By Kathy Kappler, RN

As a senior advisor we often work with couples. Awhile back, I was referred to a lovely couple and visited them at their home. It became clear that the wife needed assistance and the husband was at risk for injuring himself as he assisted her with care. The wife was basically bedridden with a long standing chronic illness. While all of this was quite apparent to me as we visited and I gathered information, I was aware that the husband and wife were not in agreement regarding any plan for assistance. As a Senior Advisor, it is important to listen carefully and gain the trust of the client. I knew that this case would take some time. The wife was receiving physical and occupational therapy at home and there became a problem with compliance of the service and the recommendations for safety. This became an issue of concern and eventually the service was ended and they started with another agency. The husband then became a little frustrated and it took me many conversations to continue to move forward. He is very proud and private and not very open to other people suggesting things. Again, it was important to listen to him and move at a comfortable pace in order to maintain the trust. I wanted to show the husband some options for assisted living and after educating him on the process he agreed. We toured a community that could easily care for his wife and also offer them the social activities that had been very important to them in the past. We toured at a very specific time as he was concerned about only being gone while someone was with his wife. He seemed to be pleasantly surprised with the environment of the community and the apartment that was available. He agreed to let me set up an assessment of his wife from the community to be done at their home. After that was completed, he was taken back at the cost even though I had prepared him what to expect. So I then went over her care needs to help him understand the services. He wanted to show his wife but she was not safe to travel at that time. I suggested he let me show other options so he could compare the cost. He wanted to think about that. And that he did. And he continued to think some more! He has actually agreed to let another company come do an assessment to compare the cost.

There are many issues to consider when working with this couple. The wife can be non-compliant with care at times, has the mindset that she can improve enough to not need the same level of care and get the cost down, and vacillates between very interested in moving and staying home. I respect her desire to improve and while she may improve some from the original assessment, her condition is not likely to have any major change. The husband is very tired and worn out, very protective of his time and schedule, has some chronic back pain certainly aggravated by assisting his wife, and also vacillates between moving and not moving. As a Senior Advisor, it is my role with this couple to continue to call and visit them with the goal of slowly moving them along. I understand it is a huge decision for them to sell their beautiful condo and make this move. Balancing the time they need to not feel pushed with the time I need to make sure they are safe and nothing has happened to cause more concern is challenging. As with other clients, I am available to assist them throughout this process whether it is new living option needed in one day or several months down the road like this couple.

*Image courtesy of Ambro at