“Living Apart Together” couples need to discuss caregiving, health issues with family, each other

Published on February 14, 2022 in Rhode Island News Today

With divorce rates soaring since the 1990s, and aging baby boomers 50 and older having doubled in number, this trend, along with longer life expectancy and those becoming widowed, has resulted in many older adults forming new partnerships later in life. Researchers call this new phenomenon, “Living Apart Together’ (LAT),” as an historically new form of family that allows an intimate relationship without sharing a residence. And it is gaining popularity as an alternative form of commitment. 

According to Couple Therapies, Inc., a 2016 national survey by legal scholar Cynthia Grant Bowman, as many as 9% of older American couples have Living Apart Together (LAT) relationships.

A year after the death of my oldest sister, Mickey, in 2008, my brother-in-law, Justin, an endodontist who had become a widower, found love and began to date Ruth, also widowed. Over 10 and a half years (from their late 60s to late 70s), the couple shared companionship by LAT, traveled to interesting locations for his medical conferences, even traveling overseas to France and Italy. Both enjoyed dining out, attending theater, and enjoying music. “Our relationship was wonderful for this stage in our lives,” recalls Ruth. “At our age in life, and both having grown children, it was just easier to maintain our own homes and our separate lives, but we did many things together,” she said. 

Like Justin and Ruth, millions of older persons are discovering the benefits of LAT. It allows couples to enjoy autonomy in their own living space and to maintain pre-existing relationships with their friends and children. LAT couples are able to be in a loving, long-term, intimate relationship where they have emotional support without having to cohabitate or be married. Often, and especially for those who have been widowed, there is a desire to show respect to their loved one but not engaging in a formalization of the relationship through the legal and religious act of marriage.

LAT is being studied by researchers at the University of Missouri (UM) who say that while the trend is well understood in Europe, it is lesser known in the United States. This means that with increased longevity, it becomes challenging as to how LAT partners can engage in family caregiving or decision-making, and how it could affect family needs.

“What has long been understood about late-in-life relationships is largely based on long-term marriage,” said Jacquelyn Benson, an expert of older adult relationships from the University of Missouri (UM), in a Feb. 9, 2017, statement discussing their LAT partnered research. “There are now more divorced and widowed adults who are interested in forging new intimate relationships outside the confines of marriage. Recent research demonstrates that there are other ways of establishing long-lasting, high-quality relationships without committing to marriage or living together. However, U.S. society has yet to recognize LAT as a legitimate choice. If more people—young and old, married or not—saw LAT as an option, it might save them from a lot of future heartache,” she says.

In this UM study, “Older adults developing a preference for living apart together,” Benson and Marilyn Coleman, Curators Professor of Human Development and Family Science, interviewed adults who were at least 60 years old and in committed relationships but lived apart. The researchers found that couples were motivated by desires to stay independent, maintain their own homes, sustain existing family boundaries, and remain financially independent. Couples expressed challenges defining their relationships or choosing terms to properly convey the nature of their relationships to others, they say, many citing that traditional dating terms such as ‘boyfriend’ and ‘girlfriend’ to be awkward terms to use at their ages.

“While we are learning more about LAT relationships, further research is needed to determine how LAT relationships are related to issues such as health care and caregiving,” Benson said. “Discussions about end-of-life planning and caregiving can be sensitive to talk about; however, LAT couples should make it a priority to have these conversations both as a couple and with their families. Many of us wait until a crisis to address those issues, but in situations like LAT where there are no socially prescribed norms dictating behavior these conversations may be more important than ever,” she says.

Another UM research study, “Living apart together relationships in later life: Constructing an account of relational maintenance,” Benson found that if more people—young and old, married or not—saw ‘Living Apart Together’ as an option, it might save them from a lot of future heartache. However, caregiving needs might cause such couples to change living arrangements.

These couples choosing to “live apart” are tested when their partner requires caregiving. “While autonomy is paramount for these couples, participants in the study also emphasized the importance of having a flexible mindset about their relationships, especially when one partner needs additional care,” she says, noting that certain family issues that become important in your later years, like caregiving or medical decision-making, could be difficult to navigate for the LAT couples and their relatives.

