You may know some aging folks who are staying in their own homes with caregivers helping as they lose independence. By far, most people want to stay in their own homes rather than go to a senior’s community. Maybe you’ve never calculated what that can cost. Medicare does not pay for home care, as it is considered “custodial” rather than “medical”.

According to the Centers for Medicare and Medicaid services, the estimated spend in the U.S. on home healthcare in 2021 was $121.6B. They project that spend to hit $226.4B by 2030. What does that mean for your aging parents and for you?

There is no way to avoid the reality that it’s quite expensive to hire home care workers. If you can get a qualified or trained one, that is. As there is a nationwide labor shortage, the problem is worse than ever, since raising salaries is the only way employers can manage to attract and keep workers in this difficult field. As a result, the hourly cost of hiring scarce caregivers is rising, right along with the effect of inflation. What do we mean by “expensive”?

It depends on where you live.

According to the Genworth Cost of Care survey, done annually, the median price in the U.S. for a home health aide in 2021 was $61,776. In Colorado, the median price was $76,648. It’s even higher in Washington. In West Virginia, the median was $42,900. What’s your guess that these figures will rise for 2022?

In some parts of California, where I live, the wealthiest folks tend to pay for 24/7 care for aging parents at home, rather than choosing assisted living or memory care facilities. One client at is paying $45 per hour for workers around the clock. She lives with her parent and supervises care closely even while paying the price, as she says frequent monitoring is needed.

Another client we know has a full crew of workers around the clock for her husband with dementia and difficult behavior. The “crew chief” we’ll call him needed to replace one worker on staff. The replacement worker proposed that he’d do the job for $60 per hour. Our client declined. That was significantly more than anyone else was charging for the job. The family lives in a very elegant home and it appeared that the applicant was simply trying to take advantage of the home care situation. One could call it price gouging.


Assisted living and memory care

Assisted living and related facilities are not any better in terms of monthly expense to the family. A shiny new memory care facility in a CA area of elegant homes charges $14,000 a month for any resident. And they pay their staff a starting salary of $18 per hour. But the starting workers have a whole week of training! As anyone who has an aging loved one with dementia knows, a week of training would not lead to a safe situation for the resident with dementia.

The Takeaways

Plan for the possible need for long term care. No one has a date certain for when they can’t do what they’re used to doing any longer. We do need to plan ahead for aging loved ones as well as ourselves. The fantasy that we will remain fully capable of all we want to do until our last day on earth is just that—a fantasy. Yes, some make a sudden exit with a medical event such as a stroke or heart attack, but medical professionals are adept at keeping us alive, even after these life-threatening events. Millions of aging parents live on with impairments after medical crises, and this creates a need for long term help.

Understand that the cost of care can come up suddenly. Have funds available. When an aging parent has a stroke that creates disability, for example, you won’t have endless time to plan for how to accommodate the disability. If your loved one can’t get out of bed unassisted, you, or a hired person will need to assist every single day. Many conditions can lead to a sudden need for help at home after a hospital or rehab stay.

Hire smart. Given the current conditions in our economy, hiring will not be as easy as it once was. We do not have a reliable supply of dependable and competent workers. If you want good workers, you will be paying the price. And bringing any unsupervised person into your home or that of your aging parent has risks. I’ve spelled them out in my book, Hiring A Home Care Worker: What Could Possibly Go Wrong? Get this if you are considering hiring a worker.

With sufficient assets, caring for a loved one at home and allowing safe aging in place is an ideal. You can accomplish it with clear thinking and a realistic look at the cost of care.


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