Assisted Living vs. In-Home Care: Comparing Costs in O'Fallon
Most older adults want to stay at home as long as they can, and many families in O'Fallon start by bringing in a few hours of help each week. As needs grow, the hours climb, and so does the bill. At some point, families ask a practical question: would assisted living cost less, and would it serve our parent better? This guide compares 2025 St. Louis-area costs for in-home care and assisted living and walks through what each option includes.
The 2025 numbers
CareScout's 2025 Cost of Care Survey reports these medians for the St. Louis metro area, which includes O'Fallon and St. Clair County (CareScout Cost of Care tool):
| Type of care (St. Louis area, 2025) | Median cost |
|---|---|
| Home health aide | $35 an hour |
| Home health aide, 44 hours a week | about $6,673 a month |
| Assisted living | $6,050 a month |
For Illinois as a whole, the 2025 median for a home health aide was $36 an hour, about $6,864 a month at 44 hours a week, and assisted living was $6,219 a month (Genworth and CareScout 2025 Cost of Care Survey summary, PDF).
What home care adds up to
Home care is usually billed by the hour, so the monthly cost depends on how many hours you need. Using the St. Louis-area median of $35 an hour and an average of 4.33 weeks a month:
| Hours of home care a week | Approximate monthly cost |
|---|---|
| 10 hours | $1,516 |
| 20 hours | $3,031 |
| 28 hours (4 hours a day) | $4,243 |
| 40 hours | $6,062 |
| 60 hours | $9,093 |
| Around the clock (168 hours) | about $25,460 |
At about 40 hours a week, home care costs roughly the same as the St. Louis-area assisted living median. Full-time help at 44 hours a week, the basis for the CareScout monthly figure, is about $623 a month more than assisted living. Beyond that, home care becomes considerably more expensive, and round-the-clock coverage costs about four times the assisted living median.
These are medians. Agencies may charge more for nights, weekends, or holidays, and may set minimum shift lengths. Ask for written rates.
What the money buys
In-home care brings help to your parent's own home. A caregiver can help with bathing, dressing, meals, light housekeeping, and companionship during scheduled hours. The rest of the time, your parent is on their own or relies on family. The home itself still has costs, such as a mortgage or rent, utilities, taxes, food, repairs, and possibly safety changes like grab bars or ramps.
Assisted living in Illinois includes a set of mandatory services under state law: three meals a day, housekeeping, laundry and linen service, 24-hour security, an emergency communication response system, and help with activities of daily living as each resident requires (210 ILCS 9/10). Rent, meals, utilities, and social activities are typically bundled into one monthly fee.
Questions that help families decide
How many hours of help does your parent need?
If your parent needs help a few hours a day and is safe alone the rest of the time, home care can be both affordable and comfortable. If they need someone nearby most of the day, or at night, assisted living often costs less.
Is your parent safe at night?
Nighttime wandering, falls, and confusion are common reasons families move a parent to assisted living. Overnight home care is one of the most expensive kinds of coverage.
Is your parent lonely?
Isolation can be hard on older adults. Assisted living provides shared meals and daily activities. Home care offers companionship only during scheduled hours.
How much is family providing?
Many families fill gaps with unpaid care from spouses or adult children. Be honest about how long that is sustainable.
What will the home cost to keep?
Add up housing costs and needed modifications, and compare the total with the assisted living fee.
Help paying for care at home
Several programs can help with in-home care:
- Medicare home health covers part-time or intermittent skilled care, such as nursing or therapy, for people who are homebound and under a doctor's care. It does not cover 24-hour care or custodial care alone when that is the only help needed (Medicare, home health services).
- The Illinois Community Care Program provides in-home services and adult day services for adults 60 and older with non-exempt assets of $17,500 or less and an assessed need for long-term care (Illinois Department on Aging, Community Care Program).
- VA programs may include home health aide and respite services for eligible veterans (VA Geriatrics and Extended Care, Respite Care).
- AgeSmart Community Resources offers information and options counseling for St. Clair County families at 618-222-2561 (AgeSmart Community Resources, St. Clair County services).
For assisted living payment options, see our guide to paying for assisted living in Illinois.
Combining options
Families do not have to choose all at once. Some start with a few hours of home care, add adult day services for weekday coverage, and use respite stays for caregiver breaks. When the patchwork becomes hard to manage or costs climb, assisted living may be the next step.
A worked example
Consider a parent in O'Fallon who needs help with morning bathing and dressing, meals, and someone checking in during the evening, about six hours a day, seven days a week. That is 42 hours a week, or roughly $6,365 a month at the St. Louis-area median rate. That already exceeds the assisted living median before adding housing, food, and utilities. If the same parent began needing help at night, the gap would grow quickly.
Now consider a parent who needs help only three mornings a week, about 12 hours. Home care would cost roughly $1,819 a month, far less than assisted living, and could be the right choice for now.
About Joe's Place Caring Cottage
Joe's Place Caring Cottage offers assisted living in a small cottage in O'Fallon, with home-style meals, help with daily activities and medications, and caregivers on-site around the clock. If you are comparing home care with assisted living, call (618) 607-9906. We are happy to talk through your parent's needs and our current rates.
Frequently asked questions
How much does in-home care cost in the St. Louis area?
CareScout's 2025 survey reports a median of $35 an hour for a home health aide, or about $6,673 a month at 44 hours a week.
When does assisted living cost less than home care?
At the St. Louis-area medians, assisted living costs about the same as roughly 40 hours a week of home care. Beyond that, assisted living usually costs less.
Does Medicare pay for in-home care?
Medicare covers part-time or intermittent skilled home health care for homebound people. It does not cover 24-hour care or custodial care when that is the only help needed.
Can Illinois help pay for care at home?
The Illinois Community Care Program provides in-home and adult day services for eligible adults 60 and older.
Sources
- CareScout Cost of Care tool (2025 data)
- Genworth and CareScout 2025 Cost of Care Survey summary (PDF)
- Illinois Assisted Living and Shared Housing Act, 210 ILCS 9/10
- Medicare: Home health services
- Illinois Department on Aging: Community Care Program
- VA Geriatrics and Extended Care: Respite Care
- AgeSmart Community Resources: St. Clair County services