The Most and Least Affordable States for Your Aging Parents in 2018

Why the state where they live matters
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Your parents used to be the ones taking care of you, but as they age, you are likely finding that the opposite is now true. Nearly a third of all Americans caring for an aging loved one are looking after their parents, according to a recent survey. And as anyone who’s cared for an aging parent will attest, the cost of that care doesn’t come cheap. Whether you’re paying for an in-home care aide, an assisted living facility, or a nursing home, the financial strain of senior care -- not to mention the emotional stress -- can be heavy.

“It hasn’t always been so expensive, but the cost of caring for our parents is so out of control now that it has the capacity to actually bankrupt families,” says Jim Miller, senior advocate, author and publisher of “I think that’s why it’s so important to consider these costs far in advance of needing to provide care so you’re prepared instead of panicked.”

To that end, recently conducted a new study examining the overall affordability of growing old in all 50 U.S. states for adults 65 and older. Using 11 different variables—including each state’s cost of living index, the availability of senior health care programs and support for family caregivers, and the average cost of senior care—the result is a comprehensive ranking of every state from most to least affordable.

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Taking a multifaceted look at various socio-economic factors, one of the report’s most interesting findings was in the frequent disparity between a state’s average senior care costs and the accessibility of programs for the elderly and their family caregivers.

For instance, Mississippi—which came in as the second-cheapest state for seniors—ranked a dismal 35th for elderly and caregiver support. Conversely, Washington state scored second for elderly and caregiver support services, but 37th for the overall affordability of senior care.

“Sometimes there’s going to be a trade-off,” says Stephan Weiler, professor of economics at Colorado State University's Regional Economic Development Institute. “In a lot of rural areas in the country you’re going to have much cheaper costs, but you’ll probably have to make sacrifices when it comes to accessing medical care and senior facilities. Conversely, vibrant and attractive coastal or urban regions are going to be expensive but also brimming with care options. That’s just the nature of the beast.”

Nonetheless, experts say a study like this can be invaluable in planning for your future caregiving needs, no matter what state you call home.

“For people preparing to care for their parents it’s important to see these cost differences, because it’s a good way for them to get a handle on what’s available in their state and to begin getting a grasp on what their costs will be,” says Jason Biddle, a senior care veteran and publisher of “What are we in for? What should we expect? And are we prepared? This is a good place for them to start.”

State-By-State Results

State Overall Rank Cost of Senior Care Rank Cost of Living Rank Elderly Support Rank
Oklahoma 1 3 5 24
Mississippi 2 6 1 35
Missouri 3 12 10 22
Wisconsin 4 19 23 6
Idaho 5 14 4 31
South Carolina 6 4 21 26
Tennessee 6 8 6 37
Texas 6 9 19 23
Ohio 9 27 11 15
Arizona 10 22 3 30
Kansas 10 18 18 19
Alabama 12 1 9 46
Minnesota 13 31 26 1
Florida 14 13 28 18
Utah 15 2 20 39
Kentucky 16 25 2 35
West Virginia 16 28 14 20
Arkansas 18 11 31 21
Georgia 19 7 15 41
Louisiana 20 5 16 43
Pennsylvania 21 15 35 17
Michigan 22 23 8 37
North Carolina 23 10 17 45
Colorado 24 35 32 9
Nebraska 24 20 13 43
Oregon 26 36 37 4
Washington 26 37 38 2
New Mexico 28 21 24 33
Virginia 29 26 30 24
Nevada 30 16 34 31
Iowa 31 30 12 43
Indiana 32 29 7 50
Illinois 33 24 35 29
Maryland 34 33 42 15
South Dakota 35 17 26 48
Montana 36 32 21 39
Vermont 37 48 40 5
California 38 39 48 8
Massachusetts 38 46 46 3
Connecticut 40 43 47 7
Maine 41 49 39 13
New Hampshire 41 45 44 12
Delaware 43 41 33 28
New York 44 41 49 13
Alaska 45 50 45 10
North Dakota 46 34 25 47
Hawaii 47 47 50 11
New Jersey 48 44 41 26
Rhode Island 49 40 42 34
Wyoming 49 38 29 49


Overall rankings were calculated by weighing state scores for senior care costs, cost of living, and avaiability to elderly and caregiver support services. Average costs per state for assisted living, independent living, non-medical home care, skilled nursing, and memory care came from internal data and 2017 Genworth Cost of Care Survey data. The Council for Community and Economic Research's 2017 State Level Cost of Living Index was used to rank states by their average costs for food, housing, utilities, transportation, health care, and miscellaneous goods and services. Elderly and caregiver support service rankings were based on data from the 2017 Long-Term Services & Supports State Scorecard (AARP, The Commonwealth Fund and The SCAN Foundation).

The Experts

Stephan Weiler

Professor of Economics, Colorado State University

Stephan Weiler holds the William E. Morgan Endowed Chair as Professor of Economics at Colorado State University. ord University and his Economics PhD from UC Berkeley where he studied with eventual Nobel Laureate George Akerlof. From 2004 through 2006, Stephan was appointed as Assistant Vice President and Economist at the Federal Reserve’s Center for the Study of Rural America to lead the Center’s applied research work. His research, comprising over 100 articles, book chapters and policy papers, has spanned a variety of development and labor market issues in Africa, Appalachia, Europe, and the American West, now being distilled into the new Regional Economic Development Institute.

Jim Miller

"Savvy Senior" creator and author

Jim Miller is the creator of Savvy Senior, a syndicated information column devoted to Boomers and Seniors that is published in more than 300 newspapers and magazines nationwide, and can be found online at

Jim is also a contributor to KFOR-TV in Oklahoma City and NBC’s “Today” show in New York, and is the author of "The Savvy Senior, The Ultimate Guide to Health, Family and Finances for Senior Citizens" (Hyperion).

Joanna Leefer

ElderCareGiving founder and senior care advisor

Joanna R. Leefer is a senior care advisor and advocate. She is the founder of ElderCareGiving, a service that finds and gets the best care for aging loved ones. She writes a monthly column on eldercare for the Community Newspaper Group, has a bi-monthly blog on senior issues and speaks to professionals and families. Her book "Almost Like Home: A Family Guide to Navigating the Nursing Home Maze", was featured in Jane Brody’s New York Times column for two weeks running.

Jason Biddle

Aging in place specialist and founder of The Helping Home

Through field research and training as a Certified Aging in Place Specialist, Jason Biddle developed a proprietary Home Livability Assessment to perform in-home evaluations and offer homeowners recommendations to make their homes safer and more accessible. Jason has also also worked at a senior move management agency and served as a board member for Rebuilding Together Nashville for two years, charged with the task of giving insight on how to best meet the aging in place needs of local low-income homeowners.

In 2014, Jason launched The Helping Home, a website featuring in-depth guides and resources to empower older adults with the information they need to age in place safely at home through the use of home modifications, medical equipment, and assistive devices.

Nick DiUlio

Nick DiUlio is an award-winning freelance writer and editor whose published work has focused on everything from profiles of artists and important political figures to hard-news stories with both national and local appeal. See full bio