The Lifetime Risk of Spousal Nursing Home Use and its Economic Impact on the Community-dwelling Spouse

Published: 2021
Project ID: UM21-12


A single person in a nursing home is relatively well protected financially, because Medicaid covers nursing home expenses once assets are depleted. Couples, however, are less well protected. For them a great financial threat is that one spouse moves to a nursing home and that the associated high cost rapidly depletes household assets, impoverishing the spouse living in the community. Using data from the Health and Retirement Study, this project will quantify the lifetime risk that one spouse will reside in the community while the other resides in a nursing home, to estimate the lifetime distribution of such nursing home nights and the associated cumulative, out-of-pocket nursing home expenses. We will examine how this lifetime risk and cost vary by respondent characteristics. For affected couples, we will study the impact on the household’s asset position, whether the couple spends down to Medicaid eligibility for nursing home expenses, and to what extent Social Security income protects the community-residing spouse from poverty following the spousal nursing home episode.