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Getting long-term care for a spouse or partner

As couples get older, partners or spouses sometimes must change their roles to become primary caregiver. Ultimately, when this task becomes unreasonably difficult, they must decide when the time is appropriate for obtaining long-term nursing home care.

Almost 25 percent of family caregivers in this country between the ages of 65 and 74 are caring for their spouse or partner. This is as high as 46 percent for those who are at least 75, according to an AARP 2015 report.

At first, caregiver tasks may be comparatively easy and include keeping medical appointments, furnishing meals, helping with medications and providing a safe place to live. These responsibilities become even more frequent and emotionally and physically taxing as that person's health deteriorates. Caregiving may become a full-time task.

Long-term care planning should take place before it is needed and, if possible, when the ailing person can take part in decisions. This allows time for consideration of finances, the feasibility of available long-term care facilities and other matters.

There are signs that long-term care is needed. First, the caregiver is not getting enough sleep because their partner or spouse is waking up throughout the night. Ongoing exhaustion complicates daily tasks, makes simple decisions harder and can cause accidents.

Next, medications become too complicated. Older people in this country, on average, take up to five prescription drugs daily. These have different requirements and timing. Some must be taken on a full stomach, some on an empty stomach, at night or in the morning. Side effects and a patient's resistance make this even more challenging.

Finally, the physical tasks become overwhelming. Helping a spouse or partner with eating and going to the bathroom, lifting them in and out of bed or up from a fall is strenuous. These can even become dangerous.

The next important step in proceeding with long-term care is gaining the agreement of the couple's children. They should be invited to see the person's daily lives and the challenges with caring for them. A therapist, social worker or advocate from a local agency on aging can provide resources and help.

An attorney can help with this planning, dealing with and protecting assets and seeking assistance, such as Medicare. Important estate documents may also be drafted.

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