The percentage of seniors who are married has grown over the past 50 years, according to the U.S. Census Bureau. Remarriage, increased life expectancy, and a shrinking age gap between women and men mean more families are looking for senior living that supports both parents’ needs.
“Couples want companionship, and people are living longer, so they need adequate space and unique health care arrangements for spouses with different care needs,” says Dr. Melissa Henston, a geriatric psychologist in Colorado.
Senior living options for couples vary based on care needs and community design. Here are six common scenarios aging couples face, along with possible solutions to help them grow old together.
Scenario No. 1: Your aging parents have different senior care needs
One spouse may require assistance with activities of daily living (ADLs), like dressing and bathing, while the other is independent. One partner may be experiencing dementia symptoms while the other has no cognitive decline.
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Senior care is a spectrum, and it’s important to find a community that meets both of your parents’ needs.
Many assisted living communities have attached memory care facilities. If one spouse exhibits signs of cognitive decline, or if there’s a family history of dementia, this is a good option. Some communities allow the couple to transfer to a memory care apartment together — however, since assisted living and memory care aren’t the same, a partner diagnosed with dementia may have to move to a separate wing of the building designed for residents with wandering tendencies or sundown syndrome. Their spouse will be able to visit easily and regularly for meals, activities, and relaxation, allowing them to remain together as an elderly couple.
Assisted living cost considerations: Communities often use a tiered pricing model. The partner who needs memory care or assistance with ADLs would pay more for a higher level of care, while the independent spouse would pay a base rate.
A continuing care retirement community, or CCRC, is an ideal choice for older couples who plan for senior living in advance. CCRCs offer multiple levels of care in one inclusive campus. Healthy seniors, sometimes as young as 55, will move into independent apartments or homes and transition between levels of care as needed. If one spouse develops health problems that require extra help, they can transfer to assisted living while the other remains comfortably in their apartment nearby. If one partner has a fall and needs rehabilitation, they can easily move to nursing care until they’ve healed.
CCRC cost considerations: There are two main payment models for CCRCs. Most require a large up-front payment — which averaged $329,000 in 2019 — to cover continued medical care, in addition to a median monthly fee of $3,500. Others have much lower entry fees but require increased monthly payments as care needs increase.
Independent living communities generally offer spacious apartments or suites with kitchenettes, private bathrooms, and many of the same amenities as a luxury condominium. They have senior-friendly features, like wheelchair accessibility, hand-held showers, and emergency alert systems. Independent living relieves the burdens of home maintenance, light housekeeping, and activities. This allows a physically capable partner more time for their own emotional and mental well-being while caring for their less healthy spouse. Since independent living communities don’t provide medical care, they aren’t an ideal choice for older couples who both need assistance with ADLs.
Independent living cost considerations: Because there are fewer services, independent living is generally less expensive than assisted living, with a national average cost of $2,552 per month. If your aging parents want a maintenance-free, quiet retirement, but they need more assistance than independent living provides, home health services can be added.
Scenario No. 2: Elderly couples want alone time
More than 25% of senior couples sleep in separate beds, according to a National Sleep Foundation study. Snoring, noisy CPAP machines, and elderly insomnia all contribute to this statistic. In an independent living community or CCRC, your parents will have to share a small space after moving and downsizing. Some seniors have a hard time adjusting to close cohabitation after years of luxuries like man caves, offices, and multiple bedrooms.
If your parents are considering a move to an independent apartment or two-person assisted living suite, be sure they take a virtual or in-person tour of the space to pre-plan furniture and decor so they’ll be comfortable and prepared upon move-in.
Most independent living and some assisted living communities offer large, apartment-style suites or two-bedroom options. Two-bedroom units in assisted living communities often have long waiting lists, so plan in advance if possible.
If one parent thinks they’ll have significant sleep problems or be unable to cohabitate, see if the facility has two rooms in close proximity. Some communities offer discounted rates when couples live in separate units.
Scenario No. 3: Elderly parents have different interests
The ratio of women to men in assisted living is almost 7-to-1. However, many senior living communities offer a variety activities that cater to a wide range of interests. When visiting communities, it’s important to ensure that both parents’ emotional and social needs are met — if they aren’t, social isolation can lead to depression and more rapidly deteriorating health.
Check activity schedules. Be sure that both parents find activities they’ll enjoy before settling on a community. On your tour, ask an activities director if there are any special activities designed for male residents, like a poker night, putting green, or chess club.
If there are men who are particularly active in the community, see if they have time to join your dad for lunch during the visit or talk on the phone.
Scenario No. 4: Older couples want to remain intimate
Most children don’t want to hear about their parents’ intimate lives. However, sex is a normal part of aging, and it’s an important consideration for some couples transitioning to assisted living.
Many couples have their own rooms, so normal intimacy can continue. However, if partners require certain assistance, like rooms with no locks or night time check-ins, policies could vary by community. Most memory care facilities that cater to couples have unique rules designed to ensure consent between partners.
Talk to the community about intimacy. Your aging parents might be embarrassed, but it’s important for them to discuss rules and guidelines with a community director or therapist before their move.
Scenario No. 5: Senior couples may want to stay close but not live together
As a child of an aging couple, you may assume that a shared living arrangement is the best situation for your parents. But not every good relationship works the same way.
“Overall, couples living together is a wonderful way to provide safety, security, and care,” says Henston. “Family members who help provide care and advice should listen carefully to what the couple needs and want before making any placement decisions, though.”
When one partner requires extra care, the healthier spouse often takes on the role of an elderly caregiver by default. That burden can cause significant isolation and physical decline. Caregiver burnout is tremendously detrimental, so sometimes it will lead to a happier marriage in the long run for elderly parents to live separately.
Listen to both parents. “The strength of the marriage or partnership must be taken into consideration,” says Henston. “Sometimes, children who are trying to assist their parents make assumptions.” Even if they’ve been together since before you were born, your parents may have reasons to select a community where they don’t live in the same apartment.
Henston describes one woman who’d never been very vocal about her less-than-ideal husband. After discussing senior living environments with her children, the woman “decided to live in the same facility but separately from her less functional husband, rather than care for him and put her own health at risk.”
Even in loving, healthy relationships, parents have the right to select different levels of care. If one spouse is more physically active, or one requires memory care, they may make the decision to live in separate parts of a community. Listen closely to your parents’ concerns and respect their wishes.
How to find the right senior living option for your older parents
When one parent’s health begins to decline, it can be hard to make an urgent choice that appeals to both parents. In an emergency situation, the decision will often be made for the parent with medical concerns, leaving the healthier spouse in a bad emotional and social situation.
A geriatric care manager, physician, or social worker should assess both partners’ individual health concerns. The spouse who needs the highest level of care will typically dictate which type of senior living the couple should pursue, but it’s important that the more independent partner has the resources and stimulation they need to age happily.
If couples begin looking into senior living options when they’re both well, it simplifies the process when one partner’s health deteriorates. By starting the search early, both parents will be on the same page and can get on waiting lists for larger suites or continued care communities in advance.
Work with an expert. A Place for Mom’s local Senior Living Advisors can detail which communities near you provide special accommodations for couples, and they’ll help find the right fit for your family.