatory compliance.
4. Preference for aging at home
Many seniors prefer home-based care, but hourly home care can become expensive when many hours are needed, and may even rival assisted living and nursing homes in some scenarios.
Huge financial risk for families
Because long-term care can last years, the total lifetime cost is substantial:
Average long-term care spending is estimated around $171,000 for women and $98,000 for men, reflecting longer lifespans for women.
Medicare typically does not cover extended long-term care, leaving families to rely on savings, insurance, or Medicaid. Many families fail to realize this until they are faced by an urgent need for additional help caring for a loved one.
Today’s adult children face a steep hurdle in financing long-term care, as wages are already stressed by rising cost of living costs and fewer families are protected by retirement plans and most lack adequate savings.
Part of the broader affordability crisis
The rising cost of care is becoming part of the broader U.S. affordability crisis, alongside housing and healthcare costs. Policymakers and consumer advocates are debating solutions such as:
expanded Medicaid home-care coverage
caregiver tax credits
long-term care insurance reforms
public long-term care programs
Without changes, experts warn that long-term care costs could strain both family finances and government programs as the elderly population grows.