The 10 Worst States to Grow Old in, 2016 Study

All Rights Reserved

Where you choose to grow old is a highly personal decision, ruled by considerations like proximity to family and friends, home prices, and how you like to spend your time.

But experts say you should be thinking even farther ahead, to a day when you’re less independent and will need assistance and support. For some seniors, this may mean living close to family, for others, it will entail finding a place with excellent senior living options.

While the factors that make a particular state an ideal environment to grow old are highly individual, there are certain elements that make some states a better bet than others. These include the availability of quality healthcare, affordability of senior care, support for seniors and family caregivers and overall quality of life for seniors.

In research conducted by, the following 10 states had the lowest combined rankings in these categories.

We assembled these ratings by examining data on quality of life for residents over 55, quality of healthcare, long-term care, support for seniors and family caregivers, senior care costs and more than 105,000 consumer ratings of senior care providers in each state. Sources included the Gallup-Healthways Well-Being Index, Genworth’s 2015 Cost of Care Survey and the Long-term Scorecard, a joint effort by AARP, The Commonwealth Fund and The SCAN Foundation.

10. Alabama

Alabama is the 10th worst state in which to grow old, according to our research.

While it’s home to numerous historical monuments and some scenic beaches, the state ranked second to last in the nation in quality of life and health care.

On the other hand, the state also has the country’s second-cheapest senior care – with the average yearly cost of a home health aide at under $38,000 and a year in an assisted living community at roughly $37,000.

8. Ohio (tied with Pennsylvania)

Although Ohio can be a great place to live for many families, boasting world-renowned museums, universities, and sports teams, it also ranks among the lowest for residents aged 55 and older.

The state is tied with neighboring Pennsylvania for the eighth-worst place to grow old. Its spot on the bottom 10 list is due to its low rankings in quality of life and health care (it ranked the sixth lowest).

It ranked 14th in the nation for elder care costs, with a year of assisted living services running roughly $47,000 on average, and a home health aide about $45,000.

8. Pennsylvania (tied with Ohio)

Home to the city of brotherly love, numerous historical monuments, world-renowned universities and more, Pennsylvania has a lot going for it – but it didn’t rank well in any of the categories we measured.

The northeastern state is 40th on the list for quality of life and healthcare, and 31st for senior care costs, making it one of the most expensive places in the nation for assisted living ($42,660 per year on average), home health aides (about $48,000 yearly) nursing homes (about $105,000 for a semi-private room).

7. Mississippi

Similar to its neighbor to the east, Mississippi is home to a number of historical landmarks, world-class barbecue and excellent blues music.

But seniors considering living here also have reason to feel the blues, due to the state’s low quality of life and healthcare ranking (the third-lowest in the nation).

On the bright side, the southern state has some of the country’s most affordable senior care – with either a year in assisted living or a home health aide’s yearly fees both running about $38,000.

6. Rhode Island

It may be home to some impressive historical sights, scenic seaside towns and a world-renowned Ivy League school, but the nation’s smallest state also appears to be one of the worst bets for those looking for a place to spend their later years.

While this New England state fared alright in the quality of life and healthcare ranking at 29th place, its senior care costs run far higher than the national average.

A year’s worth of home health aide services runs about $57,000, while assisted living costs in the state are a whopping $64,000 on average.

5. Indiana

Also known as the “Crossroads of America,” Indiana is a great home for many residents, but this Midwestern state is a less than ideal place to grow old, our research finds.

Although it placed right in the middle for affordability of senior care in the 26th spot, Indiana’s ranking was pulled down with the fifth-lowest rating for quality of life and healthcare.

The state also had especially lower scores on support for seniors and family caregivers.

4. Kentucky

Home to the world-famous Kentucky Derby, vibrant cities like Louisville and the majestic Appalachian Mountains, Kentucky has plenty to offer. But when it comes to a place to spend your golden years, the southern state ranks among the lowest in the nation.

It ranked 13th in the nation for affordability of senior care (a year in an assisted living community here is roughly $40,000 while a home health aide costs about $44,000 per year on average), but was dragged down by its poor quality of life and health care ranking at the fourth lowest in the nation.

3. New York

Claiming one of the most beloved, most-visited cities in the world, New York is second to none when it comes to many things – but as a place to grow old, the state is in the bottom three.

New York has the third-most expensive senior care in the country. A year in an assisted living community costs about $49,000 on average and a home health aide is around $52,600, while a semi-private room in a nursing home in New York runs about $131,700 on average.

