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Alternative Living Arrangements for the Elderly

by Daniel B. Kaplan, PhD, MSW, Barbara J. Berkman, DSW, PhD

Living arrangements and relationships that do not involve living with a spouse, with an adult child, or alone are fairly common among the elderly. For example, a substantial proportion of elderly people who never married, are divorced, or are widowed have long-standing and close relationships with siblings, friends, and partners. Understanding the nature of these relationships helps practitioners plan care that is in keeping with a patient’s wishes.

About 6 to 10% of the US population are estimated to be homosexual adults, including as many as 3 million of the elderly. Elderly people in a homosexual relationship face special challenges. The health care system may not be aware of their sexual preference, may not recognize their partner as having a role in caregiving decisions or as being part of the patient’s family, and may not provide services that are appropriate for their circumstances. For example, a partner may not have legal standing in decision making for a cognitively impaired patient and may not be able to share a room in a nursing home or other congregate living setting. Health care practitioners should ask questions about partners and living arrangements and try to accommodate patient preferences.

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