Make the best senior care decision
More than 11 million Americans provide care for loved ones with Alzheimer’s disease or another form of dementia — and that number continues to grow as the aging population lives longer than previous generations. Furthermore, the cost of dementia care for a relative can be enormous, both financially and personally. Direct costs can include hiring help, making home modifications, and more. Indirect costs can include lost wages due to time spent caregiving and the emotional and physical impact of caregiving work.
Nearly $272 billion worth of care is provided by family members and other unpaid caregivers each year, according to the Alzheimer’s Association’s 2022 Facts and Figures report. Understanding how in-home dementia care costs can affect your family will help you prepare for the future. 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.
Nearly 77% of seniors want to remain in their homes as long as possible, according to a 2021 AARP survey. Dementia can complicate those plans. 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.
The cost of Alzheimer’s care at home often depends on location, your relative’s level of need, and care aid training. The average cost of a home health aide in 2021 was $27 an hour, according to Genworth Financial. The hourly rate varied by location and ranged from $19.00 an hour in West Virginia to $36.00 an hour in Minnesota.
“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,” says Richard.
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 home health aides with dementia-specific training cost an average of $2.50 an hour more than those not trained in dementia care.
Dementia care requires a unique skill set, so make sure the at-home aide you hire has experience caring for dementia patients. Know your loved one’s dementia symptoms, care needs, and expectations before calling to screen and hire home care providers. The extra skills and training required to care for a senior with dementia lead to its higher cost.
Care aides trained to assist seniors with dementia can typically provide the following services:
Our free tool provides options, advice, and next steps based on your unique situation.
As dementia progresses, seniors may experience mobility difficulties, disorientation, and wandering. Since a fall can result in hospitalization or the need for long-term care, it’s important to take safety precautions in the home — another significant dementia care cost.
“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,” says Richard.
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 can increase as the disease progresses. Alarmed windows and doors to prevent wandering, automatic-off appliances, and mobility assistance 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 says. “Some of it is things you’d never think of, like door handles and windows with high-up locks.”
The average in-home dementia care cost for safety modifications is around $9,500, according to Fixr’s 2021 remodeling cost analysis.
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 report financial or professional stress, according to a report published by the National Alliance of Caregiving (NAC).
Dementia caregivers report more anxiety and depression, higher levels of stress, and lower well-being than non-caregivers, according to an Alzheimer’s caregivers study by researchers at the University College of London. The stress is directly related to providing care while also having responsibilities common to adulthood: career, childcare, marriage, and more.
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 eldercare, 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. My wife does so much. Usually, she has to make a separate plate for grandpa for dinner since there are a lot of foods he can’t eat anymore,” says Richard. “It can be hard getting the kids to do homework and also taking care of him, especially since the kids don’t really understand why he asks the same questions or gets to eat whatever he wants.”
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 these support groups to connect with other caregivers who can empathize and remind you you’re not alone.
Caregivers may have to miss work for 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 the coronavirus pandemic in 2020, Richard’s been working from home and often spends afternoons at his grandfather’s house helping with showers, trips to the bathroom, and other needs. The change in routine has cut in-home dementia care costs in half. This unexpected saving has Richard weighing the pros and cons of part-time work and considering finding a job that allows him to remain remote. And even though staying with his grandfather can make meeting deadlines difficult and cause anxiety, the 40+ hours of in-home dementia care costs they were spending each week made budgeting tighter than it is with Richard providing part of the care.
“I’m dreading going back because so much of the money I make in those hours goes straight to payments, and I don’t get to spend time with him,” Richard says.
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There isn’t a cure for dementia, but appropriate medical care can maintain quality of life, according to Stanford Health. Medication, regular doctor’s visits, and treatment for other accompanying health conditions — like depression and loss of hearing or vision — are all 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 as well as an overall wellness check to see if it’s time for dementia care, and then they’ll recommend specialists for additional testing.
Comprehensive insurance often covers these initial costs of Alzheimer’s care, but experimental treatments, medications, and other additional steps may have to be paid for out of pocket.
Medicare is government-funded, national health insurance that all Americans become eligible for when they turn 65. Medicare covers annual wellness visits, health assessments, inpatient hospital care, and some of the doctors’ fees for seniors with dementia aged 65 and older.
In 2019, average Medicare costs of dementia care were $25,213 a person — that’s almost three times higher than Medicare costs for seniors without dementia, according to the Journal of Managed Care. As Medicare costs rise, so do dementia care costs.
Some other costs of dementia care covered by Medicare include the following:
Private insurance includes employer-provided plans, long-term care insurance, Medigap insurance, and life insurance. Different plans cover different aspects of dementia care, so review your loved one’s policy for specifics. Here’s a breakdown of the types of policies 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. Review the policy to seek answers to the following questions:
Medigap insurance. Medigap is a private insurance policy that can supplement Medicare coverage. It covers co-payments and deductibles required by Medicare and fills gaps in coverage.
Life insurance. Some life insurance policies can be borrowed against for cash at face value. Others offer accelerated death benefits. This means that if an individual is only expected to live 6 to 12 months, some insurance benefits can be paid before death. Since many seniors live comfortably for years after a dementia diagnosis, life insurance payouts should be a last resort for dementia 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 was $5,250 in 2019, according to A Place for Mom data.
In-home dementia care costs for seniors who need minimal help, or who don’t require 24-hour supervision, will often be lower than memory care community costs. However, if an elderly loved one needs full-time care, mobility support, or help with incontinence, all-inclusive memory care will be less expensive than home care aides — especially when you consider amenities that may not be available at home.
While communities vary, memory care typically offers meals, assistance with ADLs, and transportation, in addition to unique features tailored to seniors with cognitive impairment:
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 our Senior Living Advisors to discuss memory care, in-home care, and caregiver support near you — all at no cost to your family.
Alzheimer’s Association. (2022). 2022 Alzheimer’s disease facts and figures.
Davis, M.R. (2021, November 18). Despite pandemic, percentage of older adults who want to age in place stays steady. AARP.
Richard (last name withheld for privacy). (2021). Personal communication.
Genworth Financial. (2022). Cost of care trends & insights.
10 conversations with various home care agencies. (2022, October). Personal communication [Phone].
Fixr. (2021, February 24). How Much Does It Cost to Remodel a Home for Aging in Place in Your Area?
National Alliance for Caregiving, & Caring Across Generations. (2019, November 26). New research shines a light on a forgotten generation — GenX caregivers ”sandwiched’ between kids and parents.
Mahoney, R., Regan, C., Katona, C., & Livingston, G. (2005, September 13). Anxiety and depression in family caregivers of people with Alzheimer’s disease. American Journal of Geriatric Psychiatry.
Stanford Medicine. Alzheimer’s disease diagnosis.
Wong, W. (2020, August 17). Economic burden of Alzheimer disease and managed care considerations. American Journal of Managed Care.
A Place for Mom. (2022). A Place for Mom Proprietary Senior Living Price Index.
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