Best & worst states for aging in place

A record 4.2 million Americans will turn 65 this year. According to the latest AARP survey, 75%   of older Americans say they want to remain in their homes and communities as they age rather than move to assisted living or a retirement community. This choice is known as aging in place.

While these communities can offer meaningful support and comfort, many older adults feel that staying home helps them remain independent, connected, and in control of their lives. 

Aging in place isn’t just a preference. It’s a lifestyle choice with real benefits. In some cases, it can be more affordable than congregate care, more flexible, and far more personal. But there are also risks to consider, including decreased socialization, limited care oversight, and inconsistent care. 

As the older adult population grows, more people will be looking for ways to age in place. The number of people ages 65 and older is projected to increase from 63.3 million in 2025 to 82.1 million by 2050, a 26% surge.  

But where they live matters a great deal. The best states for aging in place make it easier to get around, stay healthy, and feel supported. Others lag behind in critical areas such as health care access, home care services, and community resources. 

To help older adults and their families make informed decisions about where to call home for the long term, this analysis identifies which states offer more support for aging in place and which have room to improve. 

To determine the best states for aging in place in 2025, we reviewed the most recent data across 10 categories: isolation risk, home health care quality, home health aide availability, emergency care timeliness, smart home adoption, housing costs, road safety, local walkability, food delivery access, and weather hazards. 

Across the U.S., about 43% of older adults live alone,* most people spend almost three hours in the emergency room per visit, and one-quarter of older homeowners spend more than 30% of their income on housing. 

Together, these measures offer a broad look at which states provide the most and least supportive environments for older adults who value independence and quality of life. Here’s what the analysis found. 

Key findings 

• Utah is the best state for aging in place: Older adults in Utah face some of the lowest risks of social isolation, with only 35.7% living alone, ranking No. 3 nationally. The state also averages just 10.1 inches of precipitation per year, ranking No. 3, and leads the nation in smart technology use, with 37% of residents interacting with household equipment through the internet. 

• Florida is the worst state for aging in place: Despite its reputation as a destination for retirees, Florida ranks last because of limited access to home health aides, with 50 older adults per aide, and a high housing cost burden. Among older homeowners, 30.7% spend more than 30% of their income on housing. Florida’s 53 inches of annual precipitation also contribute to its low weather safety score. 

• No state is perfect, with outliers among the top and bottom: North Dakota ranks No. 2 overall, even though 46.4% of its older adults live alone, one of the highest rates in the country at No. 50. At the other end of the list, No. 45 Mississippi ranks third for the quality of its home health agencies, with 33.3% earning a 4.5- or 5-star CMS rating. In No. 7 California, older adults face long emergency room wait times, averaging 184 minutes and ranking 42nd nationwide.  

Best states for aging in place 

Utah ranks first overall. The state has one of the lowest rates of social isolation, with just 35.7% of older adults living alone, ranking No. 3. It also leads the nation in smart home adoption, with 37% of residents using internet-connected household technology. Weather is another advantage, with just 10.1 inches of annual precipitation, ranking No. 3 and reducing exposure to weather-related hazards. 

North Dakota, New Jersey, Idaho, and Texas complete the top five. North Dakota ranks No. 2 because it has the nation’s shortest emergency room wait times, at 110 minutes, and the highest level of meal deliveries for older adults. The state provides 11,069 meals per 100,000 older adults through the Older Americans Act. 

At No. 3, New Jersey offers some of the highest-quality home care in the country. In New Jersey, 31.6% of agencies earn a 4.5- or 5-star rating, and the largest cities have an Average Walk Score of 59. No. 4 Idaho benefits from a low isolation risk, with just 35.6% of older adults living alone. Texas ranks No. 5, with just 13 older adults per home health aide. 

