Emerging issues for older couples: Protecting income and assets, right to intimacy, and end-of-life decisions

Many policies and practices in the long-term-care and end-of-life arenas present challenges to older couples-particularly if they are not married. When applying for long-term care, married couples are offered some income and asset protections under Medicaid while unmarried couples find that their income and assets are at greater risk. When living in various long-term-care facilities, many couples find that their rights to privacy and intimacy have been compromised. Restrictions on expressions of intimacy and sexuality, however, are tightest for couples who are not married. Finally, when approaching death, many older couples find that they have less power over critical end-of-life decisions, especially if not married. This article explores how various long-term-care policies and practices have a direct impact on couples' rights.