After decades together, many couples can't imagine living apart. But often one partner needs more help than the other, and the healthier spouse may be worn out from caregiving. Assisted living can give the partner who needs care more help while letting the couple share a home.
This guide explains how assisted living works for couples. For the basics, see our assisted living guide.
How assisted living works for couples
Most communities let couples share an apartment, often a one- or two-bedroom unit. Each partner has an assessment and their own care plan, so one partner might receive daily help with bathing and medicines while the other needs very little. Both can enjoy meals, activities and the community's services.
Couples may be married or long-term partners; ask each community about its policies. Siblings or friends sometimes share apartments, too.
When needs differ
| Situation | Possible options |
|---|---|
| Both need some help | Shared assisted living apartment with two care plans |
| One needs help, one is independent | Shared assisted living apartment; or independent living and assisted living on the same campus |
| One has dementia | Shared apartment if safe, or memory care for one partner on the same campus |
| One needs skilled nursing | Nursing care for one partner, ideally nearby or on the same campus |
What's possible depends on the community and state rules.
Relief for the caregiving spouse
Spouses often provide a great deal of care at home, and the strain can affect their own health1. Moving together lets staff take on the heavy work, like bathing and lifting, so the couple can spend time together as partners again.
When one partner has dementia
If one partner has dementia, living together in assisted living can work for a time. As the disease progresses, the partner may need a secured setting and dementia-trained staff. Communities with memory care on the same campus make it easier for the other partner to visit daily3. Learn more in assisted living vs. memory care.
Read moreSecured Memory Care Units: How They Keep Residents Safe
How pricing works for couples
Couples typically pay a base rate for the apartment plus a second-person charge, which covers meals and services for the second resident. Care charges are usually separate for each partner, based on their level of care. Ask for a written breakdown.
Paying for care can be complicated for couples, especially if one partner may need Medicaid. Medicaid has rules to protect income and assets for the spouse who isn't receiving long-term care4. See how to pay for assisted living and Medicaid assisted living waivers.
Daily life as a couple
Couples in assisted living often find more time for each other. Without cooking, cleaning and heavy caregiving, there's room for shared meals, walks, outings and activities. Each partner can also have their own interests, friends and time apart, which helps keep the relationship healthy.
- Shared meals in the dining room, or a quiet meal in the apartment.
- Separate activities for each partner, plus some together.
- Staff help for the partner who needs it, without the other partner doing all the lifting.
- Time with visiting family in shared spaces or private dining rooms.
Plan legal and money matters together
Moving together is a good time to review legal and financial plans. Make sure each partner has a health care power of attorney and advance directive, and that someone can manage money if a partner can't5. An elder law attorney can help if Medicaid may be needed later. Talking about these things early takes pressure off later decisions.
Choosing a community as a couple
- Ask what apartment sizes are available for couples.
- Ask how care plans work when needs differ.
- Ask what happens if one partner needs more care than the community provides.
- Look for a campus with several levels of care.
- Ask about activities both partners would enjoy.
- Ask whether couples can request a move together later.
Bring our assisted living tour checklist to each visit.
If you need to live apart
Sometimes a couple has to live in different settings for safety reasons. This can be painful. Choosing places close together, planning regular visits and shared meals, and keeping familiar routines can help. Many couples find their time together improves when caregiving stress is lifted.
