When Couples Are Separated by Different Care Needs

Read time: 3 minutes

Rina’s parents had been married for decades. Then her 90-year-old father moved into independent living while her 93-year-old mother was placed in long-term care. The family asked for spousal reunification – a shared placement so they could stay together – but there was no clear plan or timeline to make that happen.

This is one of the harder realities in eldercare that doesn’t get talked about enough: care systems are built around individual needs, not couples. When one spouse needs a higher level of care than the other, the default outcome is often separation – different buildings, different care teams, visits that depend on someone else’s mobility and transportation.  The issue is exacerbated in situations where only one spouse qualifies for publicly subsidized assisted living or long-term care, but the other spouse has to find their own way into a private pay independent living residence.  

The BC Office of the Seniors Advocate’s 2025/26 report describes exactly this situation, and notes the emotional toll it takes: distress for both partners, communication gaps about waitlist status, and no clear path back to living together.

Options families should know about

• Residences that offer multiple levels of care on one campus – independent living, assisted living, and long-term care in the same building or complex – so a couple can move as their needs diverge without physically separating.
  • Ask specifically about this when touring any residence, even if only one spouse currently needs a higher level of care.
• Formal spousal reunification requests through the health authority case manager – these exist, but as Rina’s case shows, they don’t come with an automatic timeline. Follow up regularly and in writing.
• Private in-home care  – bringing in consistent paid support for the higher-need spouse can extend the amount of time a couple can stay together at home, delaying the point where separation becomes necessary at all.  In fact, in-home care is an essential component of an aging-in-place strategy for those who wish to remain in their current home for as long as possible.  In many cases it is also cheaper than the cost of moving to a private assisted living or long-term care residence.  
• The Patient Care Quality Office (PCQO) for formally raising concerns about communication, coordination, or reunification planning – this is where Rina’s family ended up going to get real answers.

The takeaway

Separation isn’t always inevitable – it’s often just what happens by default when nobody actively plans around it. Researching care residences early, and using private home care as an aging-in-place strategy, are two ways families can keep more control over the outcome instead of having it decided for them when crisis hits.

Source for all statistics: BC Office of the Seniors Advocate, 2025/26 Annual Report (published July 2026), Section 4.1 “Monitoring Seniors Services Report” and Section 5.2.1 “Long-Term Care Bed Capacity.” Full report: seniorsadvocatebc.ca (Reports and Publications).

If your family finds itself in this position, reach out to us today for help with eldercare planning, residence options, and to learn about our various services to help with aging-in-place if you’re on a waitlist for long-term care in BC.