Assisted Living for Couples: Can Couples Live Together in Senior Living Communities?


Moving to a senior living community is always a significant life change. When a couple can move together, this decision and the transition may become a little easier.

Aging couples often experience different health challenges. One partner may have several diagnoses while the other is generally healthy. In these scenarios, the healthier of the two often assumes the caregiver role. However, as chronic conditions progress, managing a loved one’s care needs can become increasingly difficult.

These situations often put older couples at a crossroads as they begin to navigate their next stage of life together — where to live, how both of their care needs will be met, and where they’ll be happy.

“In many cases, particularly when a couple has been married for many years, the ability to live together can make or break their decision on whether or not to move to an assisted living facility,” says Marissa Kirby, NHA, CHC, CHPC, and vice president of compliance at NEWGEN HEALTH, LLC.

Luckily many senior living communities, especially assisted living and continuing care retirement communities (CCRCs), offer options for couples to live in the same residence while each receives and pays for the level of care they need.

Assisted living for couples: What options are available?

Assisted living settings typically land around the middle of the senior living spectrum. These communities offer more than the maintenance-free environment of a senior apartment or independent living community without the specialized care found in a skilled nursing or memory care community. That said, it’s often the most fitting care type for senior couples with differing needs.

Couples can choose from various unit layouts across different types of assisted living communities, including studios, one-bedrooms, two-bedrooms, and even suites to accommodate their needs and match their lifestyle.

Some communities even have the amenities of an upscale condo, such as lake and garden views, fully equipped kitchens or kitchenettes, private bathrooms, full wheelchair accessibility, and other helpful features. Couples can choose the floor plan, services, and levels of care that are right for them.

All of these factors and more can greatly affect the cost of assisted living for a couple.

What is the average cost of assisted living for a couple?

The average cost of assisted living for a couple is hard to determine because care needs can vary greatly and directly impact pricing. However, the median cost for a one-bedroom apartment in an assisted living residence is $4,500 per month, according to the Genworth 2021 Cost of Care Survey.

Should a couple choose to share an apartment, they’ll pay rent for one unit and an additional sharing fee for the second occupant. The additional fee ranges from $500 to $1,800 per month, according to Nick Chareas, a Senior Living Advisor at A Place for Mom, AgingCare’s parent company.

Based on the above figures, the median cost of the sharing fee comes out to $1,150. This brings the total estimated cost to $5,650 per month for a couple sharing a one-bedroom unit in an assisted living community.

What affects the cost of assisted living for couples?

Each assisted living resident typically pays based on the services they require. For example, a senior needs assistance with medication management, bathing, and dressing, but their partner is still able to do everything independently. They’ll only pay for the first partner’s care services and other add-ons they may both want, such as housekeeping, transportation, etc.

“The spouse who doesn’t need extra care usually only pays for room and board,” explains Maria Plaksin, former admissions liaison for Consulate Health Care in Fort Myers, Florida. “The other spouse pays for the additional services they need.”

Each spouse can receive the care they require, as long as the facility is able to meet their needs. In some cases, spouses may wish to have their own separate rooms or even adjoining units. The possibilities vary in each community. Keep in mind that if the couple chooses to live in separate units, they’ll pay rent for both units.

In some cases, the base cost of room and board in an assisted living community can be significantly lower, however, the total price may increase depending on the following details:

•    Location 
•    Floorplan 
•    Selected amenities 
•    Additional services

Some senior communities use a tiered pricing model with bundled services. For instance, a resident needing very little assistance would be classified in the lowest tier. As their needs increase, their tier level (and costs) would, too. Other common pricing models are all-inclusive or à la carte. À la carte is also known as fee-for-service, where you only pay for the individual services you need.

Assisted living offers solutions to aging couples’ problems

Several problems can arise when it comes to moving, especially when significant others have different care needs. Consider the following list of challenges that aging couples commonly face and some solutions that senior living options can provide:

Different care needs

If partners have different care needs, senior living communities can provide a solution. Many communities, especially continuing care retirement communities (CCRCs), typically feature independent living, assisted living, skilled nursing, and memory care all on one campus.

Difficulty sharing a space

A couple may want to remain close but not share the same living space. One partner’s care needs may be more extreme than the other’s, which can affect their relationship and lifestyle.

