The unfortunate reality is that some states are much costlier than others when it comes to growing old. A variety of factors play a role, including the overall cost of living in states like New York, Hawaii, and Alaska, or a general inaccessibility to senior and support services in less populated states like Wyoming and North Dakota.
“There’s always going to be a certain degree of inequality when it comes to how far your dollar will go in certain states compared to others,” says Stephan Weiler, professor of economics at Colorado State University and director of CSU’s Regional Economic Development Institute. “That’s not a slight on certain states necessarily, just the reality of the world we live in. But it doesn’t mean you can’t be prepared for those variables.”
Being a senior in Maine isn’t cheap. The Pine Tree State came in at 39th place for cost of living, and 49th for the cost of senior services (second only to Alaska). The median cost of a home health aide for elderly adults here is only about $4,500 more than the national median, but an assisted living facility costs $58,680 ($13,680 more than the national median), and the annual median cost of a nursing home is $109,683, which is almost $24,000 more than the median cost for the country on the whole.
On the other hand, Maine ranked 13th for elderly and family caregiver support services.
“For having such potentially secluded regions I think that’s a pretty promising stat for Maine,” says Jim Miller, senior advocate, author and publisher of SavvySenior.org. “But if you live in a part of the state where actually have abundant access, I imagine it’s probably going to be expensive.”
9. New Hampshire
Its long, challenging winters can make New Hampshire seem like a difficult place to care for one’s aging parents, but the cold isn’t the only trial for those who call the Granite State their home. It ranked 44th for overall cost of living and 45th for the cost of senior care services.
The median annual cost for a home health aide ($60,357), a nursing home ($115,888), and an assisted living facility ($58,260) are all decidedly higher than the national median rate. Nonetheless, New Hampshire scored well for access to supportive programsrs for seniors and family caregivers, coming in 12th for this metric.
One of the things that makes Delaware unique within the larger landscape of its small, northeast neighbors is that large swaths of the First State are relatively rural and isolated. That could account for its modest 28th place ranking for elderly and family caregiver support services.
As a coastal state, it also shares the distinction of being rather expensive. It came in 33rd for overall cost of living, and 41st for senior care affordability. The median cost of a nursing home in the state is $127,750 per year, and an assisted living facility here goes for about $72,000.
7. New York
With a reputation for being an expensive place to live, it may not be surprising that The Empire State made the list of the least affordable states for aging parents. Perhaps because it’s home to the largest city in the country, New York fared pretty well when it comes to elderly and family caregiver support services, earning 13th place in that category. But it also came in second-to-last for overall cost of living.
“I often say New York City and the surrounding metro area is one of the best places for seniors because it has so many accessible services and you can easily get almost anywhere you need to,” says New York City-based eldercare advisor and advocate Joanna Leefer. “If you’re in an upstate suburb it might not be as easy, but it will be cheaper.”
The median costs for both a home health aide ($54,340) and a year in an assisted living facility ($47,850) in New York are competitive with national medians, whereas a nursing home costs about $132,900, which is about $47,000 more than the U.S. median.
Its nickname is The Last Frontier, and for good reason. Alaska is the most remote and undeveloped of all the states – also why it’s so expensive.
The state came in last place for the overall cost of senior services, and the numbers are sobering. The median cost of a nursing home here is $292,000, which is $206,000 above the national median. A home health aide will run you about $63,000 and an assisted living facility costs about $72,000 a year.
On the plus side, Alaska came in 10th for elderly and family caregiver support, probably due to the relative high population densities in Anchorage and Fairbanks.
5. North Dakota
Like fellow Midwestern state Wyoming, North Dakota’s remoteness makes it a challenging place to find affordable care for one’s aging parents, contributing to its 47th place ranking for elderly and family caregiver support in our study.
“Few people, especially seniors, can handle a climate like North Dakota’s, so you don’t have dense, urban clusters like you do in some other states,” says Miller.
It’s also not terribly cheap for North Dakotan seniors in need of daily assistance. The median cost of a nursing home is $127,630 annually and $63,972 for a home health aide, both of which are notably higher than national medians. Assisted living is where you might find some relief at about $36,000 per year.
The good news: The Aloha State scored really well for elderly and family caregiver support, coming in at 11th place. The bad news is that it’s an incredibly expensive state for your aging parents.
Its isolated location and enviable tropical climate, brought Hawaii in at dead last for overall cost of living. What’s more, a nursing home in this popular tourist haven costs about $137,000 a year, which is more than $50,000 above the national median, and hiring a home health aide is about $10,000 more expensive than the national median, at about $59,400 per year.
3. New Jersey
The Garden State scored well when it comes to elderly and family caregiver support, scoring 24th for this dimension. But despite the access to these programs, living out your golden years in the country’s most densely populated state doesn’t come cheap.
New Jersey is one of the 10 most expensive states in the nation for senior care services. The cost of hiring a home health aide in the state is comparable to the national median, but the median cost of a year in a nursing home is $120,450 — $34,675 more than in the broader U.S. Moreover, the annual cost of an assisted living facility here is $69,732 on average — more than $24,000 above the national median.
2. Rhode Island
Even though Rhode Island will inevitably have more resources for seniors than some of the more secluded states on this list, it only came in 34th for elderly and family caregiver support.
This New England state ranked 42nd for cost of living, and 40th for the cost of senior care. The annual cost for a home health aide ($57,772), nursing home ($101,835), and assisted living facility ($61,860) all surpass national averages in the same categories.
“Dense, popular, East Coast states are always going to be more expensive across the board,” says Weiler.
In terms of dollars and cents, Wyoming isn’t necessarily an expensive state to call home, but it’s the most expensive state for your aging parents, according to our analysis. The annual cost for both a nursing home (about $85,000) and an assisted living facility (about $50,000) both fall right around the national median. The average cost of hiring a home health aide is slightly higher than in the rest of the country ($61,776 annually).
What stands out most about Wyoming, however, is that it came in second-to-last in the category of supportive policies and programs for the elderly and family caregivers.
“This isn’t all that surprising given how rural and sparse Wyoming is,” says Weiler. “They simply have fewer facilities and support networks than other more densely populated parts of the country.”