Worst states for aging in place 

Florida ranks as the worst state for aging in place. The ranking is primarily due to limited home health aide availability. Florida has 56 older adults per aide, placing it 50th in the nation. In addition, 30.7% of homeowners ages 65 and older spend more than 30% of their income on housing, ranking Florida 45th on that measure. The state also fares poorly for weather hazards. Despite its nickname, the Sunshine State averages 53 inches of precipitation per year, more than almost any other state. 

However, Florida didn’t perform poorly across every measure. Just 39.5% of older adults live alone, ranking the state eighth nationally. In addition, 20.6% of home health agencies earned a 4.5- or 5-star rating from CMS, placing Florida 13th. 

Kentucky, North Carolina, Georgia, and Alabama join Florida in the bottom five. Kentucky has one of the highest rates of fatal car crashes involving older adults, with 28.2 deaths per 100,000 drivers. In North Carolina, older adults spend an average of 195 minutes in the emergency room, longer than in most other states. 

Georgia has limited meal delivery access for older adults, providing services to only 957 per 100,000 older adults under the Older Americans Act. In Alabama, just 14.6% of the population has adopted smart home technology, potentially making it more difficult for older adults to age in place. 

Top and bottom states across the metrics 

Here’s how the top- and bottom-ranking states compare across the 10 key metrics used to determine the best states for aging in place. 

*Older adults who live alone: Although some older adults who live alone maintain active social lives, NIH research shows a clear correlation between social isolation and increased mortality risks. Congregate senior living settings are designed to foster connection by offering social opportunities, shared experiences, and a supportive environment. 

Home health agencies with a 4.5- or 5-star rating: Access to high-quality home health care is important for older adults managing chronic conditions at home. This metric reflects the availability of well-rated agencies offering in-home medical and personal support services.  

Older adults per home health aide: The availability of home health care and home care labor looms as a threat to the future of aging in place. The number of older adults per professional caregiver indicates how accessible hands-on assistance may be for people who want to remain at home. Lower ratios generally suggest better staffing levels and the potential for more individualized attention for those who need help with daily tasks. Without a strong and growing caregiving workforce, aging in place may remain out of reach for many people. 

Wait time between emergency room arrival and departure: Emergency room wait times matter for older adults who may experience frequent or urgent health issues. States with shorter wait times can provide faster critical care, which can be lifesaving and reduce the stress of a hospital visit. 

Population using internet-connected home devices: A home designed or modified for safety is central to aging in place. Many older adults may need significant home modifications to reduce fall hazards and improve accessibility. Beyond structural changes, smart home technology can support safety, comfort, and independence. States with higher adoption rates for connected devices may be better equipped to support technology-enabled aging in place alongside essential physical home updates.  

Homeowners ages 65 and older who spend more than 30% of their income on housing: High housing costs can limit an older adult’s ability to afford health care, home modifications, and other living expenses. This metric shows where older homeowners may face financial strain that makes it harder to remain at home. 

Fatal car crashes involving older adults per 100,000 drivers: Driving safety is an important concern for older adults who rely on cars to maintain independence. Lower fatal crash rates may reflect safer driving environments and stronger programs and infrastructure for people aging in place. 

Average Walk Score in the largest cities: Walkability helps older adults stay active and reach essential services without driving. States with higher Walk Scores are more likely to offer environments that support aging in place without a car.  

Home-delivered meals per 100,000 older adults: Meal delivery programs support older adults who have limited mobility or lack consistent access to nutritious food. Higher numbers reflect stronger local infrastructure for meeting basic needs at home.  

Average annual precipitation: Heavy rain and snow can increase fall risk, limit mobility, and disrupt in-home care. States with less precipitation may provide a safer and more predictable environment for aging in place. 

As America’s older adult population reaches record highs, technology is playing an important role in helping people remain safely and comfortably at home. From fall-detection wearables to voice-activated assistants, newer tools can support independence while easing concerns for loved ones and health care providers. Smart devices and user-friendly apps designed around older adults’ needs are helping make aging in place possible for more people. 

