Assisted Living: Spousal Relationships and Social Challenges


By Pamela D. Wilson, CSA, MS, BS/BA, CG

Couples living together in assisted living communities may presently be a rarity; however the prevalence of couples living in assisted living communities is expected to increase. What challenges do couples experience when moving to and living in an assisted living community?   How might couples with different care needs and personalities live successfully with others in an assisted living community?

Social versus Self-Isolating

Some spouses are extremely social, desiring to be out in the community rather than remaining in the assisted living apartment. This social desire may be in direct conflict with a spouse who prefers isolation or the quiet of the assisted living apartment. The spouse who chooses to remain in the room may be viewed as anti-social by other residents. The social spouse may be viewed by staff and residents as uncaring toward the less social spouse. Provided that these spouses have lived with this social and isolating pattern for many years, both can live successfully in an assisted living community by continuing to follow their daily patterns and habits and ignoring others who might judge.

The Restrictive or Controlling Spouse

How many couples include a restrictive spouse? The spouse who tells the other spouse to stop talking or who encourages the spouse to return to the assisted living apartment versus socializing with others? How many times do we hear, “he/she is always telling him/her what to do,” or we hear one spouse uttering impatient statements to the other in public which makes everyone uncomfortable. This situation is likely a life-long marriage pattern that does not change when a couple moves into assisted living. It’s up to the couple to change the dynamic of the situation and best for others not to become involved.

Different Care Needs

When one spouse takes care of the other spouse and the difference in ability or function is significant, residents of assisted communities sometimes marginalize or avoid establishing relationships with couples who have different care needs. For example, if one spouse has dementia and yells in public or has inappropriate behaviors while in the main areas of the community (likened to a child who behaves poorly in public) other residents may object and say that the couple should spend more time in the dementia ward rather than subjecting residents in the main areas of the community to this type of inappropriate public behavior.

Couples with different care needs may feel excluded from community interactions or may feel shunned by other residents. This couple also may be avoided by the other residents in the community because they are considered “needier” or more “problematic”. While many residents in assisted living communities acknowledge that they are becoming older and frail, they do not wish to associate with others who may have higher needs or exhibit public displays of disruptive behaviors.

Many individuals in assisted living have previously been caregivers for spouses or family and resist re-initiating this role by establishing a relationship with couples who are caregiving for a spouse. Life in assisted living for couples with different care levels may not result in the type of situation imagined that might support greater social interaction and new friendships.

The Caregiving Spouse

The caregiving spouse represents a situation where the husband and wife life in different areas in the same community and are provided different levels of care due to physical or cognitive ability, and medical care needs. For example one spouse lives in assisted living and one spouse lives in memory care. The healthier spouse spends all of his or her time in memory care and receives little or no stress reduction versus being in a private residence in the same situation watching over their spouse.

The expectation by adult children was that life in assisted living and memory care for their parents would make life easier on the spouse who is healthier. This is usually not the situation because the healthier spouse does not create a separate life, does not meet other residents and does not establish social connections, many times out of guilt or feelings of responsibility to the spouse with greater care needs. In these situations it may be best for the spouses to live independently, one at home and one in a care community to receive assistance meeting individual care and socialization needs.

The choice to move to an assisted living community is an individual choice—perfect for some and not ideal for others. Prior to moving into assisted living, consider the reasons for moving versus remaining in a private residence where services may be accessed. This is especially important for married couples who have different care needs as the vision of assisted living may be very different from the reality.

©2016 Pamela D. Wilson, All Rights Reserved

Pamela D. Wilson, MS, BS/BA, CG, CSA, Certified Senior Advisor specializes in working with family and professional caregivers to navigate healthcare and aging concerns. Wilson, an expert in the field of caregiving, has personally helped thousands of family and professional caregivers since 2000 in her career as an advocate, a care navigator, and an educator. Through her company, The Care Navigator, she is an advocate and service provider in the roles of guardian, power of attorney, care manager, and transition specialist. She was producer and host of The Caring Generation®, from 2009 to 2011, an educational radio program for caregivers on 630 KHOW-AM.  

Her new book, The Caregiving Trap: Solutions for Life’s Unexpected Changes, is available through all major bookstores as well as on  You can follow Pamela on YouTube, Facebook, Twitter, and Linked In

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