Cost of In-Home Care vs. Nursing Homes For Seniors

If you’re researching senior care and looking to understand the average cost of care, we’ve put together a concise run-down of in-home care cost vs. nursing home cost to help guide the decision process for determining which is the best option for you and your family’s specific senior care needs. 

Senior In-Home Care Costs vs. Nursing Home Costs

Both in-home care and nursing homes have a wide range of potential costs depending on which services are needed. The average nursing home costs about $8,821 per month while senior in-home care costs an average of $4,576 a month. 

In-home care covers a wide variety of types of services – from health care to companion care – and the cost of care varies accordingly. The largest drivers of cost will be what level of care is required and how much care is required. Requiring 24 hour care from registered nurses will likely be at least twice as high as the $4,576 average. Comparatively, occasional home care from specialists or people helping with household chores will likely cost significantly less than the average long-term care costs. 

Nursing homes often have a higher baseline cost than in-home care as nursing homes inherently include room and board in addition to care, which typically drives nursing home costs higher than in-home care for equivalent levels of care. 

Related: Nursing Homes vs Assisted Living Facilities

Average Costs of In-Home Care 

The average cost of in-home care for seniors in the United States is $4,576 for home health care. Typically seniors will receive somewhere around 40-44 hours per week of care with in-home senior care. If significantly more care is needed, this can drive the cost significantly higher. 

24/7 care from health aids or nurses is typically only required for hospice and palliative care. That said, many seniors who need significant help with activities of daily living (ADLs) such as going to the bathroom, eating, showering, etc often need some form of 24/7 care – even if it isn’t all medical care – This is often called custodial care.

It’s important to note that there are two primary types of in-home care for seniors: health care and household help. The average costs here are for health based care which is often more expensive due to the inherent nature of the work.

The average hourly cost of senior in-home care depends on the type and frequency of care, but averages $24 per hour. Per day, home care services are $147 on average and home health care services are $150. 

Specialists such as occupational therapists can range anywhere from $50 per hour to $200+ per hour. It’s worth noting that these specialists are often covered by insurance and patients typically pay significantly less than this out of pocket. 

Annually, home care services average out to about $53,768 per year in the United States, while home health care services cost $54,912.

Related:How Much Does Senior In-home Care Cost

Most Expensive States for In-Home Care

The state where care is being provided has a huge impact on the cost of in-home care for seniors. Below are the most expensive states for in-home care.

  • Minnesota – $6,292
  • Washington – $6,031
  • Rhode Island – $5,911
  • Hawaii – $5,720
  • Idaho – $5,720
  • Massachusetts – $5,649
  • New Hampshire – $5,577
  • Wyoming – $5,552
  • California – $5,529
  • North Dakota – $5,529

Least Expensive States for In-Home Care

Conversely, the following states are the least expensive states for senior in-home care:  

  • Louisiana – $3,241
  • Alabama – $3,432
  • Mississippi – $3,527
  • West Virginia – $3,527
  • Arkansas – $3,813
  • North Carolina – $4,004
  • Tennessee – $4,004
  • Georgia – $4,099
  • Kentucky – $4,147
  • Kansas – $4,195

Average Cost of Nursing Home Care 

The US national average cost of nursing home care is split into two categories measuring the price of semi-private rooms and private rooms. The average cost of a semi-private room is $7,756 per month, while the average cost of a private nursing home room is $8,821 per month.

As with in-home care, nursing home care costs will vary based on certain variables and factors unique to every senior and their family. What state they live in, what level of care they need, and what special needs might accrue extra costs for elderly people must be considered as a whole. Adding additional care, particularly from specialists can drive the cost significantly up.

