Price of elder care soars as demand increases, baby boomers age

Many Americans who serve as caregivers are consumed by the immense cost of tending to ailing or aging family members. 

And as the baby boomer generation ages, more Americans are in for a rude awakening as to just how expensive caring for older adults has become.  

The price of nursing home care increased by an average of 2.4 percent each year between 2012 and 2019, for a cumulative increase of 20.7 percent, according to data from the health research group Altarum Institute.    

That stems from multiple sources, including personnel costs and the price of adhering to facility regulations, said Terry Fulmer, president of the John A. Hartford Foundation, a nonprofit that works to improve the lives of older adults.  

But the cost of care has primarily shot up due to increased demand in adult day cares, assisted living facilities or nursing homes. 

Jean Spera, 67, has been a full-time caretaker for her husband, John, since 2011, when his health started to rapidly deteriorate without any clear cause. 

For years, she managed to take care of John in their Holliston, Mass., home without any outside help, even as he became more fragile and confused. 

But everything changed when John had a seizure in the middle of their kitchen. After a three-day hospital stay, John’s doctors recommended that he go to a rehab center housed in a nursing home.    

“I was overwhelmed, I wasn’t able to bring him home because I didn’t know how I was physically going to take care of someone who was twice my size and on our limited income,” said Spera.    

Shortly after John became sick, Spera quit her job at a nursing home to take care of him. Eventually, she picked up part-time work to help cover some smaller costs like groceries. She had to dip into the couple’s $235,000 retirement savings to make ends meet.   

But those funds went quickly after she stopped working full-time. “It took us 15 years to save that, and it was gone in six,” she said.    

Spera brought John home after five months in rehab, mainly for financial reasons.   

Luckily, the couple’s primary and supplemental health insurance, MassHealth and Tufts Health Plan, covered some of John’s stay, but not all of it. And paying out of pocket for more time in the rehab center was not something they could afford.    

“I would have had to sell my home and go live in a box somewhere,” she said.   

In the end, the pair was slapped with a $10,000 bill for John’s five-month stay.

The median cost of a private nursing home stay in the United States is $12,622 per month, according to the AARP family caregiving cost calculator.    

The median cost per month in a semi-private nursing home is $11,254, and $3,492 in an assisted living facility. A home health aide for 10 hours a week is $1,333, according to the AARP cost calculator.

But, of course, those prices vary by state.   

In Massachusetts, for example, the median cost of a private nursing home is $15,208 per month, while a semi-private nursing home is $14,265 per month and $8,462 per month to stay in an assisted living facility.    

There were roughly 1.3 million people living in a nursing home in 2017, according to the U.S. Centers for Disease Control and Prevention.  

Another 251,000 people were enrolled in an adult day care program in 2018, and 918,700 people lived in a residential community that year as well, according to a 2022 report from the National Center for Health Statistics.     

One 2021 analysis found that 83 percent of households with a retiree need some level of care, according to the Center for Retirement Research at Boston College.  

Of those households, 22 percent will need “minimal levels of care” like help with groceries, cooking and finances. Another 38 percent will have moderate needs, and 24 percent will have severe care needs — or around-the-clock care for several years, according to a brief from the center.     

Even for the quarter of adults who require round-the-clock care, half of those care hours are provided by family members, a spokesperson for the Center for Retirement Research at Boston College clarified.  

And many baby boomers do not have enough retirement savings to cover the cost of living in good health, let alone in poor.     

More than two-fifths of baby boomers don’t have any retirement savings, according to a survey of 2020 Census data.    

Without savings, most retired adults will need to rely solely on income they receive through Social Security because Medicare, the federal health insurance policy for adults 65 and older, does not cover nursing home or assisted living facility stays.    

The average retired worker receives a monthly Social Security check of $1,782 per month upon retirement at age 65, according to the Center on Budget and Policy Priorities. 

To prepare for the high cost of care, Angie Chen from the Center for Retirement Research at Boston College recommends that working-age adults of means set aside a portion of their retirement savings for long-term care costs.   

But since most Americans can’t even save enough money to enjoy the same standard of living in retirement as they did during their working years, asking people to set aside hundreds of thousands of dollars for their potential long-term care is “not really reasonable,” Chen said.   

Instead, she said, there should be more programs available to cover the cost of nursing home or assisted living expenses. One state that has already implemented a program to address this is Washington.   

Under the Washington Cares payroll tax, which took effect this summer, qualifying residents can receive up to $36,500 to help cover the cost of long-term care services and support.  

But while that legislation is a big help for older Americans who need some care, it won’t provide enough financial support for those that need years' worth of around-the-clock care, Chen said. 

Chen added that some older adults could turn to Medicaid as a last resort, but that also isn’t really a viable option.  

“We don’t really have a great solution,” Chen said.   

To help the nation’s growing aging population, more services and support should be offered to family caregivers like those outlined in 2022 National Strategy to Support Family Caregivers, which the John A. Hartford Foundation helped craft, according to Fulmer.