Enduring commitment: older couples living apart

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  • 1 The Open University, , UK
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As people live longer, there is an increasing possibility of couples becoming separated because one partner moves into a care home. Our qualitative mixed-method pilot study in an English town involved eight married couples aged over 65 years to explore experiences and practices of couplehood in these circumstances. This article focuses on the most striking emergent element of expressed couplehood in these now challenged long-term relationships: commitment. Drawing on in-depth (biographical) individual and joint interviews, observations and emotion maps, this article explores how separation affected the couples’ current sense and enactment of commitment to the relationship. Commitment in the partnership is now often one-sided. How committed the community-living partner feels – and its enactment – is heavily shaped by the shared history of happy and unhappy periods in the relationships, current contextual constraints, and family and institutional support.

Abstract

As people live longer, there is an increasing possibility of couples becoming separated because one partner moves into a care home. Our qualitative mixed-method pilot study in an English town involved eight married couples aged over 65 years to explore experiences and practices of couplehood in these circumstances. This article focuses on the most striking emergent element of expressed couplehood in these now challenged long-term relationships: commitment. Drawing on in-depth (biographical) individual and joint interviews, observations and emotion maps, this article explores how separation affected the couples’ current sense and enactment of commitment to the relationship. Commitment in the partnership is now often one-sided. How committed the community-living partner feels – and its enactment – is heavily shaped by the shared history of happy and unhappy periods in the relationships, current contextual constraints, and family and institutional support.

Introduction

In the UK, as in other Western contexts, married older1 adults (aged over 65 years) are less likely than singles to enter long-term residential care2 because partners often provide mutual care and support (Thomeer et al, 2017). Rising life expectancy is enabling couple relationships to last much longer (ONS, 2013). Yet for some, the increasing care and housing needs of one partner can result in involuntary separation and living apart through a care home move (Glasier and Arbeau, 2019). Unlike Sweden, where couplehood is accommodated in these circumstances (Torge, 2018), in the UK a care home move almost always separates couples. With the increased likelihood of progressive and chronic illnesses with age (House of Lords, 2013), more couples may likely find themselves in this situation. Given this invisibility of couplehood in UK residential care policy and practice, investigating how relationships are maintained and practised becomes important for understanding how to support both partners.

The context and conditions shaping this form of living apart are distinct from other LAT (living apart together) (Duncan and Philips, 2011) and LLAT (living apart together in later life) relationships (Connidis et al, 2017). Here, living apart is likely to occur in long-established, often heterosexual marriages, involving previous caregiving/receiving at home, with remote possibility of living together again. Unlike LLAT, LA/CH (living apart via care home) is in response to external constraints of increasing care and housing needs, rather than a particular solution to reconciling relationship intimacy with autonomy. This form of living apart is unconventional: expectations of conducting the relationship at a distance are not a normative aspect of couplehood for married older couples.

Our pilot study in an English town explored how couplehood is practised and maintained by married heterosexual couples living apart in response to the greater health and care needs of one partner. We found that while self-identifying as couples (a prerequisite for participation), CL (community living) spouses varied in the ways and extent to which they sustained this relationship. In this article we utilise the analytical lens of commitment to examine this variation, adding to the literatures on commitment and living apart.

Background

Commentators note that historical time and life phase (age) at which a partnership is formed are important for understanding the sociocultural norms shaping the conduct of intimate and family life (Bildtgard and Oberg, 2017). Our sample of couples born between 1920 and the 1950s comprises both post-Second World War and the oldest members of baby boomer generations (Philipson, 2007) who have experienced broader normative sociocultural shifts in intimate relationships. Prior to the 1970s, in the UK and other Western contexts, marriage was the only socially acceptable form of co-residential sexual relationship (Beaujouan and Bhrolcháin, 2011). The landscape of intimacy has changed since then – for those (re)partnering at ages 60 and over, it is now common to choose from alternative acceptable union forms (for example, cohabitation, LAT) including remarriage. Notwithstanding the changing sociology of intimate relationships in later life (Connidis et al, 2017), the (heterosexual) marriage continues to be dominant among older adults despite the growing rise in divorce since the turn of the century, although this largely accounts for those who are ‘young’ old (65–74 years) (ONS, 2017). In 2017, 60 per cent of people aged 65 and over in England were married or in a civil partnership, 10.5 per cent were divorced, 24.1 per cent were widowed and 5.5 per cent were single (ONS, 2017). The proportion aged 70 years and over who were married also increased from 50.3 per cent in 2008 to 55.8 per cent in 2018 (ONS, 2019). Contemporary cohorts who formed partnerships prior to the 1970s grew up in a culture where marriage signalled lifelong commitment (Hackstaff, 1999).