These technologies can monitor vital signs and daily routines while also helping older adults, families, and medical professionals stay connected. Examples include medication dispensers that notify caregivers when a dose is missed and smartwatches that detect a fall and alert emergency services. The chart below highlights 10 tools available for aging in place in 2025. 

Five tips for a healthy aging-in-place plan 

If you’re planning to age in place, wanting to remain at home is only the beginning. Thoughtful preparation, flexibility, and a realistic view of your future needs can help you get ready for the next stage of life. 

1. Make home safety modifications: Prioritize home safety modifications that reduce injury risk and support independence. Install grab bars, improve lighting, remove tripping hazards, and consider accessibility updates such as ramps or stair lifts. Professional consultants are available in many areas to help identify and address potential hazards so your home can better support aging in place. 

2. Build a strong support network: Stay connected with family, friends, and neighbors, and explore local community groups. You might join a book club, volunteer for a cause you care about, attend events at an older adult or religious center, or use online social platforms. A strong social network can provide companionship, help with daily tasks, and essential support during emergencies. 

3. Plan financially: aging in place requires a careful budget for anticipated costs. These may include regular home maintenance, rising health care expenses, and the potential need for in-home support services. A skilled financial planner can help you create a plan that accounts for expected expenses and unforeseen financial challenges. 

4. Stay proactive about your health and mobility: You've likely heard it before, but regular exercise, preventive care, dental hygiene, and steps to manage chronic health conditions can help you stay active and independent longer. Your health is one of your most important assets when aging in place. 

5. Be realistic about changing needs: The desire to remain at home is understandable, but aging in place may not always be the right choice for your physical or mental well-being as your needs change. Staying open to a future transition, whether to assisted living or a nursing home, isn’t a defeat. Planning for these care options can help you maintain control over your choices and preserve your dignity if circumstances change. 

Conclusion 

Where you live can greatly affect your ability to age in place comfortably and safely. No state is perfect, so focus on the factors that matter most to you and your care circle. Use these findings as a starting point for discussing where you want to live, what support you may need, and how you can prepare for the future. 

Methodology 

We used the most recent data for 10 metrics to determine the best and worst states for aging in place. We used a Z-score distribution to scale each metric relative to the mean across all 50 states and Washington, D.C., and capped outliers at plus or minus 3. We multiplied scores by negative 1 when a lower rate was better, such as for fatal car crash rates and emergency room wait times. We calculated each state’s overall ranking by averaging its Z-scores across all available metrics. If data for a metric was missing, we based the state’s ranking on the remaining metrics. 

Here’s a closer look at the metrics used: 

• Isolation risk: Percentage of adults ages 65 and older who live alone (Census Bureau, 2023)) 

• Home care quality: Percentage of home health agencies with a 4.5- or 5-star rating (Centers for Medicare & Medicaid Services, 2023)) 

• Home health aides: Number of adults ages 65 and older per home health or personal care aide (Bureau of Labor Statistics, May 2024 and Census Bureau, 2023)) 

• Emergency care timeliness: Median wait time between emergency room arrival and departure (Centers for Medicare & Medicaid Services, 2024)) 

• Smart home adoption: Percentage of the population who interact with household equipment through the internet (National Telecommunications and Information Administration, 2023)) 

• Housing cost burden: Percentage of homeowners ages 65 and older who spend more than 30% of their income on housing (Census Bureau, 2023)) 

• Road safety: Drivers ages 65 and older involved in fatal car crashes per 100,000 licensed drivers (Department of Transportation, 2022)) 

• Walkability: Average Walk Score across the largest cities (Redfin Real Estate, 2025)) 

• Food delivery: Number of home-delivered meals served through Older Americans Act Title III per 100,000 adults ages 65 and older (Meals on Wheels, 2025)) 

• Weather hazards: Average precipitation, including snow, in inches over the past year (National Oceanic and Atmospheric Administration, May 2024 to April 2025)