Can You Reside with a Loved One in a Long-Term Care Facility when Your Health Situations Are Different?

Q. My parents just celebrated their 50th wedding anniversary. They are one of those happy couples who spend every waking moment together and are still as much in love as the day they met.  My mother has memory issues that are getting worse, and Dad needs dialysis several times a week. Mom will probably need services in a long-term care facility soon. Dad can’t bear the thought of being without her, though. I could see him getting very lonely and depressed. Despite their differing health needs, are there long-term care facilities where they could reside together? Thanks so much for your help!

A. Good news! More long-term care communities are making room for couples with differing health needs to remain together. This arrangement has proven to be beneficial for many reasons and more widespread than ever before.

The Challenges of Going from Partner to Caregiver 

If you’re living with a spouse who has a medical condition, such as cognitive decline, it can make it a lot more challenging to live together. This is especially true if you don’t have any other option than to assume the role of caregiver, as well as partner. Anyone who currently cares for a loved one would agree that caregiving responsibilities can be stressful on your relationship, as well as your physical and emotional health.  

When it comes to caregiving roles in the home, spouses or partners carry the brunt of the workload. While other family members and neighbors can certainly pitch in and offer support, spouses are the ones who are there doing most of the daily caregiving tasks. 

The Family Caregiver Alliance reports that caregivers who are caring for their spouse put in an average of 44.6 hours per week on caregiving tasks, which can include everything from assistance with bathing, dressing, and transferring to meal preparation and more. It’s a lot for anyone to take on, and the risk of caregiver fatigue in spouses is much higher than in any other group. 

Caregiver fatigue, also called caregiver burnout, can leave informal caregivers, such as spouses or partners, at a higher risk for depression, anxiety, sleep disturbances, and heart disease. The stress of being a caregiver can end up negatively affecting the caregiver’s immune system, leaving them vulnerable to getting sick themselves. 

Senior Living for Couples with Different Health Requirements  

Moving one’s spouse or partner to assisted living or a nursing home while the other stays at home is not always the best solution. While this option might allow for the caregiving role to be passed on to the assisted living community, loved ones who have been together for decades can feel depressed, anxious, isolated, and/or lonely when they are no longer together. 

Fortunately, there’s a solution that allows a caregiving spouse to step away from their primary caregiver role and then put more focus on their wellness. Many long-term care facilities can provide the extended assistance and support couples need to remain side by side, even though their health situations are different.  

These communities are an excellent alternative for couples who may be living with different health situations. They were designed to let couples with varying needs stay together in the same space, even in memory care, where there are apartments with two bedrooms and a shared common area and bathroom. Under most of these models, the couples live in their own apartment and are visited by specialists and home health aides. These living situations present an ideal way to leave the role of primary caregiver and become partners once again.  

There Is Increasing Demand for These Arrangements 

This kind of arrangement is in increasing demand among many couples entering retirement while one or the other faces long-term health issues — particularly dementia. “A lot of couples historically would have had to live separately,” says Jonathan Garber, executive director at Watermark Retirement Communities, which runs several assisted living communities, in Rockville, Maryland, and Fairfax, Virginia. 

“The healthy spouse doesn’t have the burden of worrying about dressing, bathing, medication management. We take care of all that for them,” explains Garber. “They can make new friends, go out to dinner with other members, live a somewhat vibrant life and know their spouse with needs is being taken care of.” Meanwhile, he notes, there are things the couple still can do together. “They’ll have meals together; they’ll watch TV together. So, they’re still able to enjoy life.” This avoids the added trauma for someone already in decline of abruptly being separated from a spouse or partner. 

Here are some reasons why the arrangement works well:  

• When a person moves, it’s almost always a very difficult adjustment. Moving with your loved one/family member often makes the adjustment much easier. 
• These arrangements work best when health challenges are in their early stages. When it gets more serious, especially when physical problems start to manifest, it could become very difficult to live together. 
• The healthy partner will still need support from family or friends.  
• There is also safety to consider. Someone with dementia who tends to wander probably should be in a secure memory center. Mobility issues also play a part.  

The important thing is that couples have a choice, says Vincent Mor, a professor of health services policy and practice at Brown University’s Center for Gerontology and Healthcare Research. “If the well spouse is able to and wants to continue to take care of their loved one, that should be their decision,” Mor says. “These are fundamentally individual choices that people need to make.” 

Plan in Advance for Yourself and Your Loved Ones 

Here at the Farr Law Firm, we give our clients the peace of mind that comes from Long-Term Care Planning and protecting your assets and your legacy, all while preserving your dignity, quality of life, and financial security.  

Among other services, we offer peace of mind through our four levels of lifetime protection planning:  

Level 1 — Incapacity Planning is all about protecting your assets from lifetime probate, also known as guardianship and conservatorship. Everyone over the age of 18 should have this type of planning in place.  

Level 2 — Revocable Living Trust Estate Planning is about protecting your assets from lifetime probate and after-death probate, keeping in mind that using only a Last Will and Testament to transfer your assets at death forces your estate through the nightmare of after-death probate. All individuals and families who have children and/or financial assets should strongly consider Level 2 Planning.  

Level 3 — Living Trust Plus® Asset Protection Planning provides protection from probate, lawsuits, home care, and assisted living expenses by allowing access to Veterans Aid and Attendance benefits, and nursing home expenses by allowing access to Medicaid. This type of planning is done by clients who are typically retired and either still healthy or have recently been diagnosed with (or have a family history of) dementia or some other illness that is likely to result in the future need for long-term care.   

Level 4 – Life Care Planning, Medicaid Asset Protection, and Veterans Asset Protection provides comprehensive planning and filing services, often at times of crisis, though this type of planning can be done anytime someone is beyond the first step of the Elder Care Continuum aka Aging Continuum.   

If you have not done the appropriate level of planning, or had your planning documents reviewed in the past several years, please call us to make an appointment for an initial consultation:  

Northern Virginia Elder Law Attorney: 703-691-1888         
Fredericksburg, VA Elder Law Attorney: 540-479-1435         
Rockville, MD Elder Law Attorney: 301-519-8041         
Annapolis, MD Elder Law Attorney: 410-216-0703        `