Assisted Living for Couples in California

Yes. Assisted living communities and board and care homes are licensed in California as residential care facilities for the elderly (RCFEs), and Health and Safety Code section 1569.269 lists the personal rights of the people who live in them. One is the right to share a room with a spouse, a domestic partner or a person of the resident's choice when both live in the same facility and both consent to the arrangement. Another is reasonable accommodation of preferences about rooms and roommates.

The same section says a licensed home may not discriminate against a person seeking admission, or a resident, on the basis of marital status or registered domestic partner status, along with sex, race, religion, national origin, sexual orientation and gender identity.

The physical rules allow it too. Title 22 says no more than two residents may sleep in a bedroom, and that each resident must have a bed, except that married couples may be provided with one appropriately sized bed. So a couple can share a bedroom in a six-bed board and care home as well as an apartment in a large community.

What the right does not do is create a vacancy. A home must have a room that fits two people, and it must be able to care for both.

This is the usual situation: one partner needs daily hands-on help and the other is mostly independent, often after years as the caregiver.

A home treats the two of you as two residents. Before admission it must interview each person, complete a pre-admission appraisal for each and obtain a medical assessment for each. Title 22 also requires an individual written admission agreement with each resident. Our guide to the care assessment explains what is evaluated.

Two practical points follow. First, the home has to be right for the partner with the greater needs. A facility need not accept a particular resident, but if it does, it is responsible for meeting the needs identified in that person's appraisal. Second, the more independent partner becomes a resident too, with a care plan and a fee, even if they need little help at the start.

Age can matter for some couples. RCFEs mainly serve people 60 and older, and the regulations allow a home to accept someone under 60 whose needs are compatible with those of the other residents. If one of you is younger, ask about it early.

California Advocates for Nursing Home Reform points out that memory care is a marketing term, not a legal one. An RCFE that cares for people living with dementia has to meet the state's dementia care requirements, whatever it calls the unit. Our guide to memory care vs. assisted living covers the differences.

Couples in this position usually weigh three arrangements. None is right for everyone, and the answer often changes as the illness does.

California does not set what an RCFE may charge. California Advocates for Nursing Home Reform describes residential care as a private business in which providers charge what the market will bear, and notes that many larger facilities have different fee options depending on the care needed.

That means couple pricing is each home's own policy, and it varies. What the regulations do require is paperwork you can compare. Each resident's admission agreement must state the rate for basic services, give a fee schedule for anything charged separately, and name who pays. With two agreements in front of you, check how the room is charged when two people share it, and how each person's care is charged.

Then ask about change. A couple's bill can shift when one partner's care level goes up, when one moves to memory care or a hospital, or when one dies. Get the home's answer to each case in writing before you sign.

For the ways families cover the cost, see how to pay for assisted living in California. How a couple's income and savings are counted for a benefit program is a question for the program itself or an elder law attorney.

Bring these to the tour, and ask to see the room you would share.

A continuing care retirement community is another model some couples consider. The Department of Social Services describes these as offering independent living, assisted living and skilled nursing, typically in a single community setting, under a continuing care contract. They work differently from a monthly rental and are worth a separate conversation with a legal or financial professional.

• Do you have a room or apartment for two available now, or a waiting list?
• Is there a charge for a second person, and is each person's care billed separately?
• If one of us needs more care later, can we stay in the same room?
• If one of us moves to memory care or passes away, what happens to the other's room and rate?
• Can a spouse who lives elsewhere visit at any time and share meals?
• May we use one bed, or bring our own?

Hamssa Benrekia is a senior living placement specialist in Torrance. She talks with both partners, and the family, about each person's care needs, preferences and the monthly budget, then suggests licensed homes in the South Bay and Harbor area that may suit both, and goes on tours with you. That can include assisted living communities and homes that offer memory care. To talk about your situation, contact Hamssa. The California Assisted Living Placement Guide covers each step of the decision.