And the Empire State didn’t fare much better in the healthcare or quality of life categories – ranking 36th in the nation on these criteria.

2. New Jersey

New York’s oft-mocked neighbor to the west has reason to defend itself – its seaside towns, impressive historic landmarks and world-class universities like Princeton are nothing to sneeze at. Yet, when it comes to a great mix of affordable senior care and quality of life for those 55 and over, New Jersey doesn’t deliver.

The Garden State places 40th in the country for quality of life and healthcare for seniors.

What’s more, it’s among the most expensive in the U.S. for senior care – with average yearly costs for a home health aide at about $48,500 and roughly $69,000 for assisted living.

1. West Virginia

The worst state to grow old is West Virginia, our research shows.

Coming in at 20th place for senior care costs, long-term senior care here is relatively affordable (a year in an assisted living facility will run you $42,000 on average and a home health care aide costs about $36,600 per year).

And while the Mountain State boasts plenty of natural beauty and Civil War-era landmarks, it’s sorely lacking in important quality of life and healthcare offerings for seniors, ranking dead last in this category.


Laura Dixon

As Caring's Editorial Manager, Laura writes and edits articles about important issues for family caregivers and seniors. See full bio

over 1 year, said...

My parents, life-long residents of northern New Jersey, retired to Tom's River, a town that has gradually become a center for retired people, The prices of food and other things in Tom's River were strikingly less than northern New Jersey. There were many doctors and care centers, especially those skilled in geriatrics. At the time, seniors could take a cab anywhere for $4.00 and there were also free shuttles to medical centers. Tom's river is on the Jersey shore and enjoys much milder weather, a big consideration for my parents. The variety of shopping and dining nearby was quite good. Neighbors were freindly and looked out for each other. They were very happy there and their savings went much farther there. Many such towns exist on or near the Jersey shore.

about 2 years, said...

Where does NC stand on this list

about 2 years, said...

Did somebody get this wrong and where's Florida on the list? I agree that New Jersey and New York may not be cost efficient and high in price with health care, but, New York, especially their city, has highly skilled doctors and hospitals. New Jersey has an abundance of top rated medical centers and doctors as well. The assisted living, inclusive of memory care facilities, may not come cheap, but offer an abundance of amenities and perks with highly knowledgeable and skilled personnel who appear to genuinely care. The reality is, and no matter if it's senior care or anyone's care, most would agree it's a "feel good feeling" knowing they have the "best of the best" if needed. As a caregiver to my brother, who resided in Florida, my emergency visit became a rescue mission. I was disappointed, and saddened, when I witnessed the lack of care that he was receiving by his "favorite doctors" who he visited frequently with complaints of "not feeling right." My visit of, "maybe a week," turned out to be a month before he could safely travel home with me to New York. My walk became a run to get us out of there, to get him to the best of the best, to open doors that I sensed he was afraid to, but I knew had to be from the beginning. With a high amount of seniors choosing Florida as a primary residence, or, one during those cruel winter months, I am surprised that the lovely sunshine state doesn't make health care a top priority, but then it wouldn't be cost efficient living would it? You get what you pay for is usually true. Yes, cost of living is crucial, especially for retirees, but close proximity to family and/or your support system to foster and maintain a bond is important down this road of "getting old." If there are devastating words, and we all hope not, most would chose more positive feedback and treatment versus negative or time wasted. Best place to grow old is where home is, where family, love and memories matter. God Bless

about 2 years, said...

I for one have no idea where this survey got it's info from but just like the one for ten best places to retire neither of these surveys is grounded in reality. Neither of these surveys mentioned a couple of the most important things to the average senior. The climate year round MUST be one of the highest things to consider. Next I think should be cost of living, the attitude of the people around you when you retire, and the quality of life available in that area. Yes, health care most be a serious concern to anyone but especially to a senior citizen. For me though quality of health care means nothing if your neighbors aren't people you could enjoy being around or ones that only thought about themselves. Also good health care is worthless if the cost of living in that area is too high to be affordable. I laughingly noticed California wasn't on either list. I would have thought it should have been near the bottom of the list as one of the worst places to retire. To expensive, too many neighbors that give nothing but the cold shoulder, and healthcare that's decent but way too expensive or hard to get. Again, I've no idea where these surveys got their information, what income group they spoke with or surveyed other than it didn't include any of the retirees or income group I know of. Both of these surveys were very misleading. Alabama should never have been among the worst. True it's mainly a rural state but it's also a very friendly state when in those rural areas where people try to help their neighbors instead of looking the other way. Why do these surveys over look so many of the things that should matter most?