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Has anyone ever had to separate a married couple due to differing medical needs? This couple went into AL together, but now one spouse is being mean to the other due to dementia behaviors. It's likely one spouse will need to be moved to SNF, but the other could do well in AL for some time yet. I'm at a loss here. I hate to separate them, but I don't want one of them hurt either. Suggestions?

My mom and dad went into assisted living within a few days of each other. Dads dementia was pretty advanced, constant repetitive questions and stories. Mom had some dementia but a host of medical and mobility issues. Dad drove her crazy.

In hindsight I wish I had separated them and gotten two rooms. But at the time, as things collapsed, I didn’t even know how much money they had. Plus we’re so programmed to try and keep folks together.

If you can afford it move them into separate rooms.
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Reply to Windyridge
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I don't know if this is any help at all, but I want to share a true story with you all that is also a little bit funny. My parents in 2013 sold their little place and moved into a lovely 2 bedroom/2 bath apartment in Independent Living. They hated it there and after one year I had to move them again to another IL apt. 2 bed/2 bath with a full kitchen, living area and porch in between the bedrooms. They lasted 4 years there. Then my father (already in his 90's) had to do a stint in short term rehab after a hospital stay for aspiration pneumonia. There, the social worker informed me he was not well enough to return to IL, that he had to upgrade to at least AL. Yet she was no help at all in getting him placed and called me to come pick him up as he was no longer making 'progress.' He was a stubborn raging narcissist who was uncooperative so they wanted him gone. (A whole other story.) So I had to find an AL on my own. My codependent, enabling, martyr mother did not want him to go alone, still loyal after 60+ years of verbal and emotional abuse from him. Very fortunate for us the AL had the type of licensing that my parents' LTC policy covered so they could afford to go there. I wasn't sure if my mom (89) was at the AL level, maybe borderline) and the AL said not to worry; they would write up the evaluation to get her accepted as well. So I set everything up to move them yet again. They had a 2 bedroom, 1 bath apartment available, but I chose separate 1 room efficiencies for each of them in the same wing and hall just around the corner from each other. I saw how relaxed my mother was the 2 months dad was in rehab, a stress free break from his constant nastiness. (He had even caused a rodent problem back at IL from hoarding spoiled food in his dresser drawers!) My mother had turned into a bitter depressed old woman over the years from being treated like dirt by this selfish narcissist. It wasn't even a full week settling in when my mom said to me "This was the best idea idea you ever had! When I've had enough of his complaining, I can go to my room and lock the door." She even thanked me and appreciated everything I did to take care of them and didn't know how she'd survive without me. It was nice to hear after years of feeling like nothing I did was ever good enough. They were both negative and judgmental and I realized way back that nothing would ever make them happy. At least she had a little bit of peace and quiet from the long term stress putting up with that s.o.b.
I would think that for dysfunctional couples, just being in the same building would be good enough, or maybe they don't even really want/need that. I suppose it depends on their relationship.
Best of luck!
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NeedHelpWithMom Mar 4, 2021
Your mom was blessed to have you in her life. You were there when she needed you most.
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Yes, there have been instances on this forum where a couple needs to be separated. One put in a separate AL or LTC one in another AL, the other in the MC side if they both are the same facility the other on the AL side. And for some the reason you mention, one abuses the other.

So you separate them can they afford to live in separate places? What I suggest is talking to a lawyer who is well versed in Medicaid. Split the couples assets. When the assets are gone then apply for Medicaid. Some states Medicaid will pay for an AL some don't. In mine you pay privately for 2 yrs at least and then u apply for Medicaid. You need to make sure the AL excepts Medicaid.

There is more to this just giving you the basics and something to be aware of.
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Reply to JoAnn29
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You may not have to separate them. Many MC facilities have shared rooms where both husband and wife can live. In addition, a shared room's cost is the same as a single room.
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JoAnn29 Feb 25, 2021
That's the problem, they are sharing a room and one is abusing the other. She needs them in separate ALs.
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Equal care, equal rights, equal expenses, whether you must separate them or not.
An objective party (Geriatric Care Coordinator?) might be able to help.
And, an objective POA, non-family member might help too.

