What dementia care costs

Dementia care often costs more than families expect. Over the years, most people living with dementia will need help with bathing, dressing, meals and safety. That help is called long-term care, and it is expensive. Medicare pays for very little of it.⁶

This page gives typical prices for each kind of care, with Virginia numbers. It also explains who pays and how to plan. Prices here are medians (the middle price, where half cost more and half cost less). Your local prices may be higher or lower.

The big picture

Dementia is costly because it lasts for years and needs grow over time. The Alzheimer's Association estimates the lifetime cost of care for one person with dementia at $405,262 (in 2024 dollars). Families pay about 70% of that, through out-of-pocket costs and the value of their own unpaid care.¹

Unpaid care is a huge part of the picture. In 2025, nearly 13 million family members and friends gave more than 19 billion hours of unpaid care to people with dementia. That care was worth about $446 billion.¹

Long-term care needs are common even without dementia. A person turning 65 today has almost a 70% chance of needing some long-term care. On average, the need lasts about 3 years. Women need care longer than men (3.7 years versus 2.2 years). About 1 in 5 people will need care for more than 5 years.²

Typical costs at a glance

These numbers come from the 2025 Cost of Care Survey by CareScout, a Genworth company. Researchers surveyed about 16,000 care providers across all 50 states from July to November 2025.⁵

Sources: CareScout national and Virginia tables.^3,4

To picture these numbers: a shared nursing home room in Virginia comes to about $10,250 a month. A private room is about $11,680 a month. (This is our math from the daily rates above.)

Prices keep rising. Assisted living rose about 5% from 2024 to 2025.³ Virginia ranked 15th most costly among states for assisted living, and near the middle for home care and nursing homes.⁸

How costs change as dementia gets worse

Costs usually grow in steps as the disease moves through its stages:

• Early stage. Costs are mostly doctor visits, tests, medicines and some help with bills or driving. Many families also pay for legal planning.⁷
• Middle stage. The person needs more supervision. Families often add adult day care, part-time in-home care, home safety changes and supplies.⁷
• Late stage. Many people need help around the clock. That means many hours of home care, or a move to memory care or a nursing home.^7,10

In-home care

A non-medical aide helps with bathing, dressing, using the toilet, light cleaning and meals. The survey now combines homemakers and home health aides into one group because their prices became so close.⁵ The 2025 median was $35 an hour, both nationally and in Virginia.^3,4

Hours add up fast. Here is the rough math at $35 an hour:

• 4 hours a day, 5 days a week: about $3,030 a month.
• 44 hours a week (the survey's standard): $80,080 a year.³
• Care around the clock (168 hours a week): more than $300,000 a year.

Skilled nursing at home, from a licensed nurse, costs more. The 2025 national median was $90 an hour. In Virginia, a single nurse visit had a median of $155.⁴

Medicare pays for home health only when you need skilled care, such as nursing or therapy, on a part-time basis. It does not pay for 24-hour care, or for help with bathing and dressing when that is the only care needed.⁹ Learn more on the in-home care page.

Adult day care

Adult day health care offers a safe, social day program with meals and activities. It gives family caregivers time to work or rest. The 2025 median was $95 a day nationally and $81 a day in Virginia.^3,4

Five days a week for a year comes to about $20,995 in Virginia, or roughly $1,750 a month.^4,5 That is far less than full-time home care or a facility. Many families use adult day care to keep a loved one at home longer. See adult day care for how to choose a program.

Assisted living

Assisted living offers a room or apartment, meals, and help with daily tasks. Each state sets its own rules for it. Not every community offers dementia care, so ask.¹⁰

The 2025 median for a one-bedroom unit was $6,200 a month nationally and $6,945 a month in Virginia. That is $83,340 a year in Virginia.^3,4 Some communities also charge a one-time entrance or community fee.⁵ Extra care often costs more on top of the base rate, so ask for the full price list in writing. Read more on assisted living.

Memory care

Memory care (also called a special care unit) is a part of a residence set up for people with dementia. It may be a locked floor or wing inside an assisted living community or nursing home.¹⁰

The national survey does not report a separate price for memory care.⁵ Because it is usually a unit inside assisted living, plan for the assisted living price as a starting point, plus extra fees for dementia care. Some states require memory care units to disclose their fees and services. Ask exactly what the extra cost buys, such as staff training and staffing levels.¹⁰ See memory care.

