Aging In Place Statistics And Facts In 2024 (2024)

To give further insights into how aging in place costs differ from assisted living in each state, Forbes Health analyzed data and multiple cost factors associated with aging in place compared to assisted living costs.

To calculate the cost of aging in place, we looked at annual costs for the following instances:

• Median annual housing cost (assuming individuals looking to age in place may still have mortgages or rent to pay to provide a fair comparison to assisted living)
• The cost of homecare services
• Cost to renovate a home to make it suitable for aging in place with figures adjusted for cost of living.

Assisted living costs were taken from the Genworth cost of long-term care study and total cost figures were calculated as a percentage of the median income of older adults in each of those states. The percentage difference between an assisted living facility’s cost share of median income and aging in place’s cost share of median income was then calculated for each state to create the ranking.

The top 10 cities where aging in place is most affordable compared to assisted living are:

• 77% of adults over the age of 50 prefer to age in place. In 2020, only 1.2 million adults over 65 were residents in a nursing home^[1]Ratnayake M, Lukas S, Brathwaite S, Neave J, Henry H. Aging in place. Delaware Journal of Public Health. 2022;8(3):28–31. .
• More than half (60%) of Americans age 65 and older lived with their spouse or partner in 2021, while 72% of older men (18 million) and 49% of older women (15 million) lived with their spouses and 27% (15.2 million) of all older adults lived alone (5.2 million men, 10.1 million women) in 2021. These individuals represent 21% of older men and 33% of older women^[2]2021 Profile of Older Americans. Administration for Community Living. Accessed 12/6/2023. .
• Within the past 20 years, the percentage of older adults living in nursing homes has declined while the percentage of older adults living in traditional housing has increased^[3]Toth M, Palmer L, Bercaw L, Voltmer H, Karon S. Trends in the Use of Residential Settings Among Older Adults. The Journals of Gerontology. 2022;77(2):424-428. .
• About one in five adults ages 50 to 80 (19%) say they’re very confident in paying for help with household chores, grocery shopping, personal care and managing finances. Meanwhile, 39% were somewhat confident in paying for the same expenses and 43% didn’t have confidence they could afford these factors^[4]Older adults’ preparedness to age in place. University of Michigan Institute for Healthcare Policy and Innovation. 2022. .
• 92% of older adults surveyed prefer to live out their later years in their current home, while 8% said they would prefer to live in an assisted living facility^[5]Importance of Home Survey. American Advisors Group. 2023. .

Aging in place challenges are expected to grow exponentially over the next two decades as the baby boomer generation retires and moves toward the need for in-home support and greater health care needs, says Elizabeth Landsverk, M.D., a geriatrician and founder of Dr. Liz Geriatrics, an online support and education website for dementia caregivers.

“What everyone can do to stay independent and need less care in the future is focus on one’s health,” she says. “The chronic illnesses of hypertension, diabetes, obesity, inactivity, smoking and drinking lead to a faster decline, loss of strength and increased risk of heart attacks, strokes and dementia, which necessitate more money being spent on care.”

Why Do We Want to Age in Place?

• The large portion of older adults ages 50 to 80 (88%) feel it’s important to remain in their homes for as long as possible, according to a report from the University of Michigan. Of these older adults, 62% consider remaining in their home very important, while 26% consider it somewhat important and 12% rated it as not important at all^[6]Older adults’ preparedness to age in place. University of Michigan Institute for Healthcare Policy and Innovation. 2022. .

The top reasons older adults in the U.S. wish to age in place include:

• A desire to be independent and maintain control of personal space
• Feeling confident in their mental health and their ability to take care of themselves
• Preferring a quiet, residential area in which to live
• Feeling safe in their own neighborhood

“Many older adults fear someone else taking control and putting them in a nursing home,” says Dr. Landsverk. “Staying active and connected to community and family is key to successful aging.” Aging in place and living independently is possible for many people, but doing so takes planning, financial stability and clear-eyed recognition of the realities of aging, including the possibility of dementia, she adds.

Staying physically active, having a purpose, taking part in a community and volunteering can help individuals remain independent in their homes as long as possible, says Dr. Landsverk.

