How Much Does In-Home Dementia Care Cost? Surprising Facts and Resources

Nearly $340 billion worth of dementia care is provided by family members and other unpaid caregivers each year, according to the Alzheimer’s Association’s 2023 Alzheimer’s Disease Facts and Figures report.^[01]

Understanding how in-home dementia care costs can affect your family will help you prepare for the future. Read on to learn more about the cost of dementia care, the differences between care types, and how to balance the personal costs and rewards of caring for a loved one with dementia.

The cost of dementia care at home often depends on location, your relative’s level of need, and care aide training. The median cost of a home care aide is $30 per hour, according to A Place for Mom’s 2023 report on the cost of long-term care. The hourly rate varies by location, ranging from $21 an hour in Louisiana and Mississippi to $50 an hour in Maine.^[02]

Nearly 77% of seniors want to remain in their homes as long as possible, but dementia can complicate those plans.^[03] If your loved one chooses to age in place, in-home care can help keep them safe and engaged.

“Caring for my grandfather is the most meaningful thing I’ve ever done,” says Richard, 34, of Marion, Tennessee. “It’s definitely impacted my life — financially and for my family in general.”

Richard, like many unpaid caregivers, also relies on in-home care and family support to aid his grandfather, who’s aging in his own home several miles away.

“We have a great nurse come in to help a few hours in the morning with making breakfast, tidying the house, and making sure grandpa gets his medicine and dressed,” Richard says.

He and his wife Lizz spend about $2,000 a month for four hours of care each workday.

A home health aide with dementia-specific training or certifications may be more expensive. While there isn’t a source of national data for the average cost of in-home dementia care, a review of agencies in several states across the U.S. showed that the average cost of in-home dementia care from home health aides with dementia-specific training averaged $2.50 an hour more than assistance from aides not trained in dementia care.^[04]

Why the cost of dementia care at home may be higher

Dementia care requires a unique skill set and extra training, which contribute to its higher costs. Know your loved one’s dementia symptoms, care needs, and expectations before screening home care providers, and make sure the aide you hire has experience caring for dementia patients.

Care aides trained to assist seniors with dementia can typically provide the following services:

• Companionship and social stimulation
• Help with activities of daily living (ADLs) like bathing, dressing, and eating
• Assistance in managing symptoms of sundown syndrome and de-escalating adverse reactive behaviors
• Sensory or reminiscence therapy to reduce anxiety and inspire positive memories
• Care while you work, run errands, or spend time with family
• Engaging at-home activities geared toward the senior’s interests, well-being, and skills

For eligible people, Medicare may cover costs related to dementia care.

Let our care assessment guide you

The average in-home dementia care cost for safety modifications is around $9,500, according to Fixr’s 2023 remodeling cost analysis.^[05]

As dementia progresses, seniors may experience mobility difficulties, disorientation, and wandering. Because a fall can result in hospitalization or the need for long-term care, it’s important to take safety precautions in the home.

“Since grandpa didn’t want to move out of the home he’s been in for over 50 years, we had to make some changes,” Richard says.

He and his wife have spent over $5,000 on home modifications since the diagnosis. In the early stages of dementia, basic and inexpensive accommodations like removing trip hazards, installing grab bars, and leveling thresholds can reduce Alzheimer’s safety risks.

The cost of dementia-care-related home safety features can increase as the disease progresses. Alarmed windows and doors to reduce the risks associated with wandering, appliances with automatic shut-off mechanisms, and mobility devices like stair lifts may be necessary. Nonslip flooring, walk-in tubs or showers, and lever handles are other common changes that contribute to in-home dementia care costs.

“We know that when things get worse, he won’t be able to live on his own anymore, so we’re also starting to make some changes in our house for whenever grandpa needs to be here,” Richard notes.

When families weigh the costs of dementia care, they rarely consider the nonfinancial impact of caregiving. While caring for a loved one with dementia may be rewarding, it can also lead to serious health consequences. More than one in three dementia caregivers report significant emotional stress, and one in five express financial or professional stress, according to a study published by the National Alliance for Caregiving (NAC).^[06]

Mental and emotional costs of dementia care

Dementia caregivers report more anxiety and depression, higher levels of stress, and lower well-being than noncaregivers, according to a study by researchers at the University College of London.^[07] The stress is directly related to providing care while also balancing responsibilities such as a career, childcare, and personal relationships.

Richard and Lizz, like many unpaid dementia caregivers, are part of the “sandwich generation.” That means they simultaneously care for an elderly loved one and a child or young adult. Almost three-quarters of sandwich generation caregivers are employed full-time, and most spend three or more hours each weekday on elder care, according to the NAC report. That’s 21 hours of unpaid caregiving on top of a 40-hour workweek.

“We’re just fried a lot of the time,” Richard admits. “My wife does so much. Usually, she has to make a separate dinner plate for grandpa since there are a lot of foods he can’t eat anymore. It can be hard getting the kids to do homework and also taking care of him.”

