Older couples and long-term care: the financial implications of one spouse entering private or voluntary residential or nursing home care

A minority of older people who move into long-term institutional care are married and have spouses who continue living in the community. The financial complexities and consequences for a couple in this situation deserve to be more widely recognised. Data from the Family Expenditure Survey on the incomes of older married couples are used to examine the financial implications for couples of one spouse entering residential or nursing home care, taking into account local authority procedures for assessing residents' contributions to charges and Income Support rules as they apply to both spouses. We look in particular at the consequences of alternative ways couples might share their incomes, and alternative treatments of such sharing by local authorities and the Department of Social Security. We demonstrate that wives remaining at home are more likely to have low incomes and have recourse to means-tested state benefits if their husbands enter residential care than husbands who remain at home when their wives enter care. Local authorities are likely to be able to require larger contributions to their care costs from husbands than wives. On average, wives whose husbands enter residential care are best off financially when their combined income and savings are shared equally, but this leaves husbands with the least money to contribute to their care costs. If it is the wife who enters care the situation is reversed.