“The societal standard for elder caregiving in the United States is to expect spouses and adult children to step in as primary caregivers; however, we do not know-how these expectations apply in LAT arrangements,” Benson said in a statement releasing the findings Jan. 8, 2018, study. “In our research we are learning that, while living apart seems to be almost universally viewed as a necessity for maintaining relationship satisfaction for these couples, paradoxically couples also are willing to make changes in living arrangements to provide caregiving support to one another,” she said. She found that for most of these couples, living apart and being independent was considered ideal.  Participants in the study recognized that keeping separate homes was the simplest strategy for safeguarding their autonomy, she said.

Benson cautioned against making any conclusions about actual caregiving behaviors. “Most of the individuals we interviewed had not been tested by the realities of caregiving [yet] within their current LAT partnerships. It will be important to follow LAT partners over time to see if their willingness transforms into action and understand the mechanisms that explain these care provision decisions,” she said. Benson called for further research to better understand repartnering in later life.

Whitehouse Pushes for COVID-19 Senate Proposal to Protect Residents, Employees

Published in the Pawtucket Times on March 1, 2021

As the one-year anniversary of the coronavirus disease (COVID-19) pandemic approaches, U.S Senator Sheldon Whitehouse (D-RI) joins Senators Bob Casey (D-PA), Raphael Warnock (D-GA), Richard Blumenthal (D-CT), and Cory Booker (D-NJ) in introducing a legislative proposal to save lives of nursing home residents and employees and assist with vaccinations.   At press time, over 1.3 million nursing residents and workers in long-term care facilities have been infected with COVID-19 and more than 170,000 have died so far, accounting for approximately 35 percent of COVID-19 deaths nationwide.

Taking a Close Look at S.333

Last week, S.333, “The COVID-19 Nursing Home Protection Act,” was thrown into the legislative hopper.  Initially introduced last Congress, the latest version, now being considered by the Senate Finance Committee, would provide funding to give nursing homes the needed resources to keep residents and workers safe; funding would go towards providing vital infection control assistance and organizing local health and emergency workers – known as “strike” or “surge” teams – to manage COVID-19 outbreaks and care for residents.  At this time no House companion measure has been introduced.

S. 333, introduced on Feb. 22, would provide $210 million for the Secretary of HHS to contract with quality improvement organizations to provide essential infection control assistance to nursing homes. 

Moreover, the legislative proposal would also send $750 million in funding to states to implement “strike” or “surge” teams. States are using “strike” or “surge” teams to ensure a sufficient number of aides, nurses and other providers are available to care for residents. Such teams also help manage COVID-19 outbreaks within a facility, particularly as vaccinations proceed in these settings. Since August, approximately 20 percent of nursing homes have reported each week that they do not have a sufficient workforce to care for residents.”

The impact of the pandemic has been devastating to minority communities, where reports have indicated that facilities serving significant numbers of Black and Hispanic residents were twice as likely to have COVID-19 infections. S. 333 would require the HHS Secretary to collect and make public demographic data on COVID-19 cases and deaths, including information on age, race, ethnicity, and preferred language. 

Whitehouse supports President Joe Biden’s call for the implementation of strike teams in his American Rescue Plan to help address these persistent shortages as well as the collection and dissemination of data on suspected and confirmed COVID-19 cases and deaths by race, ethnicity and preferred language.

Controlling COVID-19 Outbreaks in the Nation’s Nursing Homes

“Nursing home residents and staff have been through a traumatic year,” said Whitehouse who sites on the Senate Finance Committee.  “We need to prioritize vaccinating and caring for the Americans who live and work in these settings.  That means providing additional staff as needed to control outbreaks and making sure every resident and care worker who wants a vaccine can get one.,” said the Rhode Island’s junior Senator who has served since Jan. 4, 2007.

“As more than 170,000 residents and workers in nursing homes and other long-term care facilities have died from COVID-19, it is critical that Congress pass the COVID-19 Nursing Home Protection Act,” says Sen. Bob Casey, Chair of the U.S. Special Committee on Aging.

“This bill would address persistent staffing shortages in nursing homes by utilizing strike teams, promote infection control protocols and require that demographic data is collected on COVID-19 cases and deaths,” notes Casey.

Adds Casey, “The challenge this terrible virus poses are unprecedented and requires an immediate and extraordinary response. That is why my colleagues and I are advancing strategies to give states what they need – funding for ‘strike’ teams to help address staffing shortages in nursing homes and assist with vaccinations in these settings. We have an obligation to protect our most at-risk citizens.”

