Assisted living costs about $70K a year. One Maryland family says staying together helps them cope amid soaring care costs

In her late 50s, McCadney moved from Chicago to Maryland as her father’s health needs grew. She settled near her brother James’ family of four. When the five-bedroom house next door to him came on the market, she purchased it and moved in with her sister, Cheryl. It was a decision that reshaped how their family would navigate care.

The two households now operate as a shared, multigenerational unit, distributing both the emotional and financial responsibilities of caregiving. It’s a model that has become less about lifestyle and more about necessity.

McCadney’s situation reflects a growing reality for the current sandwich generation. In a Policygenius survey, 66% of respondents reported feeling stressed by the cost of supporting at least three generations: parents, children and themselves (1).

"I feel very blessed and fortunate that we have the situation we have," McCadney told Business Insider (2), "because I have friends who are the primary solo caregiver, and that is hard."

The cost of aging

For much of the early 20th century, aging in America was largely a family affair. Older adults lived with relatives, care happened at home and multigenerational households were the norm. That model began to unravel after World War II, as families dispersed geographically and institutional senior care expanded.

Today, aging independently has become financially untenable for many Americans. A 2023 report from Harvard Joint Center for Housing Studies found that fewer than 15% of adults aged 75 and older living alone in major cities could afford assisted living or daily home health care without drawing on their savings (3). With Medicare covering little long-term support and Medicaid access often limited, families are left to bridge the gap themselves.

In 2024, the median cost of assisted living in the U.S. was about $5,900 per month, or roughly $70,800 per year (4). Nursing home care was even more expensive, averaging $9,277 a month for a semi-private room and $10,646 for a private room, with costs varying widely by location and level of care (5).

"Unless you're a billionaire, I don't think that most people have the luxury of saying cost is not a consideration," Lauren said.

That reality shapes how the McCadney family operates. Spread across two neighboring homes, caregiving is shared and fluid — divided by time, capacity and need rather than formal roles. Lauren renovated her home to accommodate her father’s mobility and to create space for Cheryl. Their brother manages their father’s medical and personal care, while Cheryl provides daytime support. Lauren handles outings and social activities, so when one person steps away, another steps in.

By keeping their father at home rather than moving him into assisted living or a nursing facility, the family has avoided significant costs. Beyond money, the father is happier being cared for by family.

"That's something you cannot put a price on,” Lauren said.

Challenges of two roofs

Sharing caregiving across two homes has reduced expenses but narrowed the family’s margin for flexibility and privacy. Drew and Carter, James’ twins who live at home to save on rent, contribute labor instead — mowing lawns, running errands and driving relatives to medical appointments.

That kind of help isn’t unique. According to AARP, family caregivers provided roughly $600 billion in unpaid care in 2021 (6). For James and his wife, Lorri, the setup comes with trade-offs. Both work full-time, and as their children near adulthood, they expect some responsibilities to ease. Instead, caregiving has only grown more demanding. Lorri said there are times when she sees her husband feeling exhausted or frustrated.