Most people want to stay home. In AARP’s 2024 Home and Community Preferences Survey, 75% of adults 50 and older said they want to remain in their current homes as they age. The question families eventually face is whether that is still the right and affordable choice, compared with assisted living.
This guide puts the two side by side using the most recent national figures: CareScout’s 2025 Cost of Care Survey, released March 2, 2026, which collected more than 25,000 rates from providers between July and November 2025.
The national medians
| Option | 2025 national median | Per year |
|---|---|---|
| Assisted living community | $6,200 a month | $74,400 |
| Non-medical in-home care | $35 an hour | $80,080 at 44 hours a week |
| Nursing home, semi-private room | $315 a day | $114,975 |
| Nursing home, private room | $355 a day | $129,575 |
Source: CareScout 2025 Cost of Care Survey. Assisted living rose 5% in the year; in-home care rose 3%.
Comparing like with like
The numbers above are not directly comparable, and the mistake families make most often is to set the full assisted-living bill against the cost of a few hours of help.
Assisted living’s monthly fee bundles housing. The $6,200 median includes the apartment, utilities, most meals, housekeeping and some personal care. Staying at home, those costs still exist: mortgage or rent, property tax, insurance, utilities, food and upkeep.
Home care is paid by the hour. At $35 an hour, the cost scales with need:
| Paid help at home | Approx. per month |
|---|---|
| 10 hours a week | $1,520 |
| 20 hours a week | $3,030 |
| 30 hours a week | $4,550 |
| 44 hours a week | $6,670 |
Monthly figures are $35 × hours × 52 weeks ÷ 12, rounded. At about 41 hours a week, paid home care alone matches the assisted-living median, before any housing costs. Round-the-clock care at home costs several times more.
Home modifications are mostly one-time. A home that is safe to stay in needs a one-off investment, not a monthly fee:
| Fix | Typical cost | Who | Source |
|---|---|---|---|
| Motion-sensor night lights (4-pack) | $40–$53 per 4-pack | DIY | The Home Depot, October 17, 2026 |
| Grab bar, installed | $85–$300 per bar (parts $20–$33) | Either | Fixr, August 29, 2025 |
| Stair handrail, installed | $350–$1,200 per staircase | Pro | Fixr, January 31, 2025 |
| Three-way light switches at top and bottom of stairs | $200–$450 per staircase | Pro | HomeGuide, October 17, 2026 |
| Tub-to-shower conversion (low threshold) | $2,000–$12,000 per bathroom | Pro | This Old House, October 17, 2026 |
| Straight stair lift, installed | $2,000–$8,000 per staircase | Pro | Fixr, January 31, 2025 |
| Entry ramp (modular aluminum, about 10 ft) | $1,700–$5,000 per entrance | Pro | Fixr, January 31, 2025 |
Many homes can be made substantially safer for less than one month of assisted living. Even a bathroom conversion plus a straight stair lift usually costs less than a few months of it.
A worked example
Take a parent who owns their home outright and needs help with bathing, shopping and cleaning for about 15 hours a week. At the $35 median, that care costs about $2,275 a month, or $27,300 a year. Add a one-time $3,000 for grab bars, a second stair rail, stair switches, night lights and a transfer bench, and the first year of aging in place comes to roughly $30,300 in new spending.
The assisted-living median for the same year is $74,400. That figure replaces some costs the parent would otherwise pay at home (utilities, most food, upkeep), so the true gap is smaller than $44,000, but it is still large. Now change one fact: the parent needs someone present most of the day, say 50 hours a week. Care alone becomes about $91,000 a year, and assisted living becomes the cheaper option before housing is even counted.
The lesson is that hours of help, not the modifications, drive the comparison. Modifications are what make the low-hours version possible, because a home with rails, light and a usable bathroom needs less hands-on help.
Costs people forget
At home: property tax and insurance, repairs on an aging house, utilities, transport to appointments once driving stops, and the unpaid hours family members put in. In assisted living: the move itself, level-of-care charges on top of the base rent as needs grow, and the sale or rental of the old home. Write both lists down for your own situation before comparing totals.
When aging in place tends to win
- The person needs some help (meals, cleaning, bathing a few times a week, transport), not continuous supervision.
- The home can be made safe with modifications: one level, or stairs that a rail or lift can solve, and a bathroom that can be adapted.
- Family nearby can share the load, or the local area has home-care agencies with availability.
- The house is paid off or cheap to run, so the comparison is mostly care hours against assisted living’s fee.
Programs that combine home repairs with therapy show what is possible. In the CAPABLE program, an occupational therapist, a nurse and a handy worker visit over four to five months; studies summarized by the NIH’s NIMHD report substantial improvements in daily activities and average savings of $22,120 per person against a cost of $2,882.
When assisted living tends to win
- Care needs approach full-time, or someone must be awake at night.
- Memory changes make being alone unsafe even with a stove shut-off and other changes.
- The home cannot be adapted: steep stairs to the only bathroom, no room for a ramp, or a remodel that would cost more than a year of fees.
- Isolation is the real problem. A community with meals and activities may matter more than a safer bathroom.
Help paying either way
Medicare.gov is plain that most long-term care is not covered: non-medical long-term care at home, in assisted living or in a nursing home is paid by the person, by Medicaid for those who qualify, or by long-term care insurance. Medicaid’s home and community-based services waivers, in states that offer them, can pay for some in-home services and sometimes home modifications for people who qualify; your Area Agency on Aging (Eldercare Locator, 1-800-677-1116) can explain local options. Veterans have their own programs. See the grants guide.
Pricing your own version
Two numbers decide the comparison for your family: the one-time cost of making the home safe, and the weekly hours of help the person needs. The home check gives you the first: a ranked, priced list of modifications for the actual home, with a budget picker. Pair it with quotes from two local home-care agencies and two assisted-living communities, and the decision becomes arithmetic plus preferences, rather than guesswork.
Related: what home modifications cost and the aging in place checklist.