Utah Overpowers Alaska and Others as Best Places to Grow Old in America Leading New Elder Care Study

A new nationwide study has revealed significant differences in elder care quality, affordability and caregiver availability across the United States, with Utah emerging as the highest-ranked state for older residents. Alaska and Minnesota have secured second and third positions, while Oklahoma has been placed at the bottom of the assessment.

The findings, released by home care agency 24 Hour Caregivers, highlight the growing importance of healthcare support, nursing home standards, assisted living capacity and household finances when retirement destinations are being considered.

Although warmer weather, lifestyle preferences and housing costs are frequently associated with retirement decisions, the study demonstrates how access to suitable care can become an equally important consideration as people grow older.

All 50 states and the District of Columbia were assessed using 11 indicators covering care quality, assisted living capacity, caregiver workforce availability and affordability.

Each of these four categories was given equal importance before the findings were combined into a composite index, with 50 representing the study average.

Utah achieved the highest overall score of 86.0, supported by strong nursing home quality measures and comparatively favourable affordability indicators. Alaska followed with 82.6, while Minnesota received 81.5.

At the opposite end of the assessment, Oklahoma recorded the lowest score of 24.6. West Virginia and Louisiana were also placed among the lowest-ranking states.

Florida, despite its established reputation as a retirement destination, was reported to have fallen outside the top 30.

The findings provide a broader perspective on retirement planning by demonstrating that care quality, workforce stability and financial resources can vary considerably between states.

Utah Named Highest-Ranked US State for Elder Care

Utah has secured first place in the 24 Hour Caregivers study, receiving an index score of 86.0.

The result placed the state more than three points ahead of Alaska, which finished second with 82.6.

Utah’s position was supported by a nursing home quality-measure rating of 4.58 out of five, one of the strongest results identified in the research.

The state also recorded the lowest proportion of residents aged 65 and older living below twice the poverty line, at 20.0%.

Affordability was identified as another important factor.

The estimated annual wage bill for home care in Utah was calculated at $39,468, equivalent to 55.8% of older household income.

The figure indicates that home care costs would account for a smaller proportion of household income than in several other states.

However, the estimate covers wages rather than the complete amount that may be charged by a care agency.

Additional costs associated with administration, staffing arrangements and other services may therefore need to be considered.

Utah also recorded 3.74 nursing staff hours per resident per day and 89.5 home health and personal care aides per 1,000 residents aged 75 and older.

The state’s overall position demonstrates how a combination of care quality and affordability can influence the wider assessment.

Top 10 US States for Elder Care and Senior Living Support

The following states received the highest scores in the 24 Hour Caregivers assessment.

Source: 24 Hour Caregivers study. The scores represent a composite assessment of selected elder care indicators rather than a direct measure of individual care provider performance.

Alaska Ranks Second With Highest Nursing Staff Hours

Alaska was placed second in the national assessment, achieving an index score of 82.6.

The state’s performance was strongly supported by its nursing staffing levels.

An average of 6.20 nursing staff hours per resident per day was recorded, representing the highest figure in the study.

This result indicates comparatively substantial staffing time within the nursing home measure examined.

Alaska also recorded 154.5 home health and personal care aides per 1,000 residents aged 75 and older.

Another distinctive finding involved the potential availability of family caregivers.

The state recorded 8.17 residents aged 45 to 64 for every person aged 80 or older, the highest ratio in the research.

This demographic measure was used to estimate the potential pool of family members who might provide informal support.

However, the ratio does not establish that these individuals are available, willing or financially able to undertake caregiving responsibilities.

Alaska’s estimated annual home care wage bill was calculated at $43,724, equivalent to 58.8% of older household income.

Its nursing home quality-measure rating stood at 3.88 out of five.

Minnesota Takes Third Place With Strong Assisted Living Workforce

Minnesota was ranked third, receiving an overall score of 81.5.

The state achieved particularly strong results in indicators relating to the elder care workforce.

A total of 77.7 assisted living and retirement community jobs per 1,000 residents aged 75 and older was recorded.

