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 first read about it some time ago in this article from US News, written by reporter Elaine Howley and we’re bringing the topic back for another discussion.  

Howley’s 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. But the idea clearly presents some challenges. And it causes us to wonder: would part-time in-home care be a more flexible and less costly option? Let’s take a closer look. 

Assisted Living for Couples: Spouses Can 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 the two of you age, including a huge disparity in your need for 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 asks. Moving together into an assisted living facility can be one answer. 

The Same Residential Solution Can Offer Different Care Plans 

While it may seem less common – one study showed only 13 percent of assisted living residents are married – moving together into 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. 

Angela Stewart, 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. 

Important Factors to Decide if Assisted Living is the Right Choice 

You say you’re 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?  

It’s also important to consider the fact that your move to 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 well into their so-called golden years together.  

But this longevity also comes with a responsibility to ask important questions early and often. This is especially true when it comes to dealing with an eventual decline for either you or your partner – or both of you – 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.”  

Assisted Living Improves Care Coordination  

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, a geriatrician at Ohio State University, 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. Assisted living is clearly expensive: Genworth Financial’s 2024 survey (the most recent data available) found the median monthly cost for an assisted living community is $5,900. For couples, costs will be far higher. 

We couldn’t help noting that the same Genworth survey showed the national average cost for 44 hours per week of services from a home health aide is $6,483. Staying at home and bringing in care might be a more affordable option. 

In any event, before deciding, make sure to have open and honest conversations about finances early and often. Also, experts note, 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 certainly comes with its fair share of challenges, 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. 

We wrote about the challenge of giving up your role as caregiver in this Blog article last month. 

Do Your Homework – and Keep Your Relati0nship Central 

It’s obvious that couples considering such a major move will need to investigate their chosen facility carefully, “In these cases,” Johansen adds, “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.” If you know your spouse is okay, you as the healthier spouse can start to work on your own needs. 

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)