It would not be okay to 'punish' either spouse just because their illness includes agitation. imo. I am sure that is not your intent. Can the person causing the disruption (agitated one) be temporarily transferred to a geriatric behavioral unit, have meds adjusted and monitored, (say 3-4 weks?), then returned to the AL? Add a part-time caregiver for supervision, and that might work.

I am with you on this idea, to keep the couple together as long as possible. Covid has made it harder.

In answer to your question, yes. I had to observe while the couple was separated, one going to the son's home, dying within 3 months. The other going to the daughter's home, and thriving. There seems to be a dynamic
going on with long-term married couples being bonded.
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Reply to Sendhelp
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Unfortunately, both have dementia. One is amiable. The other is agitated. But neither can tell us what is really going on at this point.
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Reply to frazzledteacher
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I worked ONE DAY for a couple who HAD been in a LTC apartment facility together for about 5 years. The man was a total slug, just sitting all day in a diaper, drinking beer and watching TV. He just needed meals brought to him and someone to put him to bed at night. ( a different CG from a different agency) The wife was a hot mess--she had rapidly increasing dementia and a foul temper. When the LTC place decided she needed a higher level of care, the family moved them back into their condo. It was a total failure.

They did this to save money--and with another couple, maybe it would have worked. But the wife was a slugger and she gave me a black eye within and hour of showing up to work with my supervisor. She fell and weighing over 300 lbs, she was a 3-4 person lift. Then she wanted to use the bathroom and suddenly it became apparent to their kids they hadn't thought this through--mom's wheelchair would not fit through doors and so she was 'stuck' in the main living area. She was manhandled by the 2 of us into the bathroom and it was a fail of epic proportions. She had a massive fecal blowout---we had to call a specialty cleaning company to come--neither of us CGs had the stomach or ability to clean this up.

I know that the cost of 2 separate 'homes' was going to be very pricey and real challenge to make work--and I know as much as they wanted to keep the couple together, it simply was not going to work out.

In the end, they moved dad into a much smaller room and mom into a higher level memory care unit. They were in the same bldg., but I know it wasn't what anyone wanted. It just was what it was.
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Reply to Midkid58
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Some senior living places offer assisted living and nursing home care, as well as memory care on the same campus. This would allow interaction between the couple while also allowing each to have their best living arrangements
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Reply to Daughterof1930
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Just curious...

I read your profile and you don’t give any background information. Could you elaborate on your relationship to this couple? Are they your parents?

The only reason why I ask is because often when we are in the middle of a situation it is extremely difficult to be objective.

For instance, a daughter might say, “I can’t possibly separate my parents. They absolutely belong together. I hope I can find a solution to this problem.”

Meanwhile, one person is suffering, should they remain together.

There are many situations that are unfair. Some we can tolerate in our lives and some should never be tolerated. Do you agree with this?

An objective outsider would most likely say, “Why should one person suffer at the hands of another even if they are husband and wife?”

I take the position of not allowing the innocent party to suffer. It isn’t about placing blame on anyone. It’s more about solving the problem at hand for the innocent person.

There is nothing that can justify cruelty and unnecessary suffering.

I would separate them. They will learn to adapt to their new surroundings.

Best wishes to you and this couple.
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Reply to NeedHelpWithMom
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Have you talked with the spouse that is being abused?

Sometimes we just have to ask them how they would like to proceed. Giving them all the information about the benefits and their ability to see their spouse to ensure they are okay.

Acknowledging the sadness and the pain of the change is also important but, most people that have any mental soundness can understand why their loved one needs more care, in a different setting then they are getting. Trying to keep them as close as possible to ensure visits, if they are feasible is my personal opinion.

Best of luck with this crummy situation.
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Reply to Isthisrealyreal
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frazzledteacher Feb 24, 2021
Unfortunately, both have dementia. One is amiable. The other is agitated. But neither can tell us what is really going on at this point.
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