One of the first questions families ask when a parent needs care is: "What's this going to cost?" It's a fair question—and unfortunately, the answer is often confusing, misleading, or incomplete.
Let's fix that. Here's a real breakdown of what different care options actually cost, based on 2024 data and what we see families paying in Texas.
The quick comparison
| Care Option | Monthly Cost | Annual Cost |
|---|---|---|
| Nursing Home (semi-private) | $7,500 - $9,000 | $90,000 - $108,000 |
| Nursing Home (private room) | $9,500 - $11,000 | $115,000 - $132,000 |
| Assisted Living | $4,000 - $6,500 | $48,000 - $78,000 |
| Home Care (agency, 40 hrs/week) | $5,200 - $6,000 | $62,000 - $72,000 |
| Home Care (direct hire, 40 hrs/week) | $3,000 - $3,800 | $36,000 - $46,000 |
These numbers tell an important story: home care is often significantly cheaper than facility care—especially if you hire caregivers directly rather than going through an agency.
Understanding nursing home costs
Nursing homes are the most expensive option, and for good reason—they provide 24/7 skilled nursing care. In Texas, you're looking at:
- Semi-private room: $7,500 - $9,000/month ($250-300/day)
- Private room: $9,500 - $11,000/month ($315-365/day)
That's $90,000 to $132,000 per year. And these costs have been rising 3-5% annually.
Nursing homes make sense when someone needs constant medical supervision—like after a stroke, or with advanced dementia where safety is a major concern. But for many seniors who just need help with daily activities, it's more care (and cost) than necessary.
Understanding assisted living costs
Assisted living is a step down from nursing homes. Residents have their own apartment or room, with staff available to help with daily activities. In Texas:
- Average cost: $4,000 - $6,500/month
- Higher-end facilities: $7,000 - $10,000/month
Watch out for "level of care" charges—many facilities have a base rate but add fees as care needs increase. What starts as $4,500/month can become $6,500/month once you add medication management, help with bathing, etc.
Understanding home care costs
This is where it gets interesting—and where families have the most control over costs.
Option A: Home care agency
Agencies charge $28-35/hour in most Texas markets. For 40 hours per week of care:
- Weekly cost: $1,120 - $1,400
- Monthly cost: $4,850 - $6,000
- Annual cost: $58,000 - $72,000
The agency handles everything—finding caregivers, background checks, payroll, scheduling, backup coverage. You're paying for convenience and liability protection.
Option B: Hire caregivers directly
If you hire caregivers yourself and pay them directly, you're looking at $15-20/hour for experienced caregivers. For 40 hours per week:
- Weekly cost: $600 - $800
- Monthly cost: $2,600 - $3,500
- Annual cost: $31,000 - $42,000
That's a savings of $25,000 - $35,000 per year compared to an agency. The catch? You're responsible for finding caregivers, vetting them, managing schedules, and figuring out backup coverage when someone calls in sick.
The math on agency markups: When you pay an agency $32/hour, the caregiver typically sees $14-16/hour. The agency keeps $16-18/hour for overhead, profit, and liability coverage. When you hire direct, you can pay the caregiver $18/hour—they make more, and you pay less.
The hidden costs people forget
When comparing options, don't forget:
- Home modifications: Grab bars, ramps, stair lifts can cost $500-$15,000 depending on needs
- Transportation: Getting to appointments, errands—either your time or paid services
- Family time: If you're providing care yourself, what's the opportunity cost?
- Respite care: Occasional breaks for family caregivers—typically $20-30/hour
- Coordination time: Managing caregivers, schedules, and logistics takes hours every week
What about Medicare and Medicaid?
Medicare covers very limited home health care—skilled nursing or therapy after a hospital stay, but not ongoing help with daily activities. It doesn't cover most of what families need.
Medicaid can cover long-term care for those who qualify financially, but there are often waiting lists for home care programs, and eligibility rules are complex.
Long-term care insurance helps if your parent has a policy, but most people don't—only about 7% of adults over 50 have coverage.
For most families, this means paying out of pocket, at least initially.
So what's the best value?
For seniors who need help but don't require 24/7 skilled nursing care, home care with directly hired caregivers is usually the most cost-effective option—often half the cost of a nursing home and significantly less than an agency.
The challenge is managing it. Finding good caregivers, vetting them properly, handling schedules, dealing with no-shows—it's a part-time job in itself.
That's where services like ours come in. We help you get the cost savings of hiring direct, with support for the coordination piece. But even without that, if you're willing to put in the work, direct hiring can save your family tens of thousands of dollars per year.
The bottom line
Don't assume nursing homes or agencies are your only options. For many families, hiring caregivers directly—with or without coordination help—provides better care at a lower cost.
Run the numbers for your specific situation. How many hours of care are needed? What can family provide? What's your budget? The right answer depends on your circumstances.