Related: Skilled Nursing vs Nursing Homes

Most Expensive States for Nursing Home Care

The most expensive state average prices are found in Alaska. Here, the average cost for a private room in a nursing home is $36,378 per month. The following states have the most expensive nursing home care cost in the United States (rates below for private rooms):

  • Alaska – $36,378
  • Connecticut – $13,992
  • Hawaii – $13,802
  • Idaho – $13,802
  • Massachusetts – $13,535
  • New York – $12,927
  • North Dakota – $12,764
  • Delaware – $12,699
  • West Virginia – $12,136
  • Minnesota – $12,025

Least Expensive States for Nursing Home Care

The least expensive state in the US for nursing home care is Missouri, where a private room will cost you $5,749 per month. The least expensive states for nursing home care are (private room rates):

  • Missouri – $5,749
  • Oklahoma – $5,779
  • Louisiana – $5,840
  • Texas – $6,388
  • Arkansas – $6,540
  • Alabama – $6,911
  • Illinois – $7,026
  • Kansas – $7,026
  • Iowa – $7,148
  • Mississippi – $7,148

In-Home Care vs Nursing Home Care 

In-home Care

There are benefits to both in-home care and nursing home care. In-home care allows for a more private standard of care for seniors who want to maintain their independence and remain in their own homes. If you’re looking for a more personalized type of senior care that allows for a one-on-one relationship between seniors and caregivers, in-home care can provide those things. Seniors will remain comfortable in their familiar surroundings while receiving the care and services they need. 

In-home care fits well with the lifestyles of healthy, active seniors that do not need all (or any) of their basic, daily tasks done by professional caregivers. It is also less expensive than nursing home care – unless around the clock care is required. 

In-home care can also be a good fit for seniors who are less active and need a significant amount of care, but have a living spouse who does not want to live apart from their spouse. In-home care gives the flexibility to remain by a spouse, even when they need 24 hour help – though this care is typically very expensive, upwards of $10,000 per month.

There are two main types of in-home care available to seniors; home care services and home health care services.

Home care services include helping around the house with chores and cleaning, and also personal care like companionship, meal preparation, going to the bathroom, showering, and transportation. Home care aides do not provide nursing care or medical care.

Home health care specialists are registered therapists and nurses who are legally licensed to aid with rehabilitation and wound care. They also have the ability to administer medications like pills and injections.

Often, people will pay for in-home care via private long-term care insurance policy or via private pay.  When home health care is prescribed by a senior’s physician, in most cases it can be covered under Medicare as long as it is:

  • Part-Time Or “Intermittent” Skilled Nursing Care
  • Part-time or intermittent home health aide services
  • A specialist like physical therapy, occupational therapy or speech-language pathology services
  • Medical social services

Medicare won’t cover 24 hour care, home care services, meal delivery, or personal care – such as help with ADLs – provided you do not require additional medical services.

Related: Does Medicare Cover In-Home Care

Nursing Homes

 While in-home care is a great choice for many elderly people, there are situations where nursing home care may be a better option. 

Nursing care homes are specialized senior living facilities that house a variety of medical professionals who are there to care for and assist their residents 24 hours a day, seven days a week. These professionals are responsible for performing various non-medical and medical functions. 

If a senior requires a high degree of medical care, particularly specialized care, or care on an ad-hoc basis, a nursing home may be a better option as there is typically less scheduling and advanced planning required to setup care or appointments from medical professionals.

Additionally, when a senior lives by themselves, nursing home care is often a helpful option as the senior will have community and socialization that otherwise might be difficult to facilitate on a consistent basis. 

Another consideration is if family members do not live in town, nursing homes can be a better option due to the socialization as well as the peace of mind of having their loved one in a location where people will be routinely checking on, and caring for them.

Estimating Costs of In-Home Care

In-home care will differ greatly depending on how much care is needed, what type and level of care are needed, along with what supplies and medical equipment have to be used. Additionally, the cost of care can depend on the personal preferences of the person.

The first step in estimating how much in-home care will cost is to determine what care is required. It is often beneficial to estimate not only the cost for the current care requirements, but to estimate out the anticipated costs in the future based on an increased level of care.

