“Til death do us part” – it’s the phrase that perhaps best captures the traditional view of marriage. Yet today, many of those traditions are going by the wayside, even among older Americans who have often been the most conservative cohort in U.S. society.

One vivid example is the number of unmarried seniors, many of them widowed or divorced, who are living with a partner. Some share a residence while others maintain separate homes but spend most of their time together in one place or the other. As these cohabiting seniors age, a significant question is starting to arise: what are the expectations on one partner when the other requires long-term care?

We’re examining that question through the lens of this recent New York Times article, written by reporter Paula Span. “What should be expected of an intimate partner when a companion suffers a health crisis?” the article asks. “Seniors and their families increasingly confront the question.” Let’s take a closer look at this timely issue. (Please note that a subscription may be required to access the New York Times article.)

Health Crisis Puts Family Dynamics into Sharp Focus

To begin, Span presents us with an illustrative example of a real (yet unnamed) unmarried couple, together for 20 years. They are both widowed, both in their 90s, and maintain separate residences in Florida. Yet they mostly live together in her home, because a few years ago she started to develop memory loss. She sometimes forgets to eat, and has taken some falls.

“His presence is helpful and supportive,” says Jenna Wells, one of her relatives and a Cornell University psychologist. “He takes her to the doctor. He takes her out to dinner.”

But they are both aging, and he knows that he will start to have trouble caring for her as her condition worsens. “So,” Span writes, “he proposed to her family that the two of them move together into a continuing care retirement community, where residents can shift from independent to assisted living, then to nursing and memory care units.”

The timing is key, and he knows it. If they wait too long, the facility could insist that she enter memory care directly, and this would mean that he couldn’t live there with her.

A Daughter’s Mistrust Puts Care Plan on Hold

While he has put plenty of thought into this, there’s only one major obstacle: the woman’s daughter, who holds power of attorney. “She doesn’t like her mother’s gentleman friend, as we call him,” Dr. Wells says. “They’ve never gotten along. There’s mistrust about his living in her house.” So that leaves the decision hanging in the balance. For now, the couple manages with home care aides.

“As we see this shift, with less of a focus on marriage in older people, this is going to come up a lot,” Dr. Wells says.

Span agrees. “Eventually, most older couples will face health crises and the need for caregiving, and if they haven’t vowed their mutual marital commitment ‘til death us do part,’ their roles and responsibilities can be murky,” she writes.

“No Road Map” for Seniors in Non-Traditional Relationships

The marriage contract offers a lot of things, chief among them clarity, both socially and legally. “We have a clear and shared understanding of what it means to be in a marriage,” says Susan Brown, a sociologist at Bowling Green State University in Ohio, who studies aging and relationships. “We don’t have that kind of road map for a cohabiting or living-apart-together lifestyle.”

But this lack of clarity is a growing concern. “Census data from 2023 showed that of Americans ages 65 to 74, 3.9 percent of men and 2.6 percent of women, almost 1.1 million people, were living with a partner, not a spouse,” Span writes. “Twenty years earlier, the proportions were just 1.7 percent for men and 1 percent for women.”

The numbers are rising among adults 75 and older, too. Almost 400,000 of them are cohabitating, and it’s even more challenging to measure the number of partners who don’t share residences. Span tells us that these relationships are informally known as L.A.T.’s (for “living apart together”).

Rising Rate of “Gray Divorce” and a Significant Attitude Shift

Span explains, “The trend reflects Americans’ longer lives, the spike in the divorce rate in the 1960s and 1970s, and the rate of ‘gray divorces’ occurring among those over 50, which doubled between 1990 and 2010.” (We wrote about this issue in this Blog article earlier this year.)

She adds that it also reflects attitudinal change. Baby boomers led the charge toward cohabitation decades ago, and “for each new cohort it becomes more and more acceptable,” says Deborah Carr, a sociologist at Boston University. “The old stigma around ‘living in sin’ has pretty much disappeared.”

Practical Reasons to Live Together, Stay Single

For older couples, “cohabiting offers many of the advantages of marrying or remarrying without the legal constraints and entanglements,” Dr. Brown says.

Span elaborates, “When partners maintain financial independence, it’s simpler for each to pass an estate along to their children. They retain eligibility for pensions or Social Security benefits that they could lose if they remarry. Remaining unmarried also protects partners from having to assume the other’s debts, particularly medical debt or the cost of long-term care.”

Beyond the more practical concerns, Dr. Brown says that these couples “have more flexibility in defining their roles and expectations.” Many women, especially, “aren’t interested in the gendered bargain that marriage entails, the caregiving role,” she says.

This is especially true if these women have already nursed husbands through terminal illnesses. Dr. Brown calls this a “been there, done that, attitude to remarriage.”

Research has shown that cohabitating relationships earlier in a person’s life tend to be less stable and less happy. But, Span writes, “among older couples, the relationship quality is almost indistinguishable from that reported by married couples. The unions last longer than those of younger cohabitors, and generally end only with one partner’s death.”

Many Unmarried Partners Skip Essential Estate Planning

However, there are pitfalls to these arrangements. Span tells us that unmarried partners are less likely than spouses to have prepared advance directives, appointed health care proxies and assigned power of attorney. Basically, they tend to skip over the process called advance care planning. “Without those decisions having been made and those documents, unmarried partners and family members can find themselves in conflict,” Span writes.

Along with this, older unmarried partners are also less likely to undertake estate planning. “In one study,” Span explains, “using data from the national Health and Retirement Study, Dr. Carr and her co-author, Shinae L. Choi of the University of Alabama, found that about 60 percent of married couples had done such planning over a six-year period. Among those who had been cohabiting, just 37 percent did.”

Shana Siegel, a New Jersey-based elder law attorney, notes, “Most people don’t want to deal with this until there’s a crisis.” Without legal authorization, she asks, “are they able to make decisions for the person they love?”

Unmarried Partners Often Fail to Discuss Caregiving Plans

There are other details to consider, as well, when caregiving responsibilities enter the picture. “If he goes into a nursing home, will the house they’ve been living in have to be sold?” Siegel poses. Beyond financial issues, many cohabiting couples have avoided clarifying their potential roles and responsibilities as caregivers. This oversight can lead to painful confusion and conflict with family members.

On the other hand, one group that tends to be better-prepared is same-sex couples. Span writes, “Same-sex partners who haven’t married tend to handle things differently, in part because they’re less likely to have children. Concerned that they’ll face discrimination or family interference, they’re more apt to do advance care planning than unmarried heterosexual couples.”

Legal Planning Provides Safeguards, Protects Independence

The good news is that legal safeguards do exist for unmarried couples, if the proper steps are taken. Span concludes her article with the story Rik Elswit and Norma Fisher, who have had a committed relationship for 35 years but never married in order to preserve her Social Security benefits. He has no children, and her daughter lives on the East Coast.

About a decade ago, “we noticed we were getting old,” Mr. Elswit says. “We started to put the wills and the power of attorney together to be sure we were as protected as we could be.”

Shana Siegel, the elder law attorney, approves. “They have the power to help each other and make decisions as if they were husband and wife,” she says. “But if one becomes ill, the other doesn’t have the legal responsibility to foot the bill.”

These discussions will become increasingly key as sociologists anticipate a continued rise in unmarried partnerships among older Americans. “Marriage is declining in its salience and importance, and we’re more open to alternatives,” Dr. Brown says.

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(originally reported at www.nytimes.com)