Make the best senior care decision

“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 care is a spectrum, and it’s important to find a community that meets both of your parents’ 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. This article outlines some common care types along with their associated costs — to help your aging parents find a place to flourish together.

Let our care assessment guide you

Senior living options for couples can vary based on care needs and community design. As long as both partners find something to love about their chosen community, they can live together happily. Thankfully, many senior living communities offer a variety of activities and convenient services that cater to a wide range of interests and needs. When visiting prospective communities, it’s important to make sure both parents’ needs will be met there.

“Family members who help provide care and advice should listen carefully to what the couple needs and wants before making any placement decisions,” advises Henston.

It’s important that the prospective community manager is fully aware that a couple will be living together there so that everything is considered at once. For example, if one partner’s care needs change down the line, how will that affect their situation? Ask the care manager of the prospective community about the following:

• The special privileges granted to couples, like access to one another and a right to privacy.
• The specific services each partner has access to on-site, now and in the future, especially if one or both have a health condition.
• The price of services and any price increases to expect for services in the future. Alternatively, are there any savings a couple might expect as compared to two individuals living independently?

If neither member of a senior couple needs help with ADLs, they may find a better fit in an independent living community. Sometimes, independent living communities even have third-party home care providers on-site, so tailored personal care can be an added service down the road. This can relieve the more independent partner of any care duties in the future.

These communities generally offer spacious apartments or suites with kitchenettes, private bathrooms, and many of the same amenities as luxury condominiums. Some are communities are really comprised of neighborhoods of “cottages” or full-size homes. The residences often feature senior-friendly details like full wheelchair accessibility, hand-held showers, and emergency alert systems. These communities also may include home maintenance, light housekeeping, and events and activities in the cost. Dining services are also sometimes offered. These convenient services leave more time for the couple to nurture their social, emotional, and mental well-being.

The average cost of independent living for couples

Because there are fewer services, independent living is generally less expensive than assisted living, with a national average cost of $2,843 per month.^[02] 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.

Assisted living is a great fit for senior couples who want to maintain an active social schedule, would like help with personal care tasks, and would appreciate a maintenance-free lifestyle.

Social and emotional needs can be just as important as care needs. Be sure that both parents find activities they enjoy before settling on a community. For example, while on your tour, ask an activities director if there are any special programs designed just for male residents, like a poker night, putting green, or chess club.

Some assisted living communities will have specialized care units with different care levels all on the same grounds. Specialized care units can include memory care and skilled nursing care, so if one partner develops more advanced care needs down the road, the couple can at least remain in the same community.

The average cost of assisted living for a couple

The median monthly cost to receive care in a private, one-bedroom apartment in an assisted living facility is $4,500 according to Genworth’s 2021 Cost of Care Survey.^[03] That said, it’s difficult to determine the cost of assisted living for couples since each person has their own care needs that could affect the price of services. Communities often use a tiered pricing model. If one partner needs more assistance with ADLs, then the cost of those services would be added to the couple’s base rate.

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, a community that offers memory care 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.

A spouse should be able to visit a relocated loved one easily and often for meals, activities, and relaxation, allowing them to remain together as an elderly couple. Again, make sure to ask the community manager about the access couples have to one another inside the community, especially if one partner ever has to move to another part of the facility. Ask the community manager how the couple’s right to privacy will remain intact in such cases.

The cost of memory care for couples

Depending on the care needs of each senior partner, you can expect to pay 20%-30% more for a memory care apartment compared to one in assisted living.^[04] Care needs may double if one partner needs to move into a separate apartment in memory care while the other stays in assisted living, however.

Talk with a Senior Living Advisor

A continuing care retirement community (CCRC) is an ideal choice for older couples who want the most care security, because CCRCs offer multiple levels of care in one inclusive campus. Healthy seniors, sometimes as young as 55, will move into a CCRC’s independent living unit and transition between levels of care in the future as needed. If one spouse develops health problems that require extra help, they can easily add on assisted living services while remaining together. If one partner has a fall and needs rehabilitation, they can relocate to a wing or area offering nursing care until they’ve healed. CCRCs have many living and care options. Some CCRCs have long waiting lists, so it’s best to plan for these moves in advance.

The cost of CCRCs for couples

There are two main payment models for CCRCs. Most require a large up-front payment. Others have much lower entry fees but require increased monthly payments as care needs increase.

It’s important to plan ahead when searching for senior living options for couples. By starting the search early, both parents will be on the same page and can get on waiting lists for larger suites or continuing care communities in advance. Even more, if a couple begins their senior living search when they’re both healthy, they can both have equal input on where they want to live.

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 potentially negative emotional and social situation. Overall, starting the search early should simplify the process for everyone.

How to get started

To begin, a geriatric care manager, doctor, or social worker should assess both partners’ individual health concerns. The spouse who needs the higher level of care will typically dictate which type of senior living the couple should pursue, but it’s important that the more independent partner also has the resources they need to age happily at the community. With the range of communities out there, it’s possible to satisfy both partners’ needs.

You can also find expert help to guide you through the process. A Place for Mom’s Senior Living Advisors can detail which communities in your area provide special accommodations for couples, and they’ll help find the right fit for your family.

Ask questions

You may find one or several communities that look like they will be a good fit for your parents, but make sure to ask questions before you schedule a move. Some good questions include the following:

• Will both partners’ care needs be addressed if one of them requires a higher level of care down the line?
• Does the community have special interest groups, outings, or activities that will appeal to both partners?
• Will the community help the couple transition should they need to move to separate rooms or areas of the community? Will there be a transition fee?

Take space into consideration

If you’re considering senior living for your parents, you may assume that they’d be happy in a one-bedroom apartment. However, sometimes senior couples sleep apart. Snoring, noisy CPAP machines, and elderly insomnia all contribute to this statistic. Your parents might have to share a small space after moving and downsizing to senior living. And, some seniors may have a hard time adjusting to close cohabitation after years of luxuries like dens, offices, and multiple bedrooms.

To help ease the transition, keep the following in mind:

• If your parents are considering a move to a one- or two-bedroom assisted living suite, be sure they take a virtual or in-person tour of the space to pre-plan furniture and décor so they’ll be comfortable and prepared upon move-in.
• 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.

Respect the couple’s living choices

While many adult children will assume that their parents want to continue living together, that isn’t always what each couple wants. Listen to both parents.

“The strength of the marriage or partnership must be taken into consideration,” says Henston. Even if they’ve been together since before you were born, your parents may have reasons to select a community where they don’t have to live in the same apartment.

For example, 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. Always listen closely to your parents’ concerns and respect their wishes.