In planning, it is helpful to make a table, similar to this format considering how often care is required, the time care takes, the total number of hours required per weekly, and the rate for the care:

CareWeekly FrequencyTime for CareTotal Time per WeekRateWeekly Cost

For example:

CareWeekly FrequencyTime for CareTotal Time per WeekRateWeekly Cost
Wound Care2.5 h1 h$30/h$30
Meal Prep21.510.5$30/h$315
Medication Management14.253.5$30/h$105

This is a great starting point, writing out all the care needed can be helpful for carefully thinking through care requirements – often there is significantly more care required than most people anticipate before diving in. Understanding the care your loved one requires will be helpful in determining whether in-home care, nursing care, a skilled nursing facility, or an assisted living facility is the best choice for them.

This process may end up covering all the bases for seniors with minimal care needs, but frequently, seniors who need help with things like ADLs, medication management, and meal prep will typically need someone in the home for extended shifts rather than pop in visits. Additionally, unless the care is a specialist service like wound care, the care agency will likely not send over an aid for less than a specified block of time (often a half or full shift).

Daily rates for in-home care come into play when older adults need help from a licensed professional all day long. The caregivers are paid for an entire day’s work no matter the types of care or if the senior has dementia or Alzheimer’s disease. Allowances are usually given for any time a caregiver takes for rest periods and short breaks. 

Some seniors might need homemaker services and in-home care overnight and so medical professionals can be hired on an overnight basis. Overnight rates are usually not as expensive as daily rates as the caregiver is only working for a limited timespan and most of that time is spent watching the client sleep. 

Overnight in-home caregivers ensure elderly people’s security and safety all through the night. Seniors with family members who act as their primary caregivers may find this option helpful so their family members can also get rest instead of safeguarding them instead.

All of these estimates will depend on your exact location, the cost of living in that state. Always be sure to research home-care agencies and providers in your area to compare services, prices, and options. 

Once the care requirements are established, the next step is to call local home care agencies providers to confirm a) they can provide the care, b) they are taking on new clients, and c) check rates, billing practices, and medicare / insurance acceptance.


When is In-home Care Better Than a Nursing Home?

If you or your senior loved one is still healthy and independent without Alzheimer’s disease, or their mental health might suffer from being moved to new, unfamiliar surroundings. 

If you only need limited in-home care services, an adult day service (adult day care) with a home health aide may be best option to preserve independent living.

How Much Does In-Home Elder Care Cost?

The cost of in-home elder care varies significantly based on how much care and the type of care that is required. The average cost for in-home care in the United States is $4,576. This can be significantly less or 2x to 3x more if intensive and specialized care is needed.

The rates are determined for hourly, daily, and overnight costs. State averages may reach higher costs depending on veterans’ benefits, low-income situations, dementia care, or other senior care costs.

How Much Does 24 Hour In-Home Care Cost?

The rates for 24-hour in-home care will vary from state to state and case by case. Medical home care may be an attractive option if the senior only needs part-time help, but full-time clock care can increase the average monthly costs by a lot (not to mention costs for recreational activities on a daily basis, physical therapists, medication reminders, and other health care needs.

How Much Do Nursing Homes Cost Per Day?

Nursing home costs run at about $255 per day on average, for a semi-private room and can climb to $290 on average for a private room. Often these costs can be offset by long term care insurance or Medicaid so that the entire cost paid is lower than this. Sharing a room can be another way to lower costs associated with a nursing home.

Related: Cost of Long-term Care Insurance

Are Nursing Homes the Same as Assisted Living Facilities?

While there are some similarities between nursing homes and assisted living facilities, nursing homes typically provide more medical care (skilled nursing care, limited medical care, medication management, etc) while assisted living facilities tend to offer less care (such as medication management) – often residents may bring additional care or specialists in, not provided by the assisted living facility.

There are some similarities between nursing homes and assisted living communities in that they provide housing, meals, help with activities of daily living, and some may offer services such as daily activities or transportation. 


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