This was identified as the highest figure in the study.

Minnesota also recorded 270.1 home health and personal care aides per 1,000 residents in the same age group.

The substantial workforce figures contributed to the state’s overall performance.

Annual nursing staff turnover was reported at 40.1%, while nursing staff hours reached 4.83 per resident per day.

The nursing home quality-measure rating stood at 3.14 out of five.

The estimated annual home care wage bill was calculated at $42,214, equivalent to 69.1% of older household income.

The results suggest that workforce availability was an important strength for Minnesota, although affordability remained a significant consideration.

Washington and Maryland Complete the Top Five

Washington secured fourth place with an index score of 73.4.

The state recorded a nursing home quality-measure rating of 4.07 out of five and 4.11 nursing staff hours per resident per day.

Median care aide pay was reported at $22.95 per hour.

However, higher wages were accompanied by a substantial estimated home care wage bill.

The annual cost was calculated at $52,510, equivalent to 76.1% of older household income.

Maryland followed in fifth place with a score of 70.0.

The state benefited from relatively strong older household incomes and comparatively lower nursing staff turnover.

Median income among households headed by someone aged 65 or older was reported at $75,539.

The estimated annual home care wage bill of $41,848 represented 55.4% of that income.

Nursing staff turnover stood at 39.9%, while the nursing home quality-measure rating reached 4.01 out of five.

The findings demonstrate how different combinations of income, staffing and care quality can influence state rankings.

North Dakota, Idaho and California Secure Places Among Leading States

North Dakota was placed sixth with an index score of 67.6.

The state recorded 5.21 nursing staff hours per resident per day and 76.6 assisted living and retirement community jobs per 1,000 residents aged 75 and older.

However, its nursing home quality-measure rating was comparatively lower at 2.82 out of five.

Idaho followed in seventh place with a score of 66.4.

The state achieved a nursing home quality-measure rating of 4.14 and an estimated annual home care wage bill of $38,255.

Housing affordability was also identified as a relative strength.

Approximately 27.4% of older householders were reported to spend at least 30% of their income on housing.

California secured eighth place with an index score of 66.2.

The state recorded 320.0 home health and personal care aides per 1,000 residents aged 75 and older, the highest figure among the top ten.

Annual nursing staff turnover stood at 36.8%.

The estimated annual home care wage bill was $37,752, equivalent to 52.7% of older household income.

This represented the lowest income share among the ten highest-ranked states.

However, housing costs were identified as a weaker area in California’s overall assessment.

South Dakota and New Jersey Complete the Top Ten

South Dakota was placed ninth with an index score of 64.0.

The state achieved the highest home health patient care rating in the study, at 4.10 out of five.

Median care aide pay was also reported to equal 80.2% of the median wage across all occupations, representing the highest proportion in the assessment.

However, workforce availability remained a comparatively weaker indicator.

South Dakota recorded 56.1 home health and personal care aides per 1,000 residents aged 75 and older.

New Jersey completed the top ten with an index score of 63.0.

Its nursing home quality-measure rating reached 4.39 out of five, while its home health patient care rating stood at 4.00.

The estimated annual home care wage bill was calculated at $40,795, equivalent to 56.0% of older household income.

These results demonstrate how quality indicators can contribute to stronger rankings even when other measures vary.

Florida Misses Top 30 Despite Established Retirement Appeal

Florida was reported to have finished outside the top 30 states in the elder care assessment.

The finding is notable because of the state’s established association with retirement living.

Warm weather, lifestyle preferences and housing considerations have traditionally influenced retirement decisions involving Florida.

However, the study assessed a different set of factors, including care quality, caregiver availability, assisted living capacity and affordability.

The reported result demonstrates why a destination’s popularity among retirees should not be treated as a direct measure of its elder care infrastructure.

The exact Florida index score and ranking position were not included in the supplied research summary.

Consequently, a detailed comparison between Florida and individual higher-ranked states cannot be established from the available figures.

The finding nevertheless highlights the importance of evaluating retirement destinations according to the specific care requirements of older residents.

