Alternative Living Arrangements

Aside from living with a spouse, with an adult child, or alone, other living arrangements and relationships are fairly common among the elderly and may raise considerations in care planning. About 5% of persons >= 65 years never married. A substantial proportion of those who never married, are divorced, or are widowed may have long-standing and close relationships with siblings, friends, and partners. Understanding the nature of these relationships assists the health care practitioner in planning care that is in keeping with the patient's wishes.

It is estimated that between 6 and 10% of the U.S. population are homosexual adults, including as many as 3 million elderly persons. Elderly persons in homosexual relationships face special challenges. The health care system in which they operate may not be aware of their sexual preference, may not recognize their partner as having a role in caregiving decisions, 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, may not be able to share a room in a nursing home or other congregate living setting, and may not be recognized as being part of the patient's family. Health care practitioners are well advised to ask questions about partners and living arrangements and to try to accommodate patient preferences.