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Choosing a care home – advice for couples when one or both need to move into a care home

Although many of the elderly people who need to go into a care home are living alone, a significant number are living with their spouse. Very often, they will have been married and living together for 50 or even 60 years. For both, the idea of living apart may be unimaginable, or heart-breaking.

As an adviser for Carehome Selection since 1995 and having previously managed a care home, I have often supported couples facing this issue. A common scenario is the couple are elderly and both have distinct and different care needs. For example, a husband may have nursing care needs, such as help with eating and support for continence. These nursing care needs may have been fulfilled by his wife, but she has just been diagnosed with dementia and is unable to fulfil these needs. She now has her own needs around her dementia, which will progress over time.

Couples who want to move into a care home together

So for this couple, the challenge is to find a care home where they can move together with all their needs met. If the couple have a property, they are almost certain to be self-funding, so theoretically they should have greater choice and flexibility in terms of their care home choice. In practice, self-funders can find themselves with little support when trying to meet what can be a difficult challenge.

Many homes are dual registered, which means they provide both nursing and residential care. If there are dementia care needs, although some homes are specialist dementia homes, many have the capacity and skills to care for people with the condition. Locally based advisers are particularly helpful if you are trying to find a home for a couple ‘ for example, some homes may have distinct nursing and residential areas which are entirely separate. This may make a couple feel they have, in reality, been separated, while other care homes may be able to offer a more integrated approach. It is useful to know what experience a home may have of caring for couples with different care needs – what can they offer specifically to support them? How will they help the wife or husband who has been the carer but is now not able to do so and may feel their role has been ‘taken away’?

During my years as an adviser, I would reflect that finding a care home for a couple is normally one of the more complex challenges, but is also particularly rewarding when the relationship is maintained and their changing care needs for both are met.

Maintaining the relationship when a wife or husband needs care and spouse stays at home

This is an issue we commonly see. The partner who remains in their own home feels a double blow – there is guilt because they can no longer manage to provide the care their partner needs. Additionally, they are anxious about how much of a relationship they can maintain once their partner goes into a new setting, apart from the family home.

It is really important to recognise and address this concern during your care home search. Care homes are used to supporting the partner who remains at home while their spouse goes into a care setting. But there is a great deal of variation, so it is important to ask questions like ‘ can spouses join their partners for lunch every day? They may be asked to pay for their own meal but ask about the cost ‘ it should only be the same or less than a meal in a reasonably priced caf’. Can they stay all day or are there any restrictions? How possible will it be for the couple to spend time together as they would do at home, rather than in rooms shared with others? As an adviser, I’ve noted small details which can often make a big difference. For example, I noticed at one care home, recognising the anxiety a woman was feeling about separation from her husband, staff quickly introduced her to another visiting wife whose husband was also in the care home. Meeting someone in the same situation and talking together really helped a great deal.

There are many things which can help to maintain the relationship between a husband and wife when one goes into a care home, but it is very important to build this into your care home selection process.

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