 “We applaud the efforts of Senator Whitehouse and his colleagues to provide funding for the protection of nursing home residents and staff,” said Scott Fraser, President and CEO of the Rhode Island Health Care Association, an affiliate of the Washington, DC-based American Health Care Association.  “We are especially pleased with the creation of strike teams to address the critical issue of staffing shortages during times of crisis.  This is a suggestion that RIHCA brought to Senator Whitehouse’s attention this past Spring when our homes were in critical need of additional staff due to the pandemic.  We thank him for listening and taking action,” he says.

At press time, 12 Democratic Senators join Sens. Whitehouse, Casey, Warnock, Blumenthal, and Booker, becoming cosponsors to this legislation.  They are: Sens. Maria Cantwell (D-WA), Bob Menendez (D-NJ), Jeanne Shaheen (D-NH), Tina Smith (D-MN), Amy Klobuchar (D-MN), Tammy Duckworth (D-IL), Chris Van Hollen (D-MD), Sherrod Brown (D-OH), Catherine Cortez Masto (D-NV), Jack Reed (D-RI), Maggie Hassan (D-NH) and Mazie Hirono (D-HI). 

A Call for Bipartisan Support

With the Senate now under Democratic control, there is a good chance that S. 333 will be considered by the Senate Finance Committee and if passed sent to the floor for consideration.   During the 116th Congressional session, the former Senate GOP Majority Leader, Mitch McConnell, of Kentucky, who often called himself the “Grim Reaper,” sent Democratic legislation to a legislative graveyard, refusing to act on Democratic legislation, even proposals with bipartisan support.

It’s time for Senate Republicans to support a Democratic proposal that protects the health and safety and the wellbeing of nursing home residents and workers in the nation’s 15,600 nursing homes. 

Partisan politics shouldn’t play a role in Senate Minority Leader Mitch McConnell’s decision to not urge his caucus to support this worthy legislative proposal.  S. 333 truly deserves bipartisan support and enactment, especially during the ongoing COVID-19 pandemic.

Cicilline Pushes for House Aging Committee

Published in Pawtucket Times on January 4, 2021

Yesterday, the 116th Congress came to an end, with the new Congressional session convening that day with the swearing in of lawmakers elected on Nov. 3, 2020.   Some political observers say that legislative gridlock during this Congress made it the least productive in the last fifty years.  GovTrack.us, reported that of 16,587 bills thrown into the legislative hopper, 252 became enacted laws, and 712 resolutions were passed.

During a Fox interview last February, Senate Majority Leader Mitch McConnell (R-Kentucky) candidly admitted he prevented the consideration of hundreds of bills passed by the House that were sent over to the Senate for consideration.   McConnell’s “Legislative Graveyard” created by his controlling the legislative agenda by blocking debate, markup and refusing to allow a vote on House proposed legislation, was widely reported by the media and documented in a 33-page report, “2020 Democracy Score Card,” released last September by Common Cause, a watch dog advocacy group.

The results of tomorrow’s Georgia Senate runoff will determine if the GOP can maintain legislative control of the Senate. If Senate Democratic candidates win their seats, the Senate Democratic caucus will have the majority with 50 Senate seats, with Vice President Kamala Harris having a tie breaking vote. But if McConnell, called “the Grim Reaper” by his critics, continues to maintains political control of the upper chamber, Democratic legislative proposals introduced to improve the quality of life of America’s seniors and to help those struggling to financially make ends meet, would be rejected.  

Legislative Proposals to be Reconsidered by New Congress

During the116th Congress, Washington, DC-based aging advocacy groups, including the National Committee to Preserve Social Security and Medicare (NCPSSM) , AARP, Social Security Works, Leadership Council on Aging, and National Council on Aging, pushed for passage of legislative proposals to enhance the quality of life of America’s seniors and to strengthen and expand Social Security and Medicare, to keep these programs fiscally sound.  As the new Congress begins, lawmakers might consider bringing back legislative proposals that were not enacted in the previous Congressional session because of a Republican-controlled Senate.  Here are a few legislative proposals that have some merit and I hope to see reintroduced this year:

Congressman John Larson (D-Conn.) called on Congress to finally address the Social Security “Notch” issue. By ignoring this issue, workers born in 1960 and 1961, would likely see lower Social Security retirement benefits in the future, charged NCPSSM.  Last session, Larson, who chairs the House Ways and Means Social Security Subcommittee, introduced the “Social Security COVID Correction and Equity Act,” to increase benefits for those born in 1960 and 1961 without impacting the benefits for any other beneficiary. 