In similar scenarios, couples can choose to reside in a two-bedroom apartment, in separate units in different wings, or in separate semi-private rooms to help ensure they get the personal space they need while maintaining their relationship.

Separation anxiety

If a couple is already living apart due to different care needs, it could be causing anxiety or depression. For example, one spouse lives in their house while the other lives with their adult child who cares for them. This separation can negatively affect the mental health of elderly couples.

Luckily, many senior living communities are able to accommodate spouses’ different needs whether they live together or separately in the same community. The latter option still gives the couple the ability to visit each other frequently, which can help ease separation-related anxieties or depression.


A couple may start to feel isolated in their home due to distance from family and friends, less frequent visits, loss of loved ones, etc.

Fortunately, assisted living communities offer shared spaces for gathering and often facilitate group activities, such as happy hours, off-site trips, and holiday parties, to help residents make friends and stay social. Most communities also allow visitors and sometimes encourage friends and family members to join their elderly loved ones for meals and special occasions.

Different interests and hobbies

Partners often have different interests and hobbies. For example, one partner may enjoy staying active while the other prefers relaxing with a good book.

Situations like this are exactly why senior living communities provide a range of amenities and activities for residents. From exercise classes and art classes to group games and interest clubs, seniors have a variety of ways to participate in current hobbies and discover new interests.

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A geriatric functional assessment is the first step

Geriatric functional assessments help ensure that both spouses receive the care they require in their new assisted living community. During these initial assessments, a senior’s individual needs and abilities are evaluated by a professional. Typically, a geriatric functional assessment will inventory and rank the following:

•    Chronic illnesses
•    Communication abilities 
•    Behaviors
•    Dietary requirements
•    Ability to perform activities of daily living (ADLs)
•    Ability to manage medications
•    Need for assistive devices

This assessment can be conducted by a physician, a social worker, a geriatric care manager (also known as an Aging Life Care Professional), or a nurse at a prospective senior living community. Having a general idea of these needs will make it easier for the couple to rule out certain types of long-term care facilities right off the bat.

Account for both parties’ needs so living options are clear

For example, if both spouses need some assistance with activities of daily living, then an independent living community might not be a good fit unless in-home care services are also utilized. A good rule of thumb is that the spouse who needs the higher level of care should determine which type of senior living facility can best accommodate the couple.

“In the case of couples, the key is to care for the frailer of the two. The couple can live together, and only the spouse who needs more care pays for that higher level of service,” Kirby clarifies.

Senior living pre-screening and assessments

Once the couple has decided on a senior living community that can meet both of their needs, a community staff member will conduct another thorough assessment of each spouse prior to move-in.

This evaluation will determine the exact care level of each senior, identify the corresponding services they’ll need, and confirm whether the community can accommodate all of their needs. It’ll also be used to then determine the upfront and monthly costs of assisted living.

Kirby says another follow-up assessment should be conducted 30 days after move-in and then every six months moving forward. This will help monitor each senior’s changing needs and allow the community to update care plans accordingly.

Balancing care needs for elderly couples

Finding appropriate care for a couple with differing needs is largely a balancing act. It often comes down to a prioritization of wants and needs between the two individuals. Concessions are inevitable when dealing with two people at very different places in their lives who want to continue living together. Unfortunately, negotiation can be especially difficult when one spouse is experiencing cognitive decline.

“The best thing you can do is work together as a family to reach a good compromise and find a facility that best matches their criteria,” Plaksin notes.

Get help finding assisted living for couples

It can be challenging to find the right senior living facility for just one person, let alone a couple. The goal should be to minimize moves between care settings since these transitions can be costly and very hard on elders. For many senior couples, consulting a Senior Living Advisor at A Place for Mom is helpful. These skilled advisors can assess current and future needs, provide a list of local assisted living options, and schedule community tours, all at no cost.

The information contained in this article is for informational purposes only and is not intended to constitute medical, legal, or financial advice or to create a professional relationship between AgingCare and the reader. Always seek the advice of your health care provider, attorney, or financial advisor with respect to any particular matter, and do not act or refrain from acting on the basis of anything you have read on this site. Links to third-party websites are only for the convenience of the reader; AgingCare does not endorse the contents of the third-party sites.

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