In early 2019, my father (Rebecca’s) suffered a devastating stroke. For months, our family lived in the space between hope and heartbreak, watching a proud, accomplished, and independent man lose pieces of himself.
Our family agonized over the possibility of placing him in a facility. We wanted him surrounded by the walls of his own home — walls that held his memories, the photographs that told his story, the familiar sights and sounds of a life he had built. With great sacrifice, we were able to hire in-home help. It was a blessing. It was also extraordinarily expensive.
That experience is hardly unique. Survey data show that 77% of adults over age 50 hope to remain in their own homes as they grow older. Home represents independence, continuity, and dignity. It is where people feel most like themselves.
But the cost of in-home care has surged nearly 10% in the past year alone, far outpacing overall inflation. Full-time assistance now averages close to $80,000 annually. Assisted living and nursing facilities often cost far more, frequently exceeding $100,000 a year.
As a result, millions of families do not have that option. The final years of a loved one’s life, which should be marked by compassion and warm reflection on a life well-lived, are instead marred by financial stress and immense burden on family members.
The tragedy is that this outcome is not inevitable. It is, in large part, a policy choice.
Many seniors do not need round-the-clock medical supervision. They need companionship, help with meals, someone to drive them to the grocery store, a steady presence in the home, and a human connection. But overzealous regulation has put these types of arrangements increasingly out of reach.
One major inflection point came in 2013, when the Department of Labor reinterpreted the Fair Labor Standards Act and eliminated the long-standing “companionship exemption.” Overnight, private household caregiving was treated like corporate employment. Families hiring through agencies suddenly faced rigid overtime rules, complex wage structures, and legal uncertainty that may make sense for institutions, but do not work inside private homes.
The result has been predictable. Costs rose sharply, flexibility vanished, and families were boxed into a narrow choice between expensive formal care or no care at all.
We believe it is time for a new approach.
That approach should begin with restoring flexibility to in-home care. Policymakers should revisit federal labor rules that treat private households like corporations and prevent families from crafting arrangements that work for them. Reasonable safeguards for workers matter, as does recognizing the unique nature of care inside someone’s home.
Congress and federal agencies should also reduce barriers and streamline how the value of room and board can count toward pay for live-in companions, where appropriate. Millions of seniors have unused bedrooms and struggle with isolation. Many younger workers struggle with housing costs. Thoughtfully structured shared-living arrangements could address both problems at once, lowering costs while increasing safety and social connection.
We already have a successful model. For decades, the au pair program has matched families with live-in child-care providers who receive housing, income, and cultural exchange in return for their work. A similar framework for elder companionship, designed with proper vetting and protections, could expand the supply of affordable support dramatically without creating another massive federal entitlement.
Such arrangements would not replace professional medical care. But they would restore practical, human-scale assistance for seniors who are still largely independent but should not be alone.
Alongside policy reform, we also need better data grounded in real experience. That is why the Association of Mature American Citizens and Independent Women is launching a joint national initiative to collect and elevate the stories of seniors, family caregivers, and in-home workers.
This is not a partisan matter. Democrats and Republicans alike have aging parents. Lawmakers of every ideology hear from constituents struggling to care for loved ones while balancing work, children, and rising living costs.
We want to highlight how the system is failing, what barriers families face, and how rules written in Washington affect daily life in kitchens and living rooms across the country. These stories will inform concrete legislative proposals aimed at lowering costs, expanding options, and protecting seniors’ ability to remain at home.
The goal is not to build a larger bureaucracy, but to remove obstacles that prevent families from caring for one another as they know best.
MR. TRUMP, TEAR DOWN THE KENNEDY CENTER
Aging at home is not about convenience. It is about preserving the dignity a person is entitled to, and about empowering families to care for loved ones in ways that are personal, flexible, and compassionate.
Dignity should not be reserved only for those who can pay a hefty price for it. It should be a promise we keep to every American who spent a lifetime building this country.
Rebecca Weber is the CEO of the Association of Mature American Citizens. Carrie Lukas is the president of the Independent Women’s Forum.
