Keeping Aging Couples Together: mediating your family’s eldercare options

by Petra Maxwell on May 30, 2011

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As the elderly population grows, one segment of that group is bigger than ever before: married seniors. 45% of men over the age of 85 still live at home with their spouse. Another 10% of senior men are married, but are living apart from their spouse (who is most likely in a nursing home). As senior couples and their concerned family members confront caregiving decisions, the couples’ desire to continue to live together is a huge challenge. There are a number of living arrangements to consider and holding a family meeting to consider them may be the best way to sort out the pros and cons.

Most senior couples prefer to continue to live together at home. But when one spouse is in need of extra help, it places the healthier spouse in a care-giving role. Remaining at home may be the goal for many, many couples, but doing so without the right support can mean injury for the healthier spouse. When families are faced with the important question of how elderly loved ones can enjoy their time together without compromising the health and safety of each partner, it makes sense to hold a family meeting – sometimes with the aid of a mediator – to weigh the options. Here are a few to consider:

Aging in place at home may seem like the best option for elderly couples. They have the chance to stay together in a familiar environment and if they can manage to hire an in-home care professional, the couple will get the care and support they need. On the other hand, families must keep in mind that constant contact with caregivers can lead the healthier spouse to feel intruded upon, and round the clock in-home care can be pricey.

Moving together to an assisted living facility is a also a popular option, but rarely do both spouses stay at the same activity and health level. One spouse is likely to fall into a caregiving role in this situation as well, when the facility does not have the services the weakening spouse needs. Moving together to a facility that provides the higher level of care the less healthy spouse requires ensures that health needs are met, but can result in the healthier spouse feeling trapped in a place that doesn’t offer the opportunities he or she needs to remain active, and can result in the healthy spouse deteriorating.

Living separately at different facilities (assisted living and a nursing home) or one spouse remaining at home while the other moves into residential care are options, but is usually distressing for both spouses and can negatively impact their health.

Continuing Care Retirement Communities (CCRCs) have been stepping up to the plate lately to fill the void. These residential centers offer a wide array of services and care which can be customized to each spouse’s needs. This may be the perfect solution for a couple that can’t remain at home together, however it can be cost-prohibitive. Most CCRCs require a buy-in fee and then monthly payments (which can be comparable to live-at-home costs). And the sliding levels of care may only be offered in specific buildings on the grounds, meaning one spouse might need to move to receive a higher level of care.

Clearly, there are a number of options available to aging couples – some of which have not even been touched upon here. There are no perfect solutions, but understanding a couple’s need to remain together is the first step in the process of making long-term care decisions. Holding a family meeting, either with or without the help of a mediator, is a great way to put everyone’s needs and concerns on the table so they can devise the best possible strategy.

{ 2 comments… read them below or add one }

Psychotherapist/Elder Mediator Kenneth Koym June 15, 2011 at 4:00 pm

Tickled mediationline & I concur. I’ve mediated since 1981 and now do elder mediation to meet their needs. Texas Family Law Certified Attorneys invited me to issue 40-hour certificates needed to comply with the 1980-1 Texas Mediation Act; no Texas law school offered a single course in ADR then. Let’s collaborate.

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Petra Maxwell June 15, 2011 at 4:52 pm

Thanks for your post. There’s a huge and growing need for Elder Mediators now, given our heightened awareness of both eldercare and caregiver issues. I’m so glad that you’re not only doing it but teaching others as well. Have you considered offering a training program via videconferencing?

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