If you’re feeling overwhelmed by the emotional toll of caring for a loved one with dementia, or if you’re beginning to experience symptoms of caregiver burnout, consider exploring support groups to connect with other caregivers who can empathize, offer advice, and remind you that you’re not alone.

Professional and financial repercussions of caregiving

Caregivers may have to miss work for a loved one’s doctor’s appointments, emergency calls, and days without in-home care. This can lead to poor performance, lost pay, and fewer vacation days. However, providing in-home care to a loved one can cut costs normally spent on professional caregivers and help forge bonds between family members.

Since the beginning of 2020, Richard’s been working from home and often spends afternoons helping his grandfather with showers, trips to the bathroom, and other needs. This has helped to cut the costs of professional in-home dementia care in half. While caring for his grandfather can cause anxiety and make meeting work deadlines difficult, this unexpected saving has Richard weighing the pros and cons of finding remote part-time work.

“I’m dreading going back (to work) because so much of the money I make in those hours goes straight to caregiver costs, and I don’t get to spend time with him,” Richard says.

There isn’t a cure for dementia, but appropriate medical care can help someone living with dementia maintain their quality of life, according to Stanford Health.^[08] Medication, regular doctor’s visits, and treatment for other health conditions — like depression and loss of hearing or vision — are key factors in successful dementia care.

The first step to securing medical care for dementia is a diagnosis. Your loved one’s doctor will likely perform a baseline cognitive assessment and an overall wellness check. They may also recommend a specialist for additional testing.

Comprehensive health insurance often covers these initial costs of Alzheimer’s care, but experimental treatments and medications may have to be paid for out of pocket.

Does Medicare cover dementia care costs?

Medicare covers annual wellness visits, health assessments, inpatient hospital care, and some of the doctors’ fees for seniors with dementia aged 65 and older. This government-funded health insurance is available to all Americans when they turn 65.

In 2019, average Medicare costs of dementia care were $25,213 per person — that’s almost three times higher than Medicare costs for seniors without dementia, according to the American Journal of Managed Care.^[09]

Other dementia care costs covered by Medicare may include:

• Cognitive assessments
• Care planning assistance
• In-home medical care prescribed by a doctor
• Up to 100 days of skilled nursing care
• Hospice care for up to six months near the end of life

Read more:VA Memory Care Resources for Veterans

Talk with a Senior Living Advisor

Does private insurance cover the cost of dementia care?

Different plans cover different aspects of dementia care, so review your loved one’s policy for specifics. Private insurance may include employer-provided health plans, long-term care insurance, Medigap insurance, and life insurance. The following types of policies are typically offered through private insurance.

Long-term care insurance. While most policies say they cover Alzheimer’s and dementia care costs, there may be stipulations. It’s also important to note that once someone is diagnosed with dementia, they won’t be able to apply for long-term care insurance. If your loved one has already purchased a policy, be sure to review it and seek answers to the following questions:

• When can your loved one collect benefits? A certain level of physical or cognitive disability may be required.
• How long is the elimination period (the amount of time after benefit trigger criteria are met and before payment kicks in)?
• What type of care is covered? Some plans cover in-home dementia care costs, while others only pay for skilled nursing or memory care.
• Is there a maximum lifetime payout?

Medigap insurance. Medigap is a private insurance policy that can supplement Medicare coverage. It covers copayments and deductibles required by Medicare and fills gaps in coverage.

Life insurance. Some policies allow seniors to use their benefits to pay for long-term care while they are alive. While policies differ, your loved one’s insurance provider may offer a “long-term care rider” to be used for long-term care costs.

In-home care and memory care both offer support for seniors with dementia, with several key differences. In-home care is generally paid for hourly, while the cost of memory care is often all-inclusive. The median monthly cost of dementia care in a memory care facility is $5,995, according to A Place for Mom’s 2023 long-term care cost data analysis.^[03]

In-home dementia care can be flexible, so costs for seniors who need minimal help, or who don’t require 24-hour supervision, will often be lower than those of a memory care community. However, if an elderly loved one needs full-time care, mobility support, or help with incontinence, memory care will often be less expensive than hiring a home care aide — especially when you consider amenities that may not be available at home. There are a surprising number of ways to pay for memory care.

While communities vary, memory care typically offers meals, assistance with ADLs, and transportation, in addition to unique features tailored to seniors with cognitive impairment:

• Comprehensive staff training to support the specific needs of residents with dementia
• Full-time supervision to prevent elopement
• A high staff-to-resident ratio
• Specially designed spaces to ease anxiety and agitation
• Safety features, which may include alarmed doors and in-room emergency call systems
• Dementia-specific activity programming
• Unique building layouts that simplify navigation, encourage social interaction, and provide a safe space for residents

Read more:Everything You Need to Know About the Cost of Memory Care

Budgeting for the cost of dementia care can be complicated, especially if your loved one’s condition is constantly evolving. For more information about dementia care costs specific to your family’s needs, reach out to one of A Place for Mom’s Senior Living Advisors to discuss memory care and in-home dementia care — all at no cost to your family.