• Between the years 2010 and 2020, the number of U.S. adults ages 45 to 64 increased by 1% from 81.8 million to 82.8 million. This age group will reach age 65 within the next decade^[7]2021 Profile of Older Americans. Administration for Community Living. Accessed 12/6/2023. .
• The number of U.S. adults ages 60 and older rose from 57.5 million to 76.5 million, an increase of 33%^[7]2021 Profile of Older Americans. Administration for Community Living. Accessed 12/6/2023. .
• The 85 and older population is projected to increase from 6.7 million in 2020 to 14.4 million in 2040, more than doubling with a 117% increase^[8]Percent of U.S. Adults 55 and Over with Chronic Conditions. Centers for Disease Control and Prevention. Accessed 12/6/2023. .
• Many older adults live with a chronic health condition. Nationwide, 78% of adults over 55 have a chronic condition, such as arthritis, asthma, cancer, cardiovascular disease, chronic obstructive pulmonary disease or diabetes. This rate increases to 85% in adults over 65^[8]Percent of U.S. Adults 55 and Over with Chronic Conditions. Centers for Disease Control and Prevention. Accessed 12/6/2023. .
• Research shows at least half of older adults ages 65 or older can expect to need care during their older years, making the availability of caregivers an important consideration for those planning to age in place^[9]Valerio T, Knop B, Kreider R, He W. Childless Older Americans: 2018. U.S. Census Bureau. 2018. .
• The national monthly median average for a home health aid is $5,148, according to the 2021 Genworth Cost of Care survey. The national monthly median average for an assisted living community is $4,500^[10]Genworth Cost of Care Survey. Genworth Financial. 2021. .

In terms of the long-term care necessary for aging in place, Dr. Landsverk recommends hiring a geriatric care manager, who can make home visits, suggest support services, evaluate in-home care needs, coordinate medical services and discuss difficult topics and explain complex issues. Care managers can cost between $50 to $200 an hour and aren’t typically covered by Medicare, Medicaid or private insurers.

A familiar environment can help an older adult feel a stronger sense of identity, utilize neighborhood services and resources and help them remain socially connected to friends. Staying engaged with a community and an individual’s family is a huge benefit of aging in place, says Dr. Landsverk. Fortunately, a number of home services like home health nurses, physical and occupational therapists, mobile X-rays and pharmacy access help make aging in place possible for individuals who require more care. Aging in the home can also help avoid serious infections and the loss of muscle mass that can occur when an older adult stays in a hospital or nursing home bed, she adds.

How Aging in Place Benefits the Health Care System

• Older adults living at home can help protect themselves against accidents and reduce the risk of falls thanks to home modifications like stair lifts, which may help save money on hospital bills.
• Falls are estimated to cost over $50 billion per year in medical expenses as of 2015^[11]Curtis S Florence, Gwen Bergen, Adam Atherly, Elizabeth Burns, Judy Stevens, Cynthia Drake. Medical Costs of Fatal and Nonfatal Falls in Older Adults. Journal of the American Geriatrics Society. 2018. .

According to Dr. Landsverk, ensuring primary care doctors and home health support are available to care for people aging in place may help cut costs to Medicare and hospitals.

The Biggest Concerns About Aging in Place

• More than one-third of adults ages 50 to 80 report feelings of isolation, which can have negative implications on both physical and mental health^[12]Trends in Loneliness Among Older Adults from 2018-2023. University of Michigan National Poll on Healthy Aging (NPHA). Accessed 12/19/2023. .
• Loneliness may increase among older adults due to lifestyle changes like living alone, as well as hearing loss, chronic illness and loss of family and friends^[13]Loneliness and social isolation linked to serious health conditions. Centers for Disease Control and Prevention. Accessed 12/7/2023. .
• 38% of respondents in a 2021 survey by AARP look after someone living on their own. Of that number, nearly half worried about the person they care for being able to continue living independently^[14]Despite pandemic, percentage of older adults who want to age in place stays steady. AARP. Accessed 12/7/2023. .

Older adults who live in rural areas are of particular concern, notes Dr. Landsverk, given the potential for isolation in remote locations. Individuals living in rural areas or the suburbs can also encounter transportation challenges if driving becomes unsafe and public transportation isn’t available, which can lead to changes in lifestyle, she says.

Dr. Landsverk recommends older adults try to stay involved in local activities, such as sports, arts and religious community groups, instead of staying home. “Apathy can be a sign of depression, dementia or substance abuse; all of which lead quickly to decline and need for more care.”

