How Many Hours of Home Care Can You Afford? A Dayton Family's Worksheet

Start with the hours, not the hourly rate

Families usually ask what home care costs per hour. The more useful question is how many hours a week your parent actually needs. Write down a typical day: when help is needed to get up, bathe and dress, when meals happen, whether someone must be there at night. Then mark which hours family can cover reliably, not just on good weeks.

The monthly arithmetic

These are statewide medians from CareScout's 2025 survey. Agencies in the Dayton suburbs may charge more, rural Darke and Preble counties sometimes less, and most set minimum visit lengths of three or four hours, which can push the real monthly cost above the table.

Where the money can come from

Private savings pay for most home care. Long-term care insurance often pays once the policy's benefit trigger is met, usually help with two activities of daily living or cognitive impairment, after an elimination period. PASSPORT pays for aides and other help for Medicaid-eligible adults 60 and older who need a nursing home level of care. VA pension with Aid and Attendance can offset home care costs for eligible veterans and surviving spouses, because care costs reduce countable income. Medicare pays only for skilled home health, not hourly aides.

When the numbers say it is time to look at assisted living

Once paid help passes about 40 hours a week, or nights need coverage, assisted living usually costs less and provides more: staff around the clock, meals and company. The decision is not only financial. Some parents do better at home with a familiar aide for a few hours a day; others brighten in a building with people around them. Try a respite week in an RCF if you are unsure.

A sample weekly plan

Here is how one Centerville family covered a mother who needed help mornings and evenings but was safe overnight. An agency aide came from 8 to 11 a.m. on weekdays to help with a shower, dressing, breakfast and medications: 15 hours. A second aide came from 5 to 8 p.m. three evenings a week for dinner and bedtime: 9 hours. Two adult children split the remaining evenings and weekends, and a neighbor checked in at lunch. A medication dispenser with alarms handled midday pills.

At $34 an hour, the 24 paid hours cost about $3,540 a month, well below assisted living, and her long-term care policy reimbursed most of it after a 90-day elimination period. The plan worked for about two years. It ended when she began waking at night confused; covering nights would have tripled the cost, and the family chose a nearby assisted living building with a memory care wing.

Write your own plan the same way, hour by hour, and note the weak points. When those weak points start to fill with emergencies, the arithmetic and the safety picture usually point the same way.

Hidden costs of keeping a parent at home

The hourly rate is only part of the bill. Add the house itself: property taxes, utilities, insurance, repairs, lawn care and snow removal. Add groceries and meal delivery, medical supplies, a medication dispenser or alert system, and transportation to appointments. Add the value of family time, which is real even when no one is paid; adult children who cut back work hours to cover gaps lose income and sometimes retirement savings.

When families total all of this, the gap between home care and assisted living often narrows well before the 40-hour mark. That does not make home the wrong choice; for many parents it is the right one. It does mean the comparison should be made with every cost on the table, written down, and revisited every few months as needs change.

Choosing an agency in the six counties

ODH licenses non-medical home health agencies under Ohio's 2021 law; 211 have offices in our six counties. Ask how aides are screened and supervised, whether they are employees, who covers a missed shift, and whether the agency takes PASSPORT or your insurance. Our roster lists each agency's license and the year it was first licensed.