What Dementia Care Actually Costs: US vs. Philippines

If you have a parent with dementia in the Philippines, or you’re weighing whether to bring a parent here versus keeping them home in Manila, Cebu, or Davao, the cost gap between the two countries is so large that it usually decides the question by itself. Most families just never see the numbers side by side. Here they are.

What dementia care costs in the US

Memory care — a secured assisted-living unit with staff trained for dementia — is the standard US answer once care at home stops being workable.

• Memory care facility: most 2025 surveys put the national median between $6,500 and $7,600 per month, and it climbs past $10,000 in expensive states. Call it about $7,000 as a planning number.
• 24/7 home care in the US: the 2025 median for in-home caregivers is $35/hour (CareScout Cost of Care Survey). Round-the-clock coverage at that rate is roughly $25,000 per month. This is the number that shocks families — more than triple the facility price.
• Nursing home (semi-private room): $315 per day in 2025 — about $9,600 per month — and dementia units often charge more.

Medicare does not pay for long-term custodial care. Medicaid does, but only after spending down assets, and only in facilities that accept it. Most middle-class Fil-Am families end up paying out of pocket.

What the same care costs in the Philippines

In the Philippines, the default is the opposite: care happens at home, delivered by employed caregivers, with family supervising. For dementia, the workable setup is a team of two to three caregivers covering shifts, because one person cannot safely do 24/7 dementia care alone — anywhere, in any country.

Rather than publish a national average — there isn’t an honest one, and the spread between Metro Manila and a rural province is enormous — here is what one family actually pays.

One family in Antique — verified August 2026

Their father has dementia and is cared for at home in Antique, a rural province in Western Visayas. Three caregivers, hired directly: there is no agency within reach of them.

What	₱ per month
Three caregivers (₱9,000 + ₱6,000 + ₱3,000)	18,000
Medicines bought locally	10,000
Nutritional supplements (Glucerna, Ensure)	5,000
Electricity	5,000
Adult diapers	3,000
Total	≈ ₱41,000 — about $670

Five details in that table are worth more than the total:

• The caregivers feed themselves. No food or board cost sits on the family — an assumption that quietly inflates most Philippine care budgets you will read anywhere, including an earlier version of this page.
• Electricity is a real line item. Dementia care at home means fans or aircon running, lights on at night, laundry every day. Almost nobody budgets it, and here it costs as much as the diapers and supplements combined.
• Some medicines are free from the local health unit. Ask yours before paying retail. It is the most under-used resource in Philippine home care.
• ₱10,000 is not the whole medication bill. One of her father’s prescriptions is obtained separately and is not in that figure. Dementia drug costs vary enormously by prescription — price your parent’s actual list at a Philippine pharmacy rather than trusting anyone’s total, including ours.
• The nearest emergency room they trust is 50 minutes away, and would ask roughly ₱10,000 as an admission deposit. How far you are from a hospital belongs in the budget conversation, not after it.

What this does and does not tell you

This is one family, one rural province, August 2026 — not a national rate. Caregiver pay in Metro Manila and Cebu runs substantially higher than in Antique, and a family in a city should expect a materially different number. We would rather show you one budget somebody actually pays than average several guesses into a figure nobody does.

The ₱18,000 is salary only. These caregivers are not enrolled in PhilHealth, SSS or Pag-IBIG — which is ordinary in the provinces, where the offices are far and informal arrangements are the norm. We are reporting what this family pays, not holding it up as the model.

Budget for two things it leaves out, because employing someone properly in the Philippines means more than the salary. Under the Kasambahay Law (RA 10361) a household worker should be registered for SSS, PhilHealth and Pag-IBIG, with the employer paying the whole contribution while the worker earns under ₱5,000 a month. And 13th month pay — one extra month’s salary a year — is a legal entitlement, not a bonus. Together they add meaningfully to the total, and they are the difference between employing someone and simply paying them. The Caregiver Payslip Generator works both out, and there is a practical reason beyond the law: a caregiver with PhilHealth of her own is a caregiver whose own hospital bill does not become your family’s emergency.

Run your own numbers with the Caregiver Cost Calculator and see the side-by-side with the US vs. Philippines comparator.

The honest comparison

Setting	Monthly cost
US memory care facility	~$7,000
US 24/7 home care	~$25,000
PH home care at home — one family in Antique, Aug 2026	~$670

The gap is real and it is large: for this family, roughly $6,300 a month against a US memory care facility, and far more against US home care. Over a five-year dementia course that is more than a third of a million dollars. A city household in the Philippines would not save as much — caregiver pay is the biggest line and it rises with the city — but the direction does not change.

But the comparison isn’t only financial, and it would be dishonest to pretend otherwise:

• Someone must supervise. The PH model works because a sibling, cousin, or paid care manager is checking in. Without that person, quality drifts.
• Medical care differs. For stable dementia, Philippine home care plus a local geriatrician is excellent value. For complex comorbidities, evaluate hospital access honestly — public hospitals are overloaded, and private hospital deposits are a real thing.
• Your parent’s world matters. Many elders with dementia do measurably better in a familiar home, hearing their own language, eating their own food. That is not a small thing. It is sometimes the deciding thing.

How the decision actually happens

The version of this story we hear over and over goes something like this — the details shift, the shape never does.

It starts at Christmas. A daughter flies home for the holidays and notices Papa tells the same story twice at one dinner. “Ulyanin na,” everyone says, and laughs — he’s seventy-eight, he’s earned the right to repeat himself. That word is part of why families wait so long: Tagalog has no everyday clinical word for dementia, so what a doctor would call a disease gets filed under the gentle vocabulary of aging — ulyanin, nagbabalik sa pagkabata, going back to childhood. The next Christmas he calls her by her sister’s name and doesn’t catch it. The year after that, the neighbor phones because he’s out on the street at five in the morning, dressed for church on a Tuesday, and can’t say which house is his. Only then does anyone say the real word — and the family joins the roughly one million Filipinos living with dementia, most of them cared for at home, by family, the way it has always been done.

Now the family is on a video call spanning three time zones, and someone finally says the word out loud. The daughter in the States pulls up memory-care facilities near her and does the arithmetic: seven thousand a month, eighty-four thousand a year, and Papa — who has never spent a night outside the Philippines — would be behind a locked door where nobody speaks Ilocano and the food is wrong. Or: three trained caregivers working shifts in his own house, his own bed, his radio programs, his neighbors dropping by — for a fraction of the price. Suddenly the question isn’t really about money anymore. The money just made it possible to ask the right question.

That’s the honest shape of it. The savings don’t buy a cheaper version of American care; they buy a different kind of care — one-on-one, at home, in his own language — that no US facility offers at any price. What they cost instead is your involvement: somebody has to hire those three caregivers, pay them properly, and answer the phone when something goes wrong.

The bottom line

If your parent is in the Philippines and has family or a care manager nearby, home-based dementia care there is dramatically more affordable than any US option — and often better for the patient. The money you save funds a level of one-on-one attention no US facility provides at any price. The catch is that you become the care organizer. The rest of this site exists to make that job doable from 8,000 miles away.

Official resources

• Alzheimer’s Association — dementia care
• PhilHealth · DOH