Oklahoma Ranks Last in US Elder Care Study

Oklahoma received the lowest score in the assessment, finishing with an index value of 24.6.

It was the only state to receive a score below 25.

Annual nursing staff turnover was reported at 55.6%, indicating substantial workforce movement within the measured nursing home sector.

The state’s nursing home quality-measure rating stood at 2.80 out of five.

Oklahoma also recorded 64.8 home health and personal care aides per 1,000 residents aged 75 and older.

Assisted living and retirement community employment was reported at 23.9 jobs per 1,000 residents in that age group.

The estimated annual home care wage bill reached $30,476, equivalent to 59.5% of older household income.

Although the absolute wage estimate was lower than in several higher-ranked states, the overall assessment was affected by workforce and care-related indicators.

The findings demonstrate why relatively low care wages do not necessarily translate into stronger overall elder care conditions.

Ten Lowest-Ranking US States for Elder Care

The following states received the lowest overall scores in the 24 Hour Caregivers study.

West Virginia and Louisiana Face Elder Care Workforce and Quality Challenges

West Virginia was placed second from the bottom, receiving an index score of 26.9.

The state recorded just 13.1 assisted living and retirement community jobs per 1,000 residents aged 75 and older.

This was identified as the lowest figure in the study.

Its estimated annual home care wage bill reached $30,819, representing 67.3% of older household income.

Louisiana also received a score of 26.9, placing it third from the bottom in the supplied ranking.

The state’s nursing home quality-measure rating was reported at 2.16 out of five.

Median care aide pay represented just 49.5% of the median wage across all occupations.

Although the estimated annual home care wage bill was comparatively low at $24,779, weaker care quality and workforce indicators contributed to the state’s overall result.

The findings highlight the importance of considering several measures together rather than evaluating elder care through cost alone.

Vermont and Rhode Island Face High Home Care Costs

Vermont was placed fourth from the bottom with an index score of 27.0.

The state recorded annual nursing staff turnover of 56.0%, the highest figure in the assessment.

Its nursing home quality-measure rating stood at 2.74 out of five.

The estimated annual home care wage bill reached $45,760, equivalent to 75.2% of older household income.

Rhode Island followed in fifth from the bottom with a score of 30.1.

Affordability was identified as a particularly significant concern.

The estimated annual wage bill for 44 hours of home care per week reached $48,048.

This represented 81.1% of median older household income before agency fees and other overheads were included.

These findings demonstrate how substantial financial pressure can arise even when home care is being assessed through wage costs alone.

Mississippi, Arkansas and Alabama Show Different Elder Care Weaknesses

Mississippi was placed sixth from the bottom with an index score of 33.0.

The state recorded the lowest nursing home quality-measure rating in the study, at 2.12 out of five.

Approximately 37.6% of residents aged 65 and older were also reported to live below twice the poverty line.

This was the highest proportion identified in the research.

Arkansas followed with a score of 33.4.

Despite recording 4.72 nursing staff hours per resident per day and a nursing home quality-measure rating of 3.80, its assisted living workforce indicator was comparatively weak.

Only 17.9 assisted living and retirement community jobs per 1,000 residents aged 75 and older were recorded.

Alabama received an index score of 34.2.

The state recorded 48.9 home health and personal care aides per 1,000 residents aged 75 and older, alongside 19.1 assisted living and retirement community jobs.

These figures contributed to its placement among the lowest-ranked states.

Wyoming and Kentucky Complete the Bottom Ten

Wyoming was placed ninth among the lowest-ranked states, receiving an index score of 34.2.

Annual nursing staff turnover reached 51.3%.

Assisted living and retirement community employment stood at 18.7 jobs per 1,000 residents aged 75 and older.

The estimated annual home care wage bill was calculated at $36,516, equivalent to 60.2% of older household income.

Kentucky completed the bottom ten with a score of 34.8.

The state recorded the highest estimated home care wage burden relative to older household income.

An annual wage bill of $40,086 represented 85.9% of household income before additional agency costs were considered.

