Accommodating couples in Assisted Living and Dementia Care communities when one of the two people has meaningfully more complex physical or dementia support needs is a challenge faced every day by Senior Placement professionals in Los Angeles and elsewhere.
People do not age at the same rate, either physically or cognitively. Sometimes the differences are relatively minor, and the couple can continue to live together, with some support.
In other instances, though, the memory loss, physical limitations, and other symptoms that occur are significantly more advanced with one person and living in the same apartment becomes complicated when their specific needs can’t be met consistently.
While one solution is almost always separate apartments within a supportive senior care community, separate apartments cost 80% or so more than one common apartments with separate support services.
This cost is prohibitive for most couples. The following discusses specific solutions for couples with different needs desiring to live together in Assisted Living or Dementia Care communities.
Timing Is Everything
In my experience, most couples move into Assisted Living relatively ‘late’ – their experience living at home typically has been deteriorating for several years, yet they resist the move to more supporting housing because they perceive the move as a loss of independence.
If the couple is confined to two rooms, though, as is often the case, with dementia or physical problems severely limiting one partner and care providers coming and going every day then independence has probably already been lost.
Better to move into an assisted living community that supports memory care where that care is more readily delivered, and the focus can be shifted to family and social activities. So many times, people have told me that “I just moved here too late” after they experience the support from the care community.
Focus on Time Together Earlier in the Disease Process
Unfortunately, many types of dementia, such as that associated with Alzheimer’s and Parkinson’s, have reasonably predictable progression timelines. For many people, the last years of these diseases are spent with rapidly decreasing cognition and increasingly debilitating physical problems.
Many couples want to live as many of their ‘better’ years together, and they want solutions within Senior Living that allow them to live together as long as is practical.
Smart Assisted Living and Dementia Care Communities are innovating to make this possible.
One partner has dementia. The other does not.
This is one of the most common scenarios. One senior has relatively intact cognition, while the other has dementia that is progressing. In a surprising number of cases, the couple can continue to live together in Assisted Living, with a care plan set up to help the partner with Dementia receive assistance with the Activities of Daily Living (dressing, bathing, etc.) in the apartment, administered by the staff.
In some cases, the partner with Dementia will go to the Community’s Memory Care section during the day and participate in activities appropriate for a person with dementia. This frees up the partner without dementia to enjoy the standard activities of the community. The couple then comes together for at least the evening meal and goes back together to the apartment to sleep.
Some communities will accommodate couples in Dementia Care sections even when only one partner has Dementia.
This is not as common – The apartments in Dementia Care are typically smaller than in Assisted Living, and some states have laws preventing a person who does not have dementia from living in Dementia Care. Some communities, though, have gotten waivers for this joint accommodation, and have worked through the logistics of giving the non-dementia partner access to activities elsewhere in the Community that provide social and physical stimulation appropriate for a senior without dementia. This is another way for a couple to stay together even as their needs for care diverge.
When Dementia Progresses
The causes of Dementia are several, and each progress at a different rate. Most types of Dementia, too, have neuromuscular and other physical changes associated with different stages of the disease process.
The later stages of Alzheimer’s, for example, typically limits a person’s ability to walk, talk, and use many of their muscles. This period is extremely hard on couples, and their strategies and choices are determined by a variety of factors, including cost.
Sometimes couples will move into separate housing at this point- a separate apartment within the community for the healthier partner, or even moving out of senior living all together, while the other moves into housing that can manage sometimes completely nonverbal and non-ambulatory residents.
Common Questions
Can a dementia patient live in assisted living?
It depends on the diagnosis and whether the resident may be disruptive to others.
When should I move from assisted living to memory care?
When care needs and cognitive capability requires greater oversight, cueing and guidance.
Does Medicare cover assisted living for dementia?
No, Medicare does not pay for assisted living.
Do dementia patients have to pay for residential care?
Yes, the cost of assisted living is paid for privately. If a resident qualifies for Medi-Cal, they may be able to live in a long-term care nursing facility.
Conclusion
Senior Living Communities are working to accommodate couples with different capabilities, giving them as many years together as possible.
Assisted Living Locators Los Angeles owner Sarah Ordover is one of LA’s top senior living advisors. Certified in dementia care, Sarah is a trained aging specialist who holds an RCFE assisted living administrators license. Sarah thoughtfully guides families through the senior living decision-making process, helping them find the best solution for their loved ones. Call Sarah at 310-853-8282 for a consultation. Assisted Living Locators is free to clients.