Nursing homes

Nursing homes give 24-hour care and medical oversight.¹⁰ They are the most costly option. The 2025 national median was $315 a day for a shared room and $355 a day for a private room. In Virginia, the medians were $337 and $384 a day.^3,4 Rates usually include meals, laundry and basic nursing care.⁵

Medicare covers a short stay in a skilled nursing facility only after a hospital stay of at least 3 days in a row as an inpatient. In 2026, days 1 to 20 are covered after the hospital deductible. Days 21 to 100 cost $217 a day. After day 100, you pay all costs.¹¹ Medicare does not pay for a long-term nursing home stay for custodial care.⁶ Medicaid can help pay for people who qualify.¹⁰ See Medicaid and long-term care and nursing homes.

Costs in Northern Virginia

The survey's Virginia figures are statewide medians.⁴ Prices can differ a lot from one area to another, so get local quotes.⁷ CareScout's free online cost tool lets you look up medians for many metro areas, including the Washington area, which covers Northern Virginia.³

For context, here is how nearby Maryland compares in 2025:⁸

Some local public programs can lower costs:

• Fairfax County Adult Day Health Care runs four centers (Herndon Harbor, Lewinsville, Lincolnia and Mount Vernon). It serves adults with dementia and offers a sliding fee scale, scholarships and transportation. Call 703-704-6048 (TTY 711).¹²
• Fairfax County in-home care. Some services are free and others are priced by income. The county also keeps a screened list of private caregivers. Call the Aging, Disability and Caregiver Resources Line at 703-324-7948 (TTY 711), weekdays 8 a.m. to 4:30 p.m.¹³
• Other areas. To find your local Area Agency on Aging, call the Eldercare Locator at 1-800-677-1116.¹⁵

What Medicare does and does not pay

Some people with dementia can get help through the Medicare GUIDE program. Approved dementia care programs offer care navigation, a 24/7 support line and caregiver training. For eligible people, GUIDE can also pay up to $2,500 a year for respite care, such as in-home help or adult day care.¹⁴ Read more on what Medicare covers.

Other ways families pay

Most families use a mix of sources over time:⁷

• Savings, income and home equity. Most families start here.
• Medicaid. Pays for nursing homes and some home care for people with limited income and savings. See Medicaid.
• VA benefits. Veterans and surviving spouses may get help. See VA benefits.
• Long-term care insurance. It usually cannot be bought once symptoms appear.⁷ See long-term care insurance.
• PACE. An all-in-one program for some older adults who qualify for nursing home care. See PACE.
• Disability benefits for younger people. See Social Security disability.
• Tax breaks. Some care costs may count as medical expenses or for a caregiver credit.⁷ See tax help for caregivers.

Costs families often forget

Beyond the big bills, families often pay for:⁷

• Adult briefs, wipes, gloves and other supplies
• Home safety changes, such as grab bars, door alarms and stove shut-offs
• Medicines and treatment for other health problems
• Transportation to visits and programs
• Lost work hours for family caregivers (see working while caregiving)

How to plan for the cost

1. Start soon after diagnosis. Include the person with dementia while they can still share their wishes.⁷
2. Gather papers in one place. Collect bank statements, insurance policies, wills and powers of attorney.⁷
3. Hold a family meeting. Talk about money, who can help, and what care the person would want. See sharing care with family.
4. Price the care near you. Call at least three providers for each type of care you may need. Ask what is included and what costs extra.
5. Check every program. Look at Medicare, Medicaid, VA benefits and local programs before you spend down savings.⁷
6. Get expert help if needed. An elder law attorney can help if Medicaid may be needed.¹⁰

Common questions

How long will our savings last?

Divide your savings by the yearly cost of care. For example, $250,000 would cover about 3 years of assisted living at Virginia's 2025 median of $83,340 a year.⁴ That does not count rising prices or other bills, so plan with some room to spare.

Is home care always cheaper than a facility?

Not always. A few hours a week of home care costs much less than a facility. But full-time or round-the-clock home care can cost more than a nursing home.³ Many families find a mix works best, such as adult day care plus some home care.

Why is memory care hard to price?

Memory care is often sold as assisted living plus added fees for dementia care. Each community sets its own fees.¹⁰ Ask for a written list of all charges and how they may change as needs grow.

Where can I get free help with planning?

Call your local Area Agency on Aging through the Eldercare Locator at 1-800-677-1116.¹⁵ The Alzheimer's Association also lists free planning resources.⁷ If a caregiver feels overwhelmed or hopeless, call or text 988 for support any time. In an emergency, call 911.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.