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Reviewed by Leslie Fuller Leslie Fuller, LMSW, owns Inspire Senior Care, a provider of training for senior living communities and dementia care.

How Much Do Home Health Aides Make Per Hour

Many older adults want to age in at home unassisted, but sometimes because of declining health or dementia, this is not possible. One way to help older adults stay in their homes longer is home care, which is non-medical assistance with daily living provided by trained aides in the comfort of a senior’s own home. But how much does home care cost, and is it the right next step for your loved one?

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The cost of home care for seniors depends on how many hours a senior spends with the caregiver, the services they need, and the supplies they need.

Home care is a highly individualized service, with price fluctuations specific to region, agency, and services provided. To plan your loved one’s care, it’s important to understand the help they need.

In July and August 2021, CareScout, a Genworth financial institution, contacted 4,195 home care providers. Taken together, the data they collected paints a picture of what home care costs look like across the country.

Based on the data above, how much would your family pay for housekeeping? Costs will depend on a number of factors, including what home care services your relative needs and how often they need support.

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Before starting your search for home care, consider how much help your loved one needs. Do they live independently on their own, but need help with some chores? Or do they need full-time help because of changes in physical or cognitive abilities?

Agencies will work with each family to conduct a needs assessment. Services that require a higher level of training or care will cost more than a lower level or general care.

A family and home care aide or agency will develop a plan that ranges from simple companionship to personal care and assistance with activities of daily living (ADLs) such as dressing and bathing.

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Most home care aides and agencies are priced by the hour. To cover transport and staffing costs, they often have a minimum number of contracted hours – usually two to four hours a day or seven hours a week.

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If a family determines that their elderly loved one needs significant assistance throughout the day, some home care agencies will offer contracts for weekly or monthly care.

If you live somewhere with a high cost of living, expect to pay more than the national average for home maintenance. However, if your city has a relatively low cost of living, you’ll pay less. State regulations also affect maintenance costs; Many states require special certifications, while others limit the costs of nursing home care.

Genworth has compiled a list of 2021 hourly, monthly and annual average home care costs in each state. These numbers, which informed the following state rankings, were rounded to the nearest cent.

Home care costs increase as a senior’s needs increase—higher demand means more hours of care. Families who choose home care often agree that they need extra help to keep their loved ones at home as safely as possible.

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By starting home care early, seniors can live longer without having to worry about isolation, nutrition, or household responsibilities. Your home care agency can help you determine how many hours per week will benefit your family, but listed below are some common schedules and costs based on care needs.

These cost estimates are based on Genworth’s average housekeeping cost of $27 an hour, as quoted throughout the article.

7 hours per week: $819 per month. Healthy, independent seniors can get all the care they need from several short visits a week. Housework, companionship, meal preparation and cleaning can be accomplished at this time for less than $1,000 per month. Seven hours per week is generally the minimum requirement for home care agencies, although some have higher or lower limits.

15 hours per week: $1,775 per month. Two to three hours of daily check-in can benefit seniors who need more care but are independently mobile and cognitively active. You can spend several hours in the morning showering, dressing, and preparing the day’s meals.

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30 hours per week: $3,510 per month. A 30-hour week may be suitable for seniors who live with working family caregivers or want more companionship and stimulation with an adult. Thirty hours a week equals six hours a day, or the senior is alone while the family caregiver is at work.

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44 hours per week: $5,148 per month. Forty-four hours of care provides coverage for a family caregiver who works full-time and does not want their senior loved one to be alone. An aide can assist with all ADLs, including toileting, eating, and bathing. For elderly loved ones who need dementia care at home, help with incontinence or other chronic conditions that prevent them from being safely alone, 44 hours a week can be a great schedule — there are other arrangements for nights and weekends.

Live-in home care: $10,645 per month. Agencies and private caregivers have different pricing structures for round-the-clock or live-in home care, depending on the number of care aides, sleeping arrangements, and room and board. These types of maintenance costs vary depending on the model. Before hiring a live-in caregiver, create a care agreement including responsibilities and fees, as these can vary greatly on a case-by-case basis.

Families looking for in-home caregivers have two options: hiring a private, independent caregiver or using a licensed home care agency. There are pros and cons to hiring independent and agency caregivers.

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There is no specific fee structure for hiring a personal caregiver. These placements are contracted by the family – often through caregiver databases – and all fees, allowances and taxes are determined contractually between the caregiver and the client.

Hourly private pay home care costs in 2022 will generally be lower than agency care costs. However, it’s worth considering more than hourly rates when deciding who to hire. Additional costs for the family may include conducting background checks or having attorneys review contracts. Private caregivers may not have worker’s compensation insurance, causing accidents on the job to cost families.

Although agency care is usually a bit more expensive, it removes the burden of planning and paperwork from families. It also provides peace of mind: if a caregiver is sick or unable to work, the company will provide another caregiver, preventing gaps in care.

Families typically pay more for agency caregivers than for private caregivers. Agencies pay salaries and workers’ compensation and liability insurance for many employees, and they take care of taxes and payroll-related expenses. Additionally, agencies often provide continuing education for care aides or require aides to be certified nursing assistants or companions.

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After surgery, home care costs may vary. This is because postoperative home care and home health care can be more involved than standard care.

If your loved one has specific medical care needs, a home health aide can provide assistance and nursing in their home. This may include wound care, medication administration, regular monitoring of vital signs, and more. The average hourly wage for home health aides is $27 per hour, and can increase based on nursing degree or skill level.

A Place for Mom’s data and Genworth’s survey put average monthly costs for assisted living and nursing homes at $4,640 and $8,910 in 2021, respectively.

At $4,640 a month, the cost of assisted living is slightly less than the $5,148 a month of 44 hours a week home care. It’s worth noting that these numbers were pretty similar in previous years, but between 2020 and 2021, home care costs rose more steeply than assisted living costs.

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Both types of care provide similar services, from assistance with ADLs to housekeeping and transportation. Not designed for seniors who require extensive medical care.

Nursing homes provide comprehensive medical care in addition to personal care services. That’s why, at around $8,910 a month for a private room,  nursing homes can be the most expensive senior care option.

If you think home care might be the right choice for your aging loved one, contact Mom’s Place for Senior Living Consultants for advice on home care options near you. They can answer your questions about home care costs and benefits, and they can help you explore the best next steps—all at no cost to your family.

Claire Samuels is a senior copywriter at A Place for Mom, where she helps guide families through the dementia and memory care journey. Before transitioning to writing, she gained industry insight as an account executive for senior living communities throughout the Midwest. Graduated from Davidson College.

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