Care Transitions: When One Spouse Moves and the Other Stays Behind


Published: 03/11/2012

by Michelle Seitzer


In sickness and in health, for better or for worse: these aspects of the marriage vows are often heavily tested in the senior years.


Countless seniors are currently caring for a spouse following an illness or injury: a dementia diagnosis, cancer, a broken hip, Parkinson’s. The level of care required versus the level of care provided often depends on the health and stamina of the “well” spouse. Over time, caregiving certainly takes a toll physically, emotionally, mentally and financially too, further impacting how long and to what extent the spouse can care for his/her partner. Given the strain of caregiving, adult children concerned about their aging parents often find themselves worrying about the caregiver as much as the one being cared for.


Eventually, that concern may translate into a discussion about the need for a care transition. Never an easy conversation, but one that is more complicated in the case of a couple with different care needs. For example: Mom’s dementia is progressing and she needs more care than Dad can provide. Other than the exhaustion he’s facing after providing constant daily care, Dad doesn’t need a care facility. What happens after she goes to assisted living and he stays behind?


There are several issues that may bubble to the surface of this scenario. Home care may end up being a better solution than residential care, so the two can stay together and Dad can still be involved in Mom’s care, if he wants that.


Some couples make a care transition together, even though only one may need care, just to stay together. Perhaps an independent living or assisted living apartment is a good compromise; Dad can still provide care but will have support at his fingertips or access to assistance as needed.


If you choose a care facility for Mom and Dad stays behind, don’t assume he’ll feel a sense of relief, that a weight will be lifted from his shoulders and he can rest. Life after caregiving is not an easy adjustment, and you’ll need to keep an eye on Dad just as much as Mom; both will likely go through a difficult time of transition.


Consider these tips if you’re facing a separation of parents or other married relatives:


  1. Be sensitive to their feelings about being apart. Understand that the spousal caregiver who is left behind may feel an overwhelming sense of guilt or inadequacy, that she failed her spouse because she couldn’t provide the care he needed. Recognize too that, even though Mom may have dementia, she will likely be well aware of her separation from her husband and may react accordingly.
  2. Be prepared for the possibility of new relationships, sometimes romantic, that may develop in the assisted living or Alzheimer’s care facility. This was the case for Justice Sandra Day O’Connor and her husband, John, and it was also portrayed in the 2006 film, Away From Her, starring Julie Christie. Deal gently with feelings of jealousy and hurt that may arise in both partners, and possibly among other family members too.
  3. Be supportive before, during and after the transition. Don’t assume that after the last box is unpacked your job is done. Ask your parents how you can help them through the transition. If the spouse who stays behind cannot drive, you will need to coordinate opportunities for regular visits. Also, be sure to visit both parents regularly after the “split.” (Take advantage of the Family Portal tool on this site to coordinate transportation and create a visit schedule).


Clearly, this is a major decision that will have an effect on everyone in the family. Weigh your options carefully before moving forward.