When A Spouse or Partner Needs a Different Level of Care

This is a common occurrence I hadn't thought much about: how do you handle living arrangements when one half of a couple needs a different level of care than the other person? If you are living at home but your spouse should be in an assisted living situation, what options do you have to remain a couple? If your partner resides in an assisted living apartment but you must be transferred to a nursing care facility, must you be separated?

Since we experience the effects of aging at different times and levels, it is quite likely one person will need professional care much sooner than their significant other. The first step is to gather information well before you think you may need to make important decisions. This allows for the couple to feel a bit more comfortable about what an establishment looks like, how spouse accommodations or visiting arrangements are made, and the overall quality of the facility.

Both people must come to accept that at some point they may not live together or as close as would be preferred. My Dad's assisted living facility did have apartments large enough for two, but that is not always the case. There are many that have only have single-occupant rooms.

Acknowledging that you may not be able to live in the same place as your partner is a tremendously emotional realization, but one that must be faced. If you require much more care than your partner, for example, he or she may be able to continue to live at home while you are somewhere else. I imagine that is one of the toughest decisions we may need to make, but safety must be foremost. 

Also, we can't forget that there are two people involved. One may be in a situation where mobility and health issues severely limit their ability to leave the apartment. If the other person is still healthy enough, the facility chosen should provide enough social activities, and transportation to shopping and medical appointments. Otherwise, the more active spouse will naturally feel some resentment in being shut off from the world. 

The financial pressure of any assisted living arrangement can put a strain on even the strongest investment foundation. Medicare provides no help for assisted living costs, which can average between $4,000-$7,000 a month. Normal health care for someone is provided under Medicare, such as a doctor visit or in-patient care at a hospital. But, living costs are not. This fact alone is one of the reasons so many of us want to age in place as long as possible. Even with in-home health care, the expenses aren't quite as daunting. 

If you are covered by Medicaid instead, there is a spousal protection regulation that can help the at-home spouse maintain financial resources greater than normally allowed. The specifics and restrictions are too much for this post but should be explored if this is your situation.

Two final thoughts I would like to add. For some, this post may be better suited to what your parents are facing. You may be young enough that the living arrangement decisions can wait a bit. But, mom and dad or your in-laws must be prepared and willing to make some hard choices. Here is a link to a solid overview of the issues that arise when your parent or relative lives by themselves: What to watch for when an elderly parent lives alone.

If you are single, the decision of when and where to live when your health requires it will be both easier and tougher. You don't have to take into consideration another person's needs, feelings, and health. But, neither do you have a partner to help you share the decision-making process.

Even so, researching your options, reviewing your desires, figuring out your finances, and visiting some facilities well before needed applies every bit as much as it does to your couple friends.

While not directly addressing this issue, here is a post from last year about being single and retired. If you missed it, give it a read: Retired and Alone.

I realize this is not a pleasant thing to think about, but, essential. Exploring your options before being forced to make a choice is critical. Discussing the options and possibilities of a life that looks very different than the one you are living now should not be swept under the rug. Time has a nasty habit of not waiting for you to be comfortable about the future. It does what it will do with distressing quickness.