If you’re married, you and your spouse may be the same age, or close to it – but your levels of general health may be far different. As one spouse starts to need more daily care, the couple faces a dilemma. Do they stay in the home with the healthier spouse as caregiver? Do they hire outside help? Or do they consider a third option – assisted living for couples?
The choice comes down to individual preferences, finances, and circumstances, but the idea of both spouses moving together into an assisted living facility at the same time struck us as an interesting notion. We read about it this past week in this article from US News, written by reporter Elaine Howley. Her take on the idea of couples sharing an assisted living address is straightforward: if it helps spouses stay together longer, and if it fits the couple’s needs, it can be an excellent option. Let’s take a closer look.
People Age at Different Rates
Howley begins her US News article by expressing that, in a perfect world, couples would be able to stay together as long as they want to, in perfect health. “Sadly,” she writes, “this isn’t a perfect world, and people age at different rates.” Because of this, it’s worth taking into account that you and your spouse may have very different needs as you age, including a huge disparity in medical care and assistance.
“This reality raises an important question for some older couples: How can we stay together for as long as possible?” Howley writes.
Different Health Tracks, Same Residential Solution
The good news? Assisted living can be an ideal choice for many senior couples. “Assisted living communities can be great for couples that are looking to continue to live together while needing some support for daily activities,” says Alyssa Lanzi, a research assistant professor at the University of Delaware in Newark.
AngelaStewart, vice president of clinical services with Touchmark, a Beaverton, Oregon-based senior living company, agrees. “It’s common for couples to stay together when moving into assisted living, even when they’re on different health tracks,” she says.
Not sure if moving into assisted living together is right for you and your spouse? Consider a few factors. First, do you have a desire to remain together? Second, how much does the higher-functioning partner want to assist their loved one as full-time caregiver? And third, what would it look like to fund two homes – the reality if couples live separately – compared with paying for just one?
Living together in assisted living might be only a temporary solution. Stewart explains, “It’s common for a couple to move in because one is on a progressive decline, and the partner moves out or to independent living once their partner has passed away or moved to a higher level of care like memory care or nursing home.”
Start Asking Questions and Making Plans Early On
People are living longer – and not only that, but they’re remaining healthier for longer, too. The benefit of this is obvious: couples are, more often than not, making it to their golden years together. But this longevity also comes with a responsibility to ask important questions early and often, especially when it comes to an eventual decline for both you and your partner that might lead to moving into assisted living.
Mary Sue Patchett, executive vice president of Tennessee-based Brookdale Senior Living, says that many couples who move into assisted living together admit that they wish they had moved earlier. “One of the benefits they cite,” she says, “is social interaction, especially having both each other and others as activity and meal companions.”
Easing the Caregiving Burden on the Healthy Spouse
Howley writes, “Another major reason couples cite is [that] moving earlier relieves some of the burden on the more physically and cognitively able spouse; assisted living communities can provide any necessary help.”
Stewart agrees: moving into assisted living earlier can actually lead to a longer, more robust life for couples who want to remain together.
“(Moving earlier) can offset higher care costs associated with hospitalizations, one-to-one care or the decline that occurs when one doesn’t optimize their best health,” she says. “For example, a toileting schedule preserves continence. Socializing prevents loneliness, which preserves your brain health. Routine exercise maintains balance and skill to ambulate.”
In addition to those benefits, Stewart says that you’ll also “enlarge your health care team, improving coordination of care and accurate medication management.”
With all of this in mind, Patchett really urges older couples to explore their options as early as possible. She says it’s important to talk through the possible scenarios to determine what makes sense for your relationship and expected level of care. “Think about it in advance. What do you want as a couple? What if something happens? Would you want to stay together as long as possible?”
Conduct a Careful Assessment of Care Needs
According to Dr. Tanya Gure, section chief of geriatrics at the Ohio State University Wexner Medical Center, one of the most critical steps you can take when you’re deciding about your future move is to carefully assess both partners’ individual care requirements.