Larson also introduced the “Social Security 2100 Act” to strengthen and expand Social Security.  The landmark legislation would keep the program financially healthy for more than 75 years, while boosting benefits for all retirees. Congress must work during the 117th session to protect and expand the nation’s Social Security program.

The late Maryland Congressman Elijah E. Cummings, Chair of the House Oversight Committee, introduced the “Lower Drug Costs Now Act” which the House passed last session, would allow Medicare to negotiate prescription prices with Big Pharma, which would save the government and seniors nearly $350 billion in drug costs. The bill would also expand traditional Medicare by adding dental, vision, and hearing benefits. 

Additionally, a bipartisan crafted bill, the “Prescription Drug Pricing Reduction Act,” introduced by Senators Chuck Grassley (R-Iowa), and Ron Wyden (D-Ore.), was not allowed to be considered on the Senate floor by Senate Majority Leader McConnell.  According to the Congressional Budget Office, this legislation would save taxpayers $95 billion, reduce out-of-pocket spending by $72 billion and finally reduce premiums by $1 billion.

Almost three months ago, the Social Security Administration announced that approximately 70 million Americans would see a meager 1.3 percent cost of living adjustment (COLA) increase to Social Security benefits and Supplemental Security Income.  With retirees experiencing financial difficulties during the pandemic, a $20 increase in their monthly check might not help them to pay for spiraling health care and drug costs, along with the expenses of purchasing personal protective equipment and cleaning supplies to keep them safe. 

Following the announcing of the 2021 COLA, Congressman Peter DeFazio (D-Ore.), chair of the House Transportation Committee, introduced the “Emergency Social Security COLA for 2021 Act” to provide Social Security beneficiaries with a 3 percent increase (or a $250 per month flat increase) which would reduce the impact of the small 2021 COLA increase. 

With COVID-19 quickly spreading throughout the nation’s nursing homes and intermediate care facilities, U.S. Senators Bob Casey (D-Pa) and Sheldon Whitehouse (D-R.I.), “The Nursing Home COVID-19 Protection and Prevention Act,” to provide needed resources to facilities to protect frail residents and staff. Residents in these facilities are among the most vulnerable because of their age and underlying medical conditions.  Days after the introduction of the Senate bill, Congressman David N. Cicilline (D-R.I.), signed on as a cosponsor of the House version.  

This legislative proposal would help states implement strategies to reduce the spread of COVID-19 in congregate settings, including through the purchase of personal protective equipment (PPE) and testing and to support nursing home workers with premium pay, overtime and other essential benefits.

New Push to Reestablish House Aging Committee

“After a lifetime of hard work, seniors should be able to enjoy their retirement years with dignity and peace of mind,” says Rhode Island’s Cicilline. “It’s the best way to secure the future of Medicare and Social Security, bring down the cost of prescription drugs, and find solutions for housing, transportation and long-term care issues that are especially important to Rhode Island seniors,” he says.

A long-time advocate for seniors, Cicilline announces in this weekly commentary his intentions of reintroducing a House resolution in the 117th Congress to reestablish the House Aging Committee

During the previous three Congressional sessions, Cicilline, representing the state’s first legislative district, introduced a House Resolution (just 245 words) to reestablish a House Permanent Select Committee on Aging. Two of the times a Republican-controlled House blocked consideration of the House Resolution. 

According to Cicilline, the House can easily create an ad hoc (temporary) select committee by just approving a simple resolution that contains language establishing the committee—giving a purpose, defining membership, and detailing other aspects.  Funding would be up to the Appropriations Committee. Salaries and expenses of standing committees, special and select, are authorized through the Legislative Branch Appropriations bill.

The previous House Aging Committee was active from 1974 to 1993 (until it was disbanded because of budgetary issues) put the spot light on an array of senior issues including elder abuse, helped increase home care benefits for older adults and helped establish research and care centers for Alzheimer’s disease.  

Cicilline noted that a House Aging Committee would perform comprehensive studies on aging policy issues, funding priorities, and trends.  Like its predecessor, its efforts would not be limited by narrow jurisdictional boundaries of the standing committee but broadly at targeted aging policy issues, he notes.

“I look forward to working with my colleagues on both sides of the aisle to get the job done,” says Cicilline.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Updated on Jan. 4, 2021