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When Holy Matrimony and Senior Care Decisions Collide

By Michelle Seitzer / Posted on 13 August 2012

“In sickness and in health, in nursing homes or in hospice…”

Of course, we know that’s not how it goes, but when soon-to-be newlyweds are standing toe to toe, eyes locked on their partner’s face, thoughts rarely turn to elder care.

When I hear the ubiquitous phrase “in sickness and in health,” I generally think of very romanticized images: a pale, thin woman in a hospital bed with beads of sweat on her forehead, her doting husband offering her a drink of cool water while monitors beep and blip; a wife donning an apron and serving homemade chicken noodle soup to her husband, who has been suffering from a nasty head cold for weeks.

Who thinks of cancer, or Alzheimer’s, or heart disease? Who thinks of resigning themselves to exploring assisted living care when things are just too difficult to manage alone?

Nothing reduces a room to silence quite like a discussion about end-of-life care, about death. Those involved in the conversation typically feel awkward and uncomfortable, uncertain about what to say and when, twisting in their seats and avoiding eye contact should their true emotions give them away.

But I’m not even talking about end-of-life care. What about the care that may precede end-of-life care, like assisted living, home healthcare, a nursing home, or retirement community? Do you think you and your spouse will be on the same page when it comes to making a decision about what’s best? (Remember too that it is unlikely you will both need the same type of senior care at the same time, further complicating the decision-making process.)

It’s so important to talk about these decisions together, as early as possible (though by early I am certainly not implying that you devote the first day of your honeymoon to this discussion). Whether you’ve been married 10 days, 20 weeks, or 50 years, talk about long-term care before the need arises. Maybe a grandparent or sibling was recently hospitalized, and the care was less than satisfactory. Use it as a teachable moment, a motivation for your own discussion about healthcare preferences.

Lay out all the possibilities – even the ones you would never dream of considering – on the table. Everything should be open for discussion, and children or other relatives should not be brought into the conversation until you and your spouse have fully talked it through and know where you stand (both individually and jointly).

If it seems that every suggestion you make is shot down by your spouse, find a way to meet in the middle. Write down the options that are causing dissension (after you’ve whittled away the ones you agree on) and seek compromise.

Even if you’ve decided that assisted living care is not a desirable option, visit a few local facilities before ruling it out completely. Check out continuing care retirement communities (they offer multiple levels of care all on one campus), which may be a good fit so you can move together and visit easily even if you need different services that require residence in separate wings. Home care may sound like the best solution – everyone gets to stay in their comfort zone – but what many don’t realize is that bringing in a professional caregiver can disrupt the balance in your home. It’s also quite difficult when only one person needs services; the relationship between the caregiver, spouse, and individual needing care can be a tricky triangle. (Read more about balancing home care here.)

If and when your kids get involved, make sure they all know where you stand, and be certain that both of you make your preferences clear.

Need more ideas or insights on approaching this sensitive subject, be it for your parents or your own partnership? You can find several articles on the SeniorsforLiving.com blog about couples and care decisions:

There is One Comment about this post

  1. [...] new way of living. The transition may be equally challenging for those left behind. Sometimes, couples are separated when one needs care and the other stays home. Young grandchildren may wonder why they’re not [...]


    on 30 August 2012 / 9:10 AM


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