“The spouse pair may have different levels of functionality,” Gure explains. “(Ask) how the services may need to differ for that partnership so there’s not too much burden on one spouse trying to take care of the other. That’s often the reason for moving into a more supervised setting anyway, but if there’s not a full consideration of those differences and needs, the transition may not go very smoothly.”
Howley adds, “Visiting a geriatrician or asking your primary care doctor for a full assessment of your current status as well as projected needs may be a good way to learn what services and care you and your partner require. This can help guide your selection of the right assisted living community for your specific situation.”
Memory Care Often Requires Separate Accommodations
When a different level of need exists between partners, there really is no one-size-fits-all answer. Every case must be taken individually. This is especially true in the case of declining cognitive health for one partner, such as dementia or Alzheimer’s.
In some circumstances it might be possible for the other partner to cohabitate with them in the memory care part of the community. But, Howley writes, “it’s more common for the less impaired partner to live in another part of the campus more appropriate for their level of need. They can then visit their partner in the memory care section.”
Sue Johansen, vice president of senior referral service A Place for Mom, explains, “It’s not really right for the person without memory care issues to be in the memory care community because you want to make sure everyone is around people engaging at their level. That means oftentimes couples will have different apartments in a community at different levels. They can spend as much time together as they want, but it just depends on the physical and emotional needs of each member of the couple.”
The Top Issues Are Often Financial
Keeping finances in mind is also essential to making an informed decision. Howley writes, “Assisted living can be expensive: Genworth Financial’s 2021 survey (the most recent data available) found the median monthly cost for an assisted living community is $4,500, totaling $54,000 annually.” For couples, costs can be higher.
The cost for one person to live in assisted living while the other spouse lives in the family home could be very challenging to keep up for any length of time. Patchett suggests that it’s usually cheaper for both spouses to move into the assisted living community together. This also means that the spouse who would otherwise have stayed in the family home doesn’t have to “deal with repairs and separate utilities and other issues. Both living in the facility might be a reasonable expense versus one living at home.”
Before moving, make sure to have open and honest conversations about finances early and often, having a financial plan in place prior to moving. Also, be sure to double-check the contractual move-out notice expectations for the facility you’re considering moving into; this way, if one partner passes away and the other chooses to move on, you’ll know what your options are.
Helping the Caregiving Spouse Through the Transition
Making such a big change, moving into assisted living together, certainly comes with its fair share of ups and downs, but there are a few things to consider that can make the transition easier.
First, the higher-functioning spouse should consider how it will feel to cede some of their caregiving responsibilities, an important thing to keep in mind before moving to a place where professionals will be stepping in to give care.
“If one spouse has been the caregiver for the other for a long time – and often it goes too long before that transition – how is that person who’s the caregiver going to relinquish those responsibilities? Because they will have to, to a certain extent,” Johansen says.
Next, it’s crucial to do as much research as you can into the community you’re moving into. Speak with a retirement counselor, visit the facility, take a tour, talk with staff and other residents. Ask specifically what the transition will look like, so that you remove some of the mystery around it. While you’re there, taste the food and get a sense for the general mood of the place. How do the team members interact with each other? What kind of activities are offered?
“In these cases,” Johansen says, “it’s often very important for the caregiver spouse to make sure the less healthy spouse is well cared for; caregiver spouses can then feel confident about engaging themselves and getting back some semblance of a life.”
You can also ask if there are support groups for caregiving spouses in the facility itself. “Many communities have a resident ambassador for people transitioning into the community to see what the options are. Maybe there are four or five other couples that are in the community where the spouses are dealing with that transition as well. We’ll hook them up with a resident ambassador who’s gone through that,” Johansen explains.
She adds, “Getting a healthful life back means your spouse is OK and being taken care of. You’re being an advocate, but it’s not your hands-on responsibility any longer. Let’s take the time to focus on you.”
Remember Why You’re Staying Together
Howley ends her article with these encouraging words from Lanzi: “It can be really overwhelming to select the right community and make the move, but in the midst of that challenge, don’t forget the partner you’re facing it with. Make active efforts to keep the relationship strong. While living in the community, you can still have date nights, hold hands while going for walks and participate in your shared hobbies and activities.”
(originally reported at https://health.usnews.com)