Over the past few years, Linda Barton has watched her mother and stepfather gradually transform from active 80-year-olds into, as she calls them, “kids.” Her mother suffers from dementia and is unable to care for herself, while her stepfather’s health is declining and he “acts like he’s six years old.”
She was exhausted from having to commute an hour to work to see them, and she didn’t want them to move in with her because of the limited space. She did the next best thing: moved them to her yard.
Linda Barton and her husband bought two small houses for their three surviving parents. BI’s Joseph Bui)
Barton, 55, and her husband spent $37,000 on a small house in an area outside Houston, Texas. After months of installing a septic system, electrical wiring, entry ramps and indoor necessities, her parents moved in. A year later, they bought another small house on their land for her father-in-law for $43,000.
They hired caregivers for three parents at less than the cost of assisted living, making caregiving more manageable. Still, it’s not a perfect solution. Patton said she was “drowning” in the cost of care because neither Medicare nor hospice provided much financial relief.
Linda Patton said the arrangement has worked well for her and her parents. BI’s Joseph Bui)
“If we don’t pay caregivers, then we end up sacrificing work when they need something,” Barton said. “It’s exhausting and we worry we won’t live to see our retirement because of the stress.”
The cost of care has soared in recent years. Instead of emptying their wallets to pay for expensive nursing home rooms, Americans like Patton are building tiny homes, renovating sheds, and buying trailers to provide housing options for their elderly loved ones who need full-time care.
Since construction costs typically range from $100,000 to $300,000, not including fees such as hiring an architect, setting up utilities, or obtaining construction permits, these accessory dwelling units require a significant investment. But even the cost of a year in a nursing home is comparable: Service and insurance company CareScout found that the annual cost of a private room in a nursing home rose from $111,000 to $130,000 between 2022 and 2025.
ADUs for nursing care increasingly popular
After Shalini Karnani Bonjour’s father passed away in 2024, she moved her elderly mother from Michigan to California to be closer to her family. Bonjour, 50, initially considered renting an apartment for his mother or moving into a senior community, but neither option was ideal.
Instead, Bonjour’s family bought a house in the Coachella Valley and planned to build an ADU in the backyard so her mother could live independently. The $475,000 project is pricey, but more affordable than buying a larger home in the area.
Although it was the best option for the family, Bonjour, 50, said, “The whole process was difficult because there were so many things to manage. You’re trying to make the project affordable, keep your neighbors happy and stay on track.”
ADUs are growing in popularity in California, drawing the attention of politicians and housing advocates to alleviate the state’s housing crisis. Rachael Reiner, director of pre-construction and project management for Bay Area ADU company Villa, told Business Insider that ADUs are especially popular among multi-generational households. So far in 2026, 75% of Villa’s sales have been for this purpose, many of which are for care purposes.
“California’s real estate market is highly competitive and expensive, so for many families, finding a larger home or a second home within their budget is simply not realistic,” Rayner said. “Building an accessory dwelling unit on an existing family property allows these families to put down roots in a neighborhood they are already familiar with without having to change schools or their daily routines — which are so important, especially for older family members.”
an emotional decision
Linda Barton took on the role of caregiver while separated from her family. BI’s Joseph Bui)
Sometimes the decision to establish an ADU to care for a loved one is driven by emotional rather than financial factors.
Lena Koropey decided to build an ADU in her Long Island backyard so that her mother, who was suffering from late-stage Alzheimer’s disease, would have a place to grow old. Once the 750-square-foot, two-bedroom, one-bath house is completed, Kolope plans to move to the backyard so her mother and her full-time live-in nanny can live in the main house.
The program isn’t cheap — a full-time live-in nanny from the company she hired costs between $520 and $550 a day, and her ADU is estimated to be about $450,000 — but Korope said it’s worth it.
“There’s a lot of value in having everyone own the same property,” Koropey, 48, told Business Insider. “You can’t really put a price on that sense of community, that family bond, or the ability to support each other.”
Despite the cost-cutting efforts for these granny flats, most of the dozen or so people Business Insider spoke to said the permitting process was cumbersome. Some cited heavy costs they had not anticipated. Some people are wary of installing an ADU for fear of lowering the value of their property, while others regret it when their loved ones move out soon after.
“ADUs are helpful in some situations where the care needs are not as great or where someone in the home has time to provide more care,” said Mildred Warner, a professor of urban and regional planning at Cornell University who has studied ADUs. “In other situations, it makes more sense to have people live in senior apartment buildings.”
James Richard Cornell built a house for his mother from scratch. Cornell Watson BI
Some families told Business Insider they decided to build on separate properties because of the complex ADU permitting process. After nearly a year of trying to build an ADU, 63-year-old James Richard Cornell decided to build a house for his mom from scratch on his land. Between 2013 and 2014, he obtained permits, cleared the foundation, and installed plumbing, flooring and siding. The 1,000-square-foot house cost about $110,000, 90 percent of which was paid for by his mother. After being diagnosed with vascular dementia, his mother moved into his primary residence.
“Nursing homes are very expensive, and I promised her years ago that I would take care of her until her last days,” Connell said. “She has done so much for me, so it’s only natural that I repay her.”
As his mother’s health deteriorated, James Richard Connell moved her into his house. Cornell Watson BI
unburden
In recent years, lawmakers in several states have introduced bills to make ADUs easier to build. In North Carolina, Rep. Vernetta Alston co-sponsored legislation that would require local municipalities to allow at least one ADU on single-family residential lots. She told BI that if the bill becomes law, it would be a meaningful way to help families who need more care options.
“I know all too well what it’s like to live in the sandwich generation, where you have to work, take care of children, take care of seniors,” Alston said. “I certainly hope it can have an incredibly positive impact on people’s lives and their ability to meet all the basic needs of themselves and their loved ones.”
The process of obtaining an ADU is often cumbersome. Cornell Watson BI
As Alison George’s mother began to doubt she could live on her own, George, 52, decided to move into a home with a guest house in Raleigh. After a $45,000 renovation, George moved her mother into a hotel and became her primary caregiver.
At the time, her mother could care for herself, but as her Alzheimer’s disease progressed, George increasingly took time away from work to care for her. She does not adhere to her medication and struggles to maintain a social life.
While this arrangement worked for a few years, her mother’s condition worsened and she moved into an independent living facility and then, in 2021, a memory care facility. Her mother’s care will cost $7,800 a month in 2025, and as George’s savings dwindle, she moves her into a Medicaid facility. The little house on George’s lawn was empty.
“Looking back, I realize her pace was dropping, even though at the time I probably didn’t want to acknowledge what was happening,” George said.