If you or someone you love is getting older, one big question eventually pops up: Is it better to keep living at home with help, or make the move to assisted living?

This isn’t just an emotional decision—it’s also a financial one. Both options come with their own sets of costs, trade-offs, and hidden expenses that aren’t always obvious when you first start comparing.

Let’s break it down in plain English, with real-world numbers, and then talk about how your home equity could help cover whichever path makes the most sense for your situation.

The Appeal of Aging in Place

Most older adults want to stay at home as long as possible. It’s familiar, it’s comfortable, and it feels like the last piece of independence we get to hold onto. But as the years add up, so do the challenges. Mobility issues, chronic health conditions, or even just the normal wear and tear of life can make it harder to live alone safely.

That’s where in-home care comes in. Caregivers—sometimes skilled nurses, sometimes non-medical aides—can step in to help with daily tasks, medication management, bathing, or even companionship.

Sounds great, right? It is—but it’s not free.

The Hidden Costs of Aging at Home

When people talk about “aging in place,” they often forget that the home itself can become a financial burden. Even if the mortgage is paid off, you still have:

• Property taxes (average: about $3,500/year nationwide, but much higher in places like California, New Jersey, or Texas).
• Homeowner’s insurance ($1,500–$2,000/year for many, but rising fast in states with fire or flood risk).
• Maintenance and repairs (a rule of thumb is 1% of home value annually; for a $400,000 house, that’s $4,000/year).
• Utilities (electric, water, gas, internet—often $250–$400/month depending on region).

Now add caregiving costs on top of that. According to the latest Genworth Cost of Care Survey, here’s what families are facing in 2024:

• Homemaker services (non-medical help): average $5,148/month ($61,776/year).
• Home health aide (basic medical support): average $5,339/month ($64,068/year).
• Skilled nursing at home: can easily run $9,000+/month, depending on hours and services.

And here’s the kicker—most seniors in later stages of aging in place don’t just need a couple of hours a week. Once someone requires daily assistance, the bills add up fast.

Example:

• A homeowner in Ohio, with no mortgage, pays $6,000/year in taxes and insurance, $3,000/year in maintenance, and $3,600/year in utilities. That’s about $1,000/month in baseline home costs.
• Add 40 hours/week of a home health aide at $28/hour: $4,800/month.
• Total monthly cost of “aging in” with in-home care: ~$5,800/month

The Cost of Assisted Living

Now, what about assisted living facilities?

The national median cost of assisted living in 2024 is around $5,350/month. This usually includes:

• A private or semi-private apartment/room
• Meals (often three a day plus snacks)
• Housekeeping and laundry
• Social activities and community programs
• 24/7 staff support for personal care and emergencies

What it doesn’t always include are “extras” like medication management, memory care, or specialized medical services—those can raise costs significantly. Memory care, for example, averages closer to $7,500/month nationwide.

Still, compared to in-home care, assisted living can be surprisingly cost-competitive once you add up the true cost of staying at home.

A Side-by-Side Comparison

Let’s do a quick comparison of what the numbers look like for an average U.S. homeowner.

Expense	Aging in Place with In-Home Care	Assisted Living
Housing (tax, insurance, maintenance, utilities)	$1,000/month	Included
Food	$500/month (groceries/dining)	Included
Transportation	$200/month (car, gas, or rideshare)	Included
In-Home Care (40 hrs/week aide)	$4,800/month	Included (basic ADLs)
Additional Medical Support	$1,000–$2,000/month (visits, nursing)	Extra, varies
Total Monthly Cost	$6,500–$8,000	$5,350–$7,500

Beyond the Numbers: Lifestyle Differences

Money isn’t the only consideration.

Aging in place pros:

• Familiar environment, sentimental attachment
• More privacy and independence
• Control over routines and visitors

Aging in place cons:

• Risk of isolation (unless family/friends visit often)
• The House becomes harder to manage physically
• Emergency response times depend on caregivers, not always immediate

Assisted living pros:

• Built-in community and activities
• Meals, housekeeping, and maintenance handled
• 24/7 help is just a button away

Assisted living cons:

• Loss of some independence
• Can feel institutional to some residents
• Costs rise sharply with higher care needs

Using Home Equity to Pay for Care

For many seniors, the biggest financial asset is their home. Whether you stay in it or move out, that equity can help pay for care. Here are the main ways:

1. Sell the Home

The most straightforward approach. Selling the home frees up cash that can go directly toward assisted living or long-term care expenses. Downsizing is another option—selling the current home and buying a smaller, lower-maintenance place, while freeing cash to cover in-home help.

2. Reverse Mortgage

A reverse mortgage lets homeowners 62+ tap their home equity without making monthly payments. Instead, the loan gets repaid (with interest) when the home is sold or the borrower moves out permanently. This can cover in-home care costs while allowing seniors to stay put.

3. Home Equity Line of Credit (HELOC)

If income is steady enough to make payments, a HELOC provides a flexible line of credit against the home’s value. This can be used to pay caregivers or cover the gap between retirement income and assisted living fees.

4. Rent Out the Home

If moving into assisted living, the home can be rented for steady income rather than sold immediately. In many markets, rental income from a paid-off home can cover a large chunk of assisted living costs.

Real-World Example

Imagine a couple in their late 80s living in a $700,000 California home, fully paid off.

• They pay about $8,000/year in property taxes (thanks to Prop 13, it’s lower than market value taxes would be).
• Insurance is $2,500/year, maintenance $7,000/year, and utilities $3,600/year. That’s about $1,800/month just to keep the house going.
• Add 50 hours/week of in-home care at $35/hour = $7,000/month.
• Total = $8,800/month.

Compare that to assisted living in California, averaging $6,500–$7,500/month.

By selling the home, they’d free up $700,000 in equity. Even conservatively invested or annuitized, that could cover assisted living indefinitely—without the stress of managing a house or hiring rotating caregivers.

The Emotional Factor

Of course, cost isn’t the whole story. Many families struggle with guilt when suggesting assisted living, worried it means “giving up” or “abandoning” a loved one.

But here’s the truth: assisted living isn’t about losing independence—it’s about gaining safety, community, and peace of mind. The financial math often lines up with the emotional reality that most seniors benefit from consistent support, social interaction, and relief from the burden of homeownership.

Key Takeaways

• In-home care plus homeownership costs: often $6,000–$9,000/month for full support.
• Assisted living: typically $5,000–$7,500/month, depending on location and care level.
• Home equity can be used—through selling, renting, or financing—to cover whichever option makes sense.
• The “cheaper” option depends on how much help is needed and whether the home is paid off.

Final Thoughts

There’s no one-size-fits-all answer. Some people thrive staying home with part-time help, while others (and their families) sleep better at night knowing round-the-clock care is built in at an assisted living community.

The best approach? Run the real numbers for your household. Add up property taxes, insurance, maintenance, and actual caregiving hours. Then compare that to local assisted living rates. Don’t forget to factor in the value of your home equity—that could be the key that makes one option clearly more affordable than the other.

Whichever path you choose, remember: this decision isn’t just about money. It’s about quality of life, safety, and the dignity every senior deserves in their later years.