When one parent needs care and the other doesn't — splitting them up

This article is for informational purposes only and does not constitute medical, legal, or financial advice. Please consult appropriate professionals for guidance specific to your situation.

You're facing something I wish I'd been prepared for: one of your parents needs memory care or skilled nursing, and the other is still independent enough that they don't. The one who's still independent doesn't want to move. The one who needs care needs a facility. And you're about to split them up after fifty or sixty years of marriage, and it feels like one of the cruelest things you could possibly do, even though you're also completely out of options.

Most conversations about elder care assume you're dealing with two parents in the same situation, or one parent. Nobody really talks about this one, which is why when you're facing it, you feel completely alone. You might be the only person in your friend group dealing with this particular kind of heartbreak. But I promise you, you're not the only one. And there are ways to make this work that honor what both of your parents need, even though it won't feel good no matter what.

The honest truth first: this situation contains real loss. Your parents are losing daily life together. The healthy parent is losing their partner's presence at home. The parent needing care is losing the familiar world. Nobody gets to avoid that loss completely. But you can make sure you're not creating more pain than what's already happening because of their health.

When They Have Different Needs

Most of the time, this happens because one parent has developed dementia or serious health changes and the other one hasn't. One of them needs specialized care in a facility. The other one has been managing okay, maybe with some help from you or from a cleaner or a grocery delivery service. They don't need a facility. They just need their life to continue.

The parent who's still independent often has feelings about this that are complicated and layered. They might feel abandoned. Their spouse is moving somewhere without them. The person who's been their partner is leaving, and they're staying. That's a specific kind of grief. They might also feel angry at their sick spouse, which makes them feel guilty. They might feel relieved to have some freedom, which also makes them feel guilty. They're losing the daily version of their marriage while still being married.

The parent who needs care needs to be somewhere safe, with supervision, with access to specific kinds of help. Keeping them at home with their spouse trying to manage is, usually, not safe enough. Your mom might not be able to physically help your dad up if he falls. She might not notice he's not taking his medication. If he has advanced dementia, she might spend her days managing behavior she doesn't understand, in a house that's becoming hard to care for. Keeping them together at home often doesn't actually work.

So you're left with something that's genuinely hard: you have to choose between what's best for one parent and what's best for the other. Most of the time, what's best is splitting them up, at least during the day or week. That means your independent parent stays home and your dependent parent is in a facility. It means they're not together every night. It means your independent parent is aging in their home without their spouse.

Or sometimes it means your independent parent moves to independent or assisted living to be near their spouse in memory care. They move, they're uprooted, but they're close enough to visit their spouse every day. That's a different kind of loss. They're leaving their home, their community, the life they knew, to be near someone who might not even recognize them some days.

There's no version of this that feels good. You're just trying to find the version that hurts the least.

Logistics of Separate Care

The practical side of splitting them up is actually complex. You need one facility for your parent in memory care or skilled nursing. If your independent parent is moving closer, you need to find them a place that's actually close to where the other one is. That's not always simple. They might want to be in independent living, or assisted living, or they might just want a nice apartment in the same town.

Once they're split up, you're managing twice as much. You're monitoring the care at one facility, visiting your spouse there, but also making sure your independent parent is okay, managing their life, handling their finances, checking in on their medical care. Some weeks you'll visit both facilities and still feel like you're not doing enough for either of them.

You're also managing the coordination between them. If your spouse in memory care needs something, you're figuring out how to communicate that to your other parent. You're trying to help visits that might be emotionally difficult. Your independent parent might visit every day, or they might visit rarely because seeing their spouse's decline is too hard. Both of those choices are legitimate. You need to support your independent parent through whatever version of visiting they can actually do.

Some of the logistics that matter: can the facilities accommodate meals together sometimes, maybe weekly? Can they have time together in common areas? Can your independent parent bring them things from home, things that feel normal? Can you create a version of routine that gives them some connection, even if they're not living together?

The financial side also gets more complex. You're potentially paying for two different facilities or living situations. You might need to help your independent parent set up a new home, move them, help them adjust. Insurance might cover different parts of each situation. You need to understand what you're paying for and what it costs.

Your Role as Connector

This is where you become incredibly important. You're the person who's keeping them connected to each other, even though they're not living together. You're the person who might be facilitating visits, who's making sure your independent parent understands what's happening with their spouse, who's checking in on both of them.

Some families find ways to keep the marriage alive even from different facilities. They have standing visits. They have date times, where you pick up your independent parent and bring them to spend time with their spouse. You create little moments of normalcy. Some of these are hard, because your independent parent is visiting someone they love who doesn't always recognize them. Some are gentle and good.

You're also the person who holds space for both of their feelings. Your independent parent might be angry at their spouse for getting sick. That's a feeling they can have with you without it being a problem. Your spouse in memory care might not be able to express complex emotions, or they might express them in ways that are hard. You're paying attention to both of them.

One thing that helps: be honest with both parents about the situation, in ways they can understand. Your independent parent needs to understand why this happened and that it's not their fault, not their spouse's fault, not anyone's fault. It's just what their spouse's body needed. Your spouse in memory care needs to feel safe where they are and know they're loved.

The guilt you might feel about splitting them up is worth examining. You didn't cause their health to change. You didn't choose for one of them to need specialized care. You're doing the thing that makes sense for both of them, even though it's not what you would have chosen. That's different from splitting them up for your own convenience. You're making a hard choice to keep both of them safe.

Some marriages survive this well, with visits and connection and love continuing. Some marriages change in this moment. Your independent parent might discover they actually have energy for their own life now, and that might feel like guilt but it's also permission. Your spouse in memory care is being cared for by trained people who know how to help them. That's actually what they need.

This situation will be complicated for as long as both of them are living. The goal isn't to make it not complicated. The goal is to honor both of their needs as clearly as you can, to keep them connected to the extent possible, and to give yourself permission to not make this feel easy or perfect. It's hard. You're doing it anyway.

How To Help Your Elders provides educational content for family caregivers. This is not a substitute for professional medical, legal, or financial advice. Every family situation is different — what works for one may not work for another.