• A 2020 report by the U.S. Census Bureau estimates only 10% of American homes are “aging ready,” meaning they feature a step-free entryway, a bedroom and bathroom on the first floor and at least one bathroom accessibility feature^[15]Old Housing, New Needs: Are U.S. Homes Ready for an Aging Population?. U.S. Census Bureau. 2020. .
• One-third of all poll participants in a 2021 AARP survey said modifications would be necessary in their current residence so they or a loved one could continue to live there should physical limitations occur^[16]Despite pandemic, percentage of older adults who want to age in place stays steady. AARP. Accessed 12/7/2023. .
• 79% said bathroom modifications like grab bars or no-step showers would be necessary, 71% noted indoor and outdoor accessibility issues, 61% said they would need an emergency response system and 48% said they would need smart-home devices, such as a voice-activated home assistant or a doorbell camera^[16]Despite pandemic, percentage of older adults who want to age in place stays steady. AARP. Accessed 12/7/2023. .
• Aging-in-place home modifications can cost anywhere from $10,000 to $100,000^[17]20 Aging in place vs. assisted living. Aging in Place. Accessed 12/7/2023. .

According to 2019 data reported by the Census on the American House Survey, 51.9% of homes with two or more floors do not have an entry-level bedroom and 38.9% of homes with two or more floors do not have an entry-level bathroom^[18]American housing survey. U.S. Census Bureau. Accessed 12/7/2023.

The community in which a person wishes to live, as well as home safety and mobility modifications are important factors to consider when deciding whether to age in place, says Dr. Landsverk.

Most Common Accessibility Features in a Home

• Older adults report the most common accessibility features in their homes as the main floor bathroom (88%) and bedroom (78%), according to the National Poll on Healthy Aging by the University of Michigan^[19]Older adults’ preparedness to age in place. University of Michigan Institute for Healthcare Policy and Innovation. 2022. .
• About half (54%) of door frames in the homes of surveyed older adults are wide enough for a wheelchair to pass through, 32% have lever-style door handles and 19% have home entrances with ramps or no stairs^[19]Older adults’ preparedness to age in place. University of Michigan Institute for Healthcare Policy and Innovation. 2022. .
• Existing bathroom features that support aging in place include shower chairs or benches (36%), raised-height toilet seats (36%) or grab bars (32%), while 7% report having barrier-free showers^[19]Older adults’ preparedness to age in place. University of Michigan Institute for Healthcare Policy and Innovation. 2022. .
• Half of older adults (49%) polled report having at least one smart home device that uses Wi-Fi and sensors for communication between devices, remote monitoring and/or voice control^[19]Older adults’ preparedness to age in place. University of Michigan Institute for Healthcare Policy and Innovation. 2022. .
• Fewer than 10% of older adults surveyed report having smart stove alarms, bath temperature monitors, water leak detectors, smart medication pillboxes or emergency response systems, each of which are specifically designed to promote safety in the home^[20]Top Aging-in-Place Remodeling Projects. American Association of Home Builders. Accessed 12/7/2023. .
• 76% of remodelers say they’ve received more requests for aging in place related features over the past five years^[20]Top Aging-in-Place Remodeling Projects. American Association of Home Builders. Accessed 12/7/2023. .
• The most common aging in place modification was grab bars, with 93% of remodelers noting having installed the devices in the past year^[20]Top Aging-in-Place Remodeling Projects. American Association of Home Builders. Accessed 12/7/2023. .

Having a bedroom and a bathroom on the first floor is essential when planning to age in place, says Dr. Landsverk, who adds that it’s important to also consider how many stairs a home has at its entry points. Small, inexpensive bathroom modifications such as a raised toilet seat with side grab bars can help prevent serious injuries.

A shower bench and low entry threshold tub or shower are also important safety features that can prevent slips and falls.

Additional Home Modifications for Aging in Place

Home modifications and safety features to make a home more accessible for aging in place include:

• Walk-in-tubs are designed with a low-entry threshold, eliminating the need for the user to step into the tub, and often include grab bars to help prevent slips or falls.
• Stair lifts are seats with motorized gears on a track installed along stairway walls to enable a person to ride in a seated position up and down a flight of stairs. Versions include straight stair lifts, curved stair lifts and outdoor stair lifts.
• Home elevators use steel cables powered by a motor, pulley system or hydraulic pump to help transport a person from one level of their home to another.
• Medical alert systems enable a person to contact a call center to notify first responders and family through the push of a button in case of an emergency or if they need help.
• Lift chairs are motorized, recliner-style chairs that use a powerlifting mechanism to gently move a person from a seated to a standing position or to sit down easily and safely.