Best and Worst States for Aging in Place

A record 4.2 million Americans will turn 65 this year and according to the latest AARP survey, 75% of older Americans say they want to remain in their homes and communities as they get older, rather than relocate to assisted living or retirement facilities. This trend is known as aging in place.

While these facilities can offer a great deal of support and comfort, for many older adults the idea of staying home means remaining 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 it also comes with real risks: decreased socialization, limited care oversight, and consistency of care are all critical considerations that are often overlooked. 

With the senior population booming, more older adults than ever will be seeking ways to age in place. The number of people aged 65 and older is projected to grow from 63.3 million in 2025 to 82.1 million by 2050, a 26% surge.

But where exactly they live matters – a lot. The best states for aging in place make it easier to get around, stay healthy, and feel supported, while others lag behind in critical areas like healthcare access, home care services, and community resources.

That’s why Seniorly broke down which states are doing it right – and which ones need to catch up – so that older adults and their families can make informed choices about where they’ll call “home” in the long haul.

To determine the best states for aging in place in 2025, we looked at the most recent data across 10 categories, including seniors’ risk of isolation, 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.

Overall across the U.S., about 43% of seniors live alone*, most people wait almost three hours in the ER per visit, and a quarter of older homeowners spend more than 30% of their income on housing.

Seniorly took a comprehensive look at which states offer the most and least supportive environments for older adults seeking independence and quality of life in their golden years. Here’s what we found.

Key Findings

• Utah is the Best State for Aging in Place: Seniors in Utah face some of the lowest risks of social isolation, with only 35.7% living alone – ranking 3rd nationally. The state also enjoys minimal precipitation, averaging just 10.1 inches of rain and snowfall per year (No. 3), and leads the nation in smart technology use, with 37% of residents interacting with household equipment via the internet.
• Florida is the Worst State for Aging in Place: Despite its reputation as a haven for retirees, Florida ranks last due to limited access to home health aides (50 seniors per aide) along with a high housing cost burden, as 30.7% of older homeowners spend more than 30% of their income on housing. Florida’s 53 inches of annual precipitation also contribute to its low score in weather safety.
• No State is Perfect, With Outliers Among the Top and Bottom: North Dakota ranks No. 2 overall, even though 46.4% of its seniors live alone – one of the highest rates in the country (No. 50). At the other end of the list, No. 45 Mississippi ranks 3rd for quality of home health agencies, with 33.3% earning a 4.5 or 5-star CMS rating. And in No. 7 California, older adults face long emergency room wait times, averaging 184 minutes and ranking 42nd nationwide.

Best States

Utah ranks first overall. The state has one of the lowest rates of social isolation, with just 35.7% of seniors living alone (No. 3), and leads the nation in smart home adoption – 37% of residents use internet-connected household technology. Weather is also a plus, with just 10.1 inches of annual precipitation (No. 3), reducing the risk of weather-related hazards.

North Dakota, New Jersey, Idaho, and Texas round out the top five. North Dakota ranks No. 2 thanks to having the nation’s shortest ER wait times (110 minutes, No. 1) and the highest level of meal deliveries for older adults, with 11,069 meals provided per 100,000 seniors through the Older Americans Act.

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

Worst States

Florida ranks as the worst state for aging in place, primarily due to its limited availability of home health aides – there are 56 seniors per aide, placing it 50th in the nation. Additionally, 30.7% of homeowners aged 65 and older spend more than 30% of their income on housing, ranking Florida 45th on that measure. The state also fares poorly in terms of 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 the board. Just 39.5% of older adults live alone, ranking it 8th nationally, and 20.6% of home health agencies earned a 4.5 or 5-star rating from CMS, placing it 13th.

Joining Florida in the bottom five are Kentucky, North Carolina, Georgia, and Alabama. Kentucky has one of the highest rates of fatal car crashes involving seniors, 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 struggles with meal delivery for seniors, providing services to only 957 per 100,000 older adults under the Older Americans Act. Meanwhile, in Alabama, just 14.6% of the population has adopted smart home technology, potentially making it more difficult for seniors to age in place.

Top and Bottom States Across the Metrics

Compare how the top- and bottom-ranking states stack up across the 10 key metrics we used to determine the best states for aging in place.

*Seniors who live alone: Though some older adults living alone maintain active social lives, NIH research shows a clear correlation between social isolation and increased mortality risks. This is precisely why Seniorly champions congregate senior living solutions. They're designed to foster connection, providing inherent social opportunities, shared experiences, and a supportive environment essential for flourishing.

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

Seniors 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 seniors per caregiver directly reflects how accessible hands-on assistance is for those choosing to age at home. Lower ratios generally indicate better staffing levels and the potential for more individualized attention for seniors needing help with daily tasks. Without a robust and growing caregiving workforce, the dream of aging in place will remain out of reach for many.