Just over one-third of residents aged 65 and older were also reported to live below twice the poverty line.

The findings demonstrate how affordability pressures can remain substantial even when care costs are not the highest in absolute dollar terms.

Home Care Affordability Becomes a Major Retirement Planning Concern

The research highlights the importance of evaluating care costs in relation to household income.

A lower hourly wage does not necessarily mean that home care will be affordable for older residents.

Where retirement income is comparatively limited, even modest care expenses can consume a substantial share of household resources.

The study’s annual home care wage estimates provide an illustration of this challenge.

However, the figures do not represent complete provider charges.

Agency fees, administrative costs and other expenses may increase the amount ultimately paid by families.

Housing, transportation, healthcare and everyday living expenses must also be considered.

For older residents requiring additional support, the number of care hours needed may change over time.

Financial planning therefore requires consideration of both current requirements and possible future changes.

Nursing Staff Turnover and Caregiver Availability Influence Elder Care Access

Workforce stability was another important factor examined in the study.

High nursing staff turnover can create challenges for care providers and the continuity of services.

The findings identified considerable differences between states.

Vermont recorded annual nursing staff turnover of 56.0%, while Oklahoma reported 55.6%.

California, by comparison, recorded turnover of 36.8%.

Differences were also identified in the number of home health and personal care aides available relative to older populations.

California recorded 320.0 aides per 1,000 residents aged 75 and older, while Alabama recorded 48.9.

These indicators provide useful context for assessing workforce capacity.

However, employment ratios do not establish whether suitable care is immediately available in a particular community.

Local staffing conditions, service requirements and provider capacity must also be considered.

24 Hour Caregivers Highlights Importance of Individual Care Requirements

The findings were discussed by Allen Tahir, Founder and CEO of 24 Hour Caregivers.

Particular attention was directed towards the relationship between care availability, service quality and affordability.

Utah’s performance was highlighted as an example of how a state can achieve a strong overall result without leading every individual measure.

Different strengths were also identified in Alaska and Minnesota.

The importance of matching care arrangements to the needs of individual older residents was emphasised.

A location offering strong nursing home staffing may not necessarily provide the most affordable home care.

Similarly, lower care wages may be accompanied by lower household incomes, reducing the financial advantage.

Families were encouraged to consider provider availability, staff continuity and the full cost of care.

The potential contribution of relatives and other informal caregivers was also identified as an important planning consideration.

What the Elder Care Rankings Mean for Retirement Decisions

The 24 Hour Caregivers study provides a comparative perspective on the support available to older residents across the United States.

The findings demonstrate that retirement suitability cannot be determined through climate, housing costs or lifestyle preferences alone.

Care quality, workforce availability and household finances may become increasingly important as support requirements change.

Utah, Alaska and Minnesota received the highest overall scores, although their strengths were distributed across different indicators.

At the opposite end, Oklahoma, West Virginia and Louisiana were affected by combinations of workforce, quality and affordability challenges.

For families considering relocation or long-term care arrangements, the study provides a starting point for further research.

However, statewide averages cannot replace assessments of individual providers and local service availability.

A highly ranked state may still contain communities where care options are limited, while suitable services may be available within lower-ranked states.

US Elder Care Outlook: Quality, Affordability and Workforce Stability Remain Central

The nationwide assessment by 24 Hour Caregivers has highlighted substantial differences in elder care conditions across all 50 states and the District of Columbia.

Utah emerged as the highest-ranked state with an index score of 86.0, followed by Alaska at 82.6 and Minnesota at 81.5.

Florida was reported to have finished outside the top 30, despite its established retirement appeal.

Oklahoma received the lowest overall score of 24.6, while West Virginia and Louisiana were also placed near the bottom.

The findings demonstrate how nursing home quality, caregiver employment, staff turnover and home care affordability can influence the support available to older residents.

For retirement planning, greater attention is being directed towards the long-term availability and financial sustainability of care.

As the needs of older Americans continue to evolve, these considerations are expected to remain important for households, care providers and communities across the country.

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