Last week, Pew published a survey of seniors, aged 65 and up. It asked those who live in their own home (aging in place) without a caregiver what they’d want to do if that arrangement later proves unsustainable.
Here are their responses:
- 60% say they want to stay put and have a caregiver
- 18% would move into an assisted living facility
- 11% would move in with a family member
- 1% want to move into a nursing home
- 8% have another option in mind
Those are their intentions. But where they ultimately end up depends on several variables, including their budget and the severity of the condition that forces a change.
A survey by U.S. News, published in November 2025, found 93% of adults aged 55 and over have a goal of aging in place.
The Annual Costs of Various Types of Care
CareScout provides some guidance as to the costs of alternative scenarios. The figures we're quoting are nationwide averages from 2024 and have probably risen since then. However, they provide a worthwhile financial comparison between the choices, and the website lets visitors choose their state for a more refined insight.
Here are some annual costs:
- Homemaker services (housekeeping) — $75,504 for 44 hours a week
- Home health aide (housekeeping and some personal care) — $77,792 for 44 hours a week
- 24-hour home health aide — $297,024
- Adult day health care (often respite for caregivers; care in a day facility) — $26,000
- Assisted living community (personal care and health services at sub-nursing home level) — $70,800
- Nursing home (semi-private room) — $111,325
- Nursing home (private room) — $127,750
Even assisted living is beyond the budgets of many. "Upper-income older adults are the most likely to say they’d prefer to move to assisted living," says Pew. "About three-in-ten (28%) say this, compared with 19% of those with middle incomes and 13% of those with lower incomes."
Moving in with an Adult Child
Many who plan to age in place eventually reach a point where this becomes unrealistic. Those lucky enough to have great relationships with their kids may be able to join a supportive multigenerational household.
We wrote about a related topic last November: Retired and Moving Closer to Your Adult Child? Tread Carefully.
It can help if the adult child can get some benefit from the arrangement, perhaps with the offer of helping with childcare. If the senior is a homeowner, he or she might be able to pay down the child's mortgage a bit or fund an accessory dwelling unit (ADU), which is a small home either attached as an addition to the main one or detached in the backyard.
It used to be difficult to get permits for ADUs, but last week, The Washington Post reported that local authorities are becoming increasingly amenable to them. "Eighteen states such as Washington, Arkansas and Maine (and even more cities) have passed laws paving the way for more," said the Post.
Each generation having its own private space and clear boundaries can be crucial to the success of multigenerational living. " ... flexible floor plans that enhance privacy, a healthy respect for boundaries and candid discussions upfront among family members are key to the success of any multigenerational arrangement," said The Wall Street Journal last year.
Prepare to Be Flexible
The Pew survey "found that only 21% of adults ages 65 and older have long-term care insurance that would help cover the expense of ongoing living assistance." And Medicare only rarely helps with the cost of adult day care.
"'Adult day care [is] focused on providing a safe, structured environment where seniors can socialize, stay active, and receive supervision,'" says Care Homecare CEO Moti Gamburd. "'Since it falls into the category of custodial care, it’s not included in traditional Medicare coverage.'"
Of course, many seniors live happy, active, and healthy lives right up until some catastrophic event takes them. But many others experience slow deteriorations in their mobility, sight, and faculties that eventually reach a point where aging in place ceases to be a sensible option.
It's natural to hang on until the last possible minute before accepting the inevitable. But it's wise to plan ahead and act before an environment becomes dangerous. And those who are decades away from facing any of this might want to consider taking out a long-term care insurance policy now.
