Study of How Married Couples Negotiate Assisted Living

By Richard Shank

The number of married couples residing in assisted living residences (ALRs) is expected to rise dramatically in the coming years. Little is currently known about the challenges and opportunities that these couples face. Subsequently, recent research presents a qualitative analysis exploring the experiences of 20 married couples living in ALRs. This research seeks to document their experiences in order to advance existing knowledge of later-life couples inside these care settings.

Despite the fact that being married tends to delay—or in some cases, prevent—relocation to a residential care environment, it is widely believed that increasing lifespan and late-life disability rates will increase the likelihood that married couples will need assisted living services. Currently, approximately one million Americans live in ALRs, which provide non-medical and personal care services, 24-hour protective oversight, and a community-based living environment.

The typical ALR resident is 85 years of age, female, and unmarried. These demographics place married couples residing in ALRs into a context where the vast majority of residents are unmarried and have different interests and needs. It is no surprise that the experiences of married couples living in ALRs was found to be quite distinct from unmarried residents. Couple

The primary reason residents live in an ALR is a change in health status. Despite feeling in control of the decision to move, residents’ family members play important roles in the decision-making process. Furthermore, for the married couples in this study, the desire to stay together played an important role in choosing to move to the ALR—separation was not an option.

Once inside the ALR, residents’ relationships are important for their quality of life. Previous research has shown that married couples living within ALRs are less socially integrated into the community than unmarried residents. These results were confirmed in this study. In fact, most married couples tend to only list other married residents as friends within the community and those relationships proved to be rare with these study participants. However, the companionship that comes with marriage was found to be an important source of support that is unavailable to unmarried residents in ALRs.

Challenges that couples face in ALRs stem from the public nature of assisted living. The coming and going of care staff creates conflicts with a couple’s need for privacy. Furthermore, the regulation of daily life by staff in scheduling everything from mealtime to activity sessions caused several respondents to feel that they had lost autonomy in their lives. Finally, married couples have greater difficulty integrating themselves into the community, especially couples who were not outgoing and were more dependent on one another. Spouses that stuck together closely were less likely to develop the types of meaningful relationships because they remained isolated and disconnected from the rest of the community.

This research advocates, wherever possible, that couples-related activities be offered for those residents who are not accustomed to interacting with non-couples. Furthermore, in regular activities, special care should be taken to ensure that married residents are creating valuable social connections within the residence—an important element in the quality of life provided by the ALR.

Source: Candace L. Kemp. 2008. Negotiating Transition in Later Life: Married Couples in Assisted Living. Journal of Applied Gerontology 27: 231-251.

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