Hawaii is the fourth most expensive state for the care of aging seniors, according to a Caring.com report released today.

While the Aloha State scored really well for elderly and family caregiver support, coming in at 11th place, it is an incredibly expensive state for aging parents, given that it is the most expensive state in the nation for overall cost of living.

A nursing home in Hawaii costs about $137,000 a year, which is more than $50,000 above the national median, and hiring a home health aide is about $10,000 more expensive than the national median, at about $59,400 per year.

Hawaii ranked No. 4 in the list of top 10 most expensive states for aging parents in 2018, behind New Jersey (No. 3), Rhode Island (No. 2) and Wyoming (No. 1).

The study looked at each state’s cost of living index, availability of senior health care programs and support for family caregivers, and the average costs of senior care. It found there was not always a correlation between supportive policies and programs for the elderly and caregivers and better senior care costs.

The 10 least expensive states for aging parents include Oklahoma, Mississippi and Missouri. In Oklahoma, the most affordable state in the nation for seniors, a nursing home costs about $53,655.

Caring.com, based in San Mateo, Calif., offers resources on senior care with online support groups, a directory, reviews and a toll-free referral line at 800-325-8591.

The ranking of all 50 states is available at this link.