Senior care on Oahu, explained by people who read the license

What is Honolulu Senior Advisor?

Honolulu Senior Advisor is a free senior care referral and advisory service for families on Oahu, the City and County of Honolulu, from town Honolulu and Hawaii Kai to Kailua, Kaneohe, Pearl City, Waipahu, Kapolei and Ewa Beach.

We publish what Hawaii's rules actually require, what the published cost data actually says, and every licensed care home, assisted living facility and nursing home on the state's and CMS's own records; then a local advisor helps you narrow it down. Providers pay us a referral fee when a family moves in, which is why the service is free to you. You should know that up front.

How many seniors and licensed care options are there on Oahu?

The City and County of Honolulu had about 214,413 residents 65 and older on July 1, 2025 (21.7% of 988,703 people), according to Census Bureau estimates, and the state licenses 455 care homes, 1,111 foster family homes and 14 assisted living facilities there, alongside 27 CMS-certified nursing homes.

The 65-and-over population grew from 188,695 in April 2020 to 214,413 in July 2025, and 32,781 residents are 85 or older. Population: U.S. Census Bureau, Vintage 2025 county population estimates by age (cc-est2025-agesex-15), July 1, 2025.

How does Hawaii's care home model work?

Most Oahu seniors who need long-term help live in small licensed homes rather than large buildings: adult residential care homes of five or fewer residents with a live-in care giver, expanded ARCHs that can keep residents at nursing facility level of care, and two- or three-bed foster family homes built around Med-QUEST.

Read how care homes are licensed, how expanded ARCHs work and how foster family homes work.

What does senior care cost in Hawaii?

CareScout's 2025 Hawaii medians are about $12,089 a month for assisted living, the highest of any state, $15,473 for a semi-private nursing home room and about $41 an hour for home care; no one publishes a median for care homes.

Med-QUEST long-term care can pay for nursing-level care in an expanded ARCH or foster family home, with the resident's income covering room and board, so the payment plan matters as much as the price. See costs and paying for care.

Where should an Oahu family start?

Start from the situation, not the care type: a hospital discharge, a fall, a dementia diagnosis, an exhausted caregiver, money running out or a family living on the mainland each point to different first steps.

• A parent is being discharged from an Oahu hospital
• A parent can no longer live alone
• A new dementia diagnosis
• Caring for an Oahu parent from the mainland
• Senior care across Oahu, town by town