AARP Report Finds Long-Term Care Costs Outpacing Americans’ Incomes

Rising home care and nursing home costs are pricing out middle-income families, forcing them to take on caregiving responsibilities or tap their savings

Paul Wynn,

AARP

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Published March 12, 2026

a nurse with her arm around a man with a caregiving facility in the background

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Many Americans are feeling the strain of rising costs — from gas to groceries and utilities — and long-term care services are increasingly part of that financial pressure. Median long-term care costs increased significantly from 2019 to 2024, led by nearly a 50 percent increase in costs in home care and assisted living, according to a new report from the AARP Public Policy Institute.

Long-term care costs continue to climb, with adult day services rising 33 percent, and nursing home costs jumping 25 percent, all while household income for those 65 and older grew 22 percent over the same period.

“After becoming more affordable in the 2010s, long-term care costs have surged since 2019, outpacing typical incomes and leaving many families struggling to keep up with the rising price of care, whether at home or in a skilled nursing facility,” says Alan Weil, senior vice president at the AARP Public Policy Institute.

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Two main forces driving higher long-term care costs include rising hourly wages for care workers and the increasing intensity of older adults’ care needs, which often translates into needing more hours of assistance.

“As long-term care becomes less affordable, caregiving increasingly shifts to family members to fill the gaps,” says Weil. “More families have no choice but to step in themselves, often providing care beyond what they realistically have the time, resources or capacity to handle.”

Long-term care costs vary by state

The report found that long-term care costs vary widely by location, with services ranging from home care to nursing homes costing twice as much in the most expensive states, such as Maine, West Virginia and Oregon, as in the least costly ones, including Louisiana, Maryland, Utah and Texas. While home care tends to be pricier in wealthier states, higher local incomes can help offset those costs for some households. Nursing home care, however, remains expensive almost everywhere, making affordability a challenge regardless of where someone lives. As a result, many middle-class families are effectively priced out across the country, often forced to withdraw savings, rely on unpaid family caregivers or go without needed care.

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Across the country, the cost of long-term care ranged from about $26,000 a year for adult day services to nearly $128,000 for a private nursing home room, according to the Genworth/CareScout Cost of Care Survey. To put that in perspective, the median household income for adults 65 and older is around $60,000 a year. That means even a moderate level of home care, such as 30 hours per week, costs roughly as much as a typical older adult earns in a year, while assisted living or a nursing home exceeds it. With median financial assets of about $50,000 for households ages 75 and older, most older Americans have little financial cushion before long-term care costs begin to erode their savings.

About 60 percent of households headed by someone age 65 or older include more than one person, so the financial strain of long-term care often affects more than just the person receiving it. When a large share of household income goes toward one person’s care, fewer resources may remain for a spouse or partner.

Long-term care costs represent an underappreciated financial threat facing many Americans today, both for older adults and those who may need to step in as caregivers. According to a recent analysis by the U.S. Department of Health and Human Services, 56 percent of adults who turned 65 between 2021 and 2025 are expected to need long-term services and supports during their lifetime. Yet many people have no plan for how they would pay for that care, often mistakenly believing Medicare will cover the costs, which it generally does not.

Unpaid caregivers provide most long-term care in the United States, delivering support valued at an estimated $600 billion in 2021. Many spouses, adult children and other family caregivers reduce work hours or leave jobs to step into a caregiving role, often sacrificing income, savings and their own retirement security.

The rising cost of care has surged well beyond what most older Americans can absorb. The result is that older adults are devoting a steadily larger share of their income just to cover care. The squeeze hits middle-income older adults hardest They earn too much to qualify for Medicaid but not enough to comfortably keep pace with escalating costs. “AARP is working to help families afford long-term care by expanding access to services and supports, so they aren’t forced to rely solely on unpaid caregivers or drain their savings,” says Weil. “We’re advocating for public policies that ease the financial burden and protect older adults and their families.”

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Paul Wynn, a veteran health care writer, has spent over a decade immersed in the caregiving community , both as a family caregiver and as a journalist covering caregiving issues for national publications.

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