Separating couples in long-term care: Heartbreaking

The golden years are meant to be shared. For couples who have built a life together, cherished countless memories, and navigated life’s journey side-by-side, the prospect of separation due to long-term care can be not only heartbreaking but also a profound disruption to their well-being. In Canada, a growing concern is the reality that many couples find themselves physically separated when one or both partners require long-term care services. This blog post delves into this critical issue, exploring the challenges faced by Canadian couples and examining international models that prioritize keeping loved ones together.

The Heartbreaking Reality: Separation in Canadian Long-Term Care

For many Canadian seniors, entering a long-term care facility marks a significant life transition. While the goal is to provide necessary medical attention and support, the current system often fails to adequately accommodate the unique needs of couples. Admitting spouses into the same facility, let alone the same room, can be a complex and often insurmountable hurdle.

Why does this separation happen?

• Facility Specialization: Many long-term care homes are designed with specific levels of care in mind. If one partner requires a higher level of medical attention or specialized services (e.g., memory care), they may need to be placed in a facility that offers those specific resources, which might not be available for their spouse.
• Availability and Waiting Lists: Finding a spot in a long-term care facility is often a lengthy process. When a couple requires care simultaneously, the chances of securing two adjacent or even available spots in the same facility are slim.
• Room Availability: Even if both partners are admitted to the same facility, the availability of private or semi-private rooms for couples can be extremely limited. Many facilities primarily offer single-occupancy rooms.
• Cost and Funding: While publicly funded care exists, the availability of funding for shared accommodation or specialized care that accommodates couples can be inconsistent across provinces and territories.
• Individual Health Needs: Sometimes, the differing and evolving health needs of each partner can necessitate placement in different environments, leading to separation.

The emotional toll of this separation cannot be overstated. For couples who have spent decades together, losing that daily physical presence, the comfort of a shared touch, and the simple act of being in each other’s company can lead to:

• Increased Loneliness and Isolation: The absence of a life partner exacerbates feelings of loneliness, a significant risk factor for declining mental and physical health in seniors.
• Heightened Anxiety and Depression: The stress of separation can trigger or worsen anxiety and depression, impacting overall mood and cognitive function.
• Diminished Quality of Life: The joy and sense of security derived from being together are lost, leading to a significant decrease in the overall quality of life for both individuals.
• Caregiver Burnout (for family members): When couples are separated, family members often bear the added burden of coordinating visits to two different locations, increasing stress and exhaustion.

Looking Abroad: Innovative Models for Keeping Couples Together

Fortunately, Canada is not alone in facing this challenge. Several countries have implemented innovative approaches and policies that prioritize keeping couples together in long-term care settings. These models offer valuable insights and potential solutions for Canada to consider.

1. The Netherlands: “Living Apart Together” Suites (LAT)

The Netherlands has been a global leader in person-centred care, and this extends to couples. They have pioneered the concept of “Living Apart Together” (LAT) suites.

• How it works: LAT suites are designed to allow couples to live in separate, but connected, rooms or apartments within the same care facility. These suites typically include a shared living space, such as a kitchen or lounge area, that the couple can use together. Each partner has their own private bedroom and bathroom.
• Benefits: This model provides couples with their own personal space while ensuring they can easily interact, share meals, and maintain their intimate relationship. It recognizes the importance of autonomy while fostering togetherness. This approach also allows for individualized care plans within the shared living environment.

2. Australia: Co-location and Couple-Focused Accommodation

Australia has also made strides in recognizing the importance of couples in aged care.

• Co-location Strategies: Some Australian aged care providers are actively seeking to co-locate couples, even if their care needs differ. This might involve placing them in the same wing or floor of a facility, with access to shared spaces and resources.
• Dedicated Couple Accommodation: Some facilities are specifically designed with accommodation options for couples, offering larger rooms or interconnecting suites that cater to their shared living needs.
• Policy Encouragement: There’s a growing policy push to encourage aged care providers to consider couple-specific needs during the admission and placement process.

3. United Kingdom: Person-Centred Care Planning and Flexibility

While not always a dedicated physical space, the UK’s emphasis on person-centred care planning can be leveraged to support couples.

• Holistic Assessments: Care assessments in the UK often take a holistic view of an individual’s needs, which can include their relationship status and the importance of their partner.
• Flexible Accommodation Options: While not always readily available, the system encourages flexibility in accommodation where possible, aiming to find solutions that keep couples together when feasible. This often involves close collaboration between care providers, families, and local authorities.

What Can Canada Learn and Implement?

The experiences of other countries offer a roadmap for improving long-term care for couples in Canada. Implementing some of these strategies could significantly enhance the well-being of seniors and strengthen families.

• Advocating for Couple-Friendly Infrastructure: Long-term care facilities in Canada need to be designed or retrofitted to include more options for couples. This could involve creating interconnected rooms, shared living spaces within suites, or dedicated couple units.
• Prioritizing Couple Placement in Admissions: Admissions policies need to be re-evaluated to give greater priority to keeping couples together. This requires greater coordination between different care facilities and a more flexible approach to assessment.
• Investing in Specialized Training for Staff: Caregivers and facility staff need to be trained to understand and support the unique dynamics of couples in long-term care. This includes recognizing their emotional needs and facilitating their continued intimacy.
• Provincial and Federal Policy Reform: Governments at all levels need to examine existing policies and funding models. Incentives could be offered to facilities that provide couple-friendly accommodation, and funding streams could be established to support these arrangements.
• Promoting a Culture Shift: Ultimately, there needs to be a cultural shift within the long-term care sector in Canada – one that truly values and prioritizes the lifelong bond of marriage and partnership.

Holding Hands Through the Years, Even in Care

The desire to stay together remains a powerful constant for couples, even as they navigate the complexities of aging and long-term care. By learning from international best practices and advocating for systemic change, Canada can move towards a future where the promise of “for better or for worse, for richer or for poorer, in sickness and in health” extends to the most vulnerable years of life, ensuring that couples can continue to hold each other’s hands, even within the walls of a long-term care facility.

What are your thoughts on this issue? Have you or a loved one experienced separation in long-term care? Share your stories and suggestions in the comments below.