The most expensive state for in-home caregiving may surprise you - and it costs almost $9,000 a month there

By Beth Pinsker

The cost of care for an aging parent, whether in their own home or in a nursing facility, varies greatly depending on where they live

The dynamics of your local real-estate market will play into how much care costs in a nursing home or assisted-living facility.

In densely populated New York state, hiring an in-home caregiver to help an aging parent with bathing and meals is cheaper than in about half the other states in the country, running about $6,700 a month, according to the just-released "Cost of Care" report from CareScout. Wide-open Wyoming, meanwhile, is the most expensive place for home care, with a comparable bill of $8,770 a month.

For a skilled-nursing facility, however, those ratios reverse. Given the high real-estate prices in New York, the cost of a shared room in a communal care setting is near the top of the state ranking list, with a monthly average cost of $15,528. The cost in Wyoming averages $9,900 per month.

"There's a supply-and-demand dynamic that sometimes produces counterintuitive results," said Samir Shah, chief executive of CareScout, which has a tool that is searchable by zip code to help pinpoint cost estimates.

As the U.S. population steadily ages - with leading-edge baby boomers turning 80 this year, and peak boomers turning 65 - caregiving costs are already a huge economic strain on families, and they are projected to go up more in the future. The median cost of at-home paid care is now $80,000 per year, and a shared room in nursing care is $115,000 per year, according to CareScout. Unpaid care by family caregivers amounts to the equivalent of about $100 billion, according to the National Institutes of Health.

"The crisis is that we're living longer and in worse health," said Jason Resendez, chief executive of the National Alliance for Caregiving. "We have to address the huge cost associated with care."

In some ways, CareScout's analysis of 2025 data shows some improvement after years of steep inflation. The $35 average hourly rate for a home health aide was only up 3%, assisted living was up 5% and adult day care was actually down 5%. CareScout noted that average inflation was 2.7% in the same period, and wage growth was 2.5%.

"We saw some moderation this year, which was very welcome," said Shah, who added that this comes after a postpandemic spike that elevated costs tremendously.

Unpaid family care

Then there's the matter of those undefined costs for family caregivers. CareScout's estimate for paid home care is based on 44 hours a week of unskilled care. That leaves family caregivers to handle the other 124 hours in the week.

"Family caregiver stress is very real," said Shah. "My father is 80, my mother and mother-in-law are in their mid-70s. All of us try to be everywhere at all times, and we are like a significant portion of the country doing unpaid care."

And who is paying for it all? One corollary number that Resendez points to is that median household income is around $80,000. Retirement savings are lagging. Vanguard's preview of its "How America Saves" report for 2025 found that the average 401(k) balance was $167,970 and the median was $44,115. That doesn't add up to being able to pay $118,000 a year for a room in a nursing home very easily.

Shah said the primary aim of the "Cost of Care" survey was to provide families and professionals in the care industry with localized information so they could make better plans. Most caregivers do not delve into the details of the cost of a private room versus a shared room, or adult day care versus home care, until they are in the thick of it.

"In crisis moments, people tend to make suboptimal decisions," said Shah. Sometimes, he said, he sees families that get 12 hours of home care, thinking that is their best option, when they could get by with three hours of home care and adult day care for the rest, saving thousands of dollars per month.

"You want to understand and plan, and do so way before a crisis or event actually hits," said Shah.

That said, Resendez's core message is that caregiving needs change over time. "You might be really engaged in one type of care at first that evolves into more intense care over time," he said. "You might have a loved one who is independent, but then a fall happens, and those care responsibilities shift. It's really difficult to measure, and often, care data is just a point-in-time snapshot."

Got a question about investing, how it fits into your overall financial plan and what strategies can help you make the most out of your money? You can write to me at beth.pinsker@marketwatch.com. Please put "Fix My Portfolio" in the subject line.

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03-07-26 1440ET