Wait time between ER arrival and departure: Emergency room wait times matter for older adults who may experience more frequent or urgent health issues. States with shorter wait times can provide faster critical care, which can be life-saving and reduce hospital stress.

Population using internet-connected home devices: For safe aging in place, a home designed or modified for safety is paramount. Many older adults will need to make significant home modifications to reduce fall hazards and enhance accessibility. Beyond structural changes, smart home technology can greatly boost safety, comfort, and independence. States with higher adoption rates of connected devices may be better equipped to support tech-enabled aging in place, complementing crucial physical home adaptations.

Homeowners ages 65+ who spend over 30% of their income on housing: Housing cost burden can limit seniors’ ability to afford health care, home modifications and other living expenses. This metric shows where seniors are financially strained by housing, making it harder to remain in place.

Fatal car crashes involving seniors per 100k drivers: Driving safety is a key concern for aging adults who rely on cars to maintain independence. Lower fatal crash rates may reflect safer driving environments and better programs and infrastructure to support seniors aging in place. 

Average Walk Score in largest cities: Walkability helps seniors stay active and access essentials without driving. States with higher Walk Scores are more likely to offer environments that are more supportive of aging in place without a car.

Home-delivered meals per 100k seniors: Meal delivery programs support seniors who have limited mobility or no access to consistent nutrition. Higher numbers reflect stronger local infrastructure for meeting basic needs at home.

Average annual precipitation: Excessive rainfall and snow can increase fall risk, limit mobility, and disrupt in-home care. States with lower precipitation may offer a safer and more predictable environment for aging in place.

As America’s senior population reaches record highs, technology is playing a pivotal role in helping older adults stay safely and comfortably in their own homes. From fall detection wearables to voice-activated assistants, the latest innovations empower seniors to maintain independence while easing concerns for loved ones and healthcare providers. Aging in place is no longer just a preference—it’s a reality made possible by smart devices and user-friendly apps designed specifically for the unique needs of older adults.

These technologies not only monitor vital signs and daily routines but also bridge the communication gap between seniors, families, and medical professionals. Whether it’s a medication dispenser that notifies caregivers if a dose is missed or a smartwatch that detects a fall and alerts emergency services, today’s consumer tech is redefining what it means to grow older at home. The chart below highlights 10 of the most effective tools available for aging in place in 2025.

Five Tips for a Healthy Aging in Place Plan

Planning to age in place requires more than just a desire to stay at home – it involves thoughtful preparation, flexibility and a realistic outlook on your future needs. These tips will help as you get ready for the next stage of life.

1. Home Safety Modifications: Prioritize home safety modifications to reduce injury risk and support independence. Install grab bars, enhance lighting, remove tripping hazards, and consider accessibility upgrades like ramps or stair lifts. Professional consultants are available in many areas to help identify and remediate potential hazards, ensuring your home truly supports aging in place.
 

2. Build a strong support network: Actively engage with family, friends, and neighbors, and explore local community groups. Join a book club, volunteer for a cause you care about, attend senior ore religious center events, or even embrace online social platforms. A robust social network provides companionship, assistance with daily tasks, and crucial support during emergencies.

3. Plan financially for the long term: To truly age in place successfully, it's essential to budget comprehensively for all anticipated costs. This includes regular home maintenance, rising healthcare expenses, and the potential need for in-home support services. A skilled financial planner can provide invaluable guidance, helping you build a robust plan that accounts for both expected outlays and unforeseen financial challenges down the road.

4. Stay proactive about your health and mobility. You've likely heard it before, but regular exercise, preventive care, dental hygiene and taking steps to manage chronic health issues 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. While the strong desire to remain at home is understandable, it's vital to acknowledge that aging in place may not always be the best solution for your physical or mental well-being as needs evolve. Being open to the possibility of a future transition—whether to assisted living or a nursing home—is not a defeat. Instead, planning proactively for these alternatives ensures you maintain control over your care choices and preserve your dignity, even if circumstances change.

Conclusion

Where you live can greatly affect your ability to age in place comfortably and safely. While no state is perfect, it’s important to consider what factors matter most to you and your family. By identifying the best and worst states, we're hoping to provide seniors and their families with the insights they need to make informed decisions about where to live and how to plan 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 +/-3. We multiplied these scores by -1 if it was better to have a lower rate, for example the fatal car crash rate and emergency room wait times. A state’s overall ranking was calculated by averaging its Z-scores across all available metrics. If data for a particular metric was missing, the state’s ranking was based on the remaining metrics.

Here’s a closer look at the metrics we used:

• Isolation risk: Percentage of seniors ages 65+ 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: The number of seniors ages 65+ 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 via the internet (National Telecommunications and Information Administration, 2023)
• Housing cost burden: Percentage of homeowners ages 65+ who spend more than 30% of their income on housing (Census Bureau, 2023)
• Road safety: Drivers ages 65+ involved in fatal car crashes per 100k 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 the Older Americans Act title 3 per 100,000 adults ages 65+ (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)