Until the late 20th century, the sociocultural context for heterosexual marriages in the West was characterised by the breadwinner-homemaker model, with a highly gendered division of labour rather than espousing equality and partnership ideals (Chambers et al, 2009). Marriage also signified sexual exclusivity. Women were primarily required to be good mothers, homemakers and partners, with participation in paid work (mostly part time and non-pensionable) acceptable only if it served family interests (Wilson, 2006). The interweaving of marital commitment with gender norms and wives’ childrearing responsibilities rendered marriage a highly gendered institution, disadvantaging women more than men. Financial dependency on husbands often contributed to remaining married. But these cohorts of young and mid-life adults also became exposed to wider shifts in family and intimate life – particularly, the increasing participation of women in paid work and the rising social acceptability of other union forms and divorce. How intimate relationships are experienced, therefore, is likely to be variously patterned by the wider sociohistorical changes, individual values, beliefs and meanings ascribed to marriage, gender, age and material circumstances, reflecting different degrees of autonomy (Widmer et al, 2006).

The research suggests that older adults in long-standing partnerships3 are more likely to stay married for life, evidencing coexistence of intimacy alongside gendered inequalities (Chambers et al, 2009). Considerable continuity is noted in the gendered patterns of everyday marital life and relationship quality pre- and post-retirement, furthering closeness or else distance and conflict. Ageing and health conditions may lead to renegotiation and redefinition of previously shared intimacies (for example, separate beds or rooms) including sexual intimacies (Hinchliff and Gott, 2004), but gender gaps in domestic work and money management persist (Bisdee et al, 2013), with men likely to do less housework, and retaining strategic control over household finances. Relationship dissatisfaction apart, those in unhappy marriages also persist (Hawkins and Booth, 2005), leading commentators to infer that marital commitment supports the continuity of unhappy marriages (Chambers et al, 2009).

Progressive illnesses, in particular, reshape relationship and gender dynamics between couples with potentially widening intellectual and emotional gaps, often long before a partner enters a care home (Rolland, 2017). Loss of emotional, intellectual, social and sexual intimacies, alongside the disruption to well-established gendered practices of household labour, provides the potential for conflict (Boyle, 2013). The practical demands of caring alongside progressive loss of reciprocity leaves the spouse who is in better health responsible for initiating intimacies that may have previously been shared or instigated by the other partner (Hayes et al, 2009).

Unlike cohabitation and LLAT, caregiving is a normative aspect of marital commitment (Cash et al, 2019), becoming less gendered during later life, with husbands and wives providing similar amounts and types of care when spouses are seriously ill (Langner and Furstenberg, 2020). However, caregiving approaches and strategies still tend to follow gendered expectations, norms and repertoires (Calasanti and King, 2007; Williams et al, 2017). Depending on the quality of relationship, caregiving may be viewed positively, as an extension of intimacy – or resented, and given reluctantly (Ray, 2000; Burridge et al, 2007).

When informal arrangements break down, care may be handed over to a care home. Persistent negative discourse on care homes, long defined as ‘institutional’ and part of the social imaginary of the fourth age (Gilleard and Higgs, 2013), means that relinquishing care may be emotionally distressing for the CL spouse and experienced as a form of abandonment (Milligan, 2005). Within the UK, eligibility to move into a care home is means-tested for the cared-for individual. Couplehood is not considered or accommodated in policy and practice. Unless both partners have qualifying care needs, or (rarely) can self-fund the ‘healthy’ partner’s place (if desired), such moves generally lead to separation and living apart. Data about partnership status at care home level is unavailable in England although most care home (CH) residents are likely to be widowed or single with the greater proportion being women (ONS, 2011). Contrasting with community care policies in the UK, which assume the availability of – and increasingly rely on – familial care to enable ageing-in-place, the role and status of the family in institutional care remains unacknowledged and unaddressed (Puurveen et al, 2018).

Previous research that has focused solely on the experiences of CL spouses (mostly married women) of CH partners with cognitive impairments (including Alzheimer’s, other dementias and Parkinson’s disease) highlight the significant impact of illnesses on marital relationships and relationship maintenance when living apart. This work notes that visits were the primary way for couples to come together (Tilse, 1997; Forshund and Ytrehus, 2018), so continuing and maintaining the couple relationship fell on the visiting spouse. Visiting frequency may indicate something about the degree of closeness, but, equally, may be shaped by the CL spouse’s own health and mobility, socioeconomic circumstances, distance to the care home and available transport (Ross et al, 1997; Baumbusch and Phinney, 2014). LA/CH is a diverse experience. CL spouses report intellectual and emotional dissonance in the relationship; varied feelings of couplehood (for example, feeling married/unmarried); adapting to new ‘visiting’ roles; and variously involving themselves in the lives of their (CH) partners (Kaplan, 2001; Braithwaite, 2002). Despite illness and changed qualitative experiences, CL spouses express a sense of commitment to the relationship, explained variously as marital vows, love, marital duty or obligation.

Older couples’ general persistence in marriages, including unsatisfactory ones, is often explained away by marital commitment. From the perspective of longevity, enduring marriages may be viewed in a unidimensional way as evidence of lifelong commitment. Consequently, commitment among older married couples remains underexplored empirically. Yet, highlighting the significance of commitment, Canary and Dainton (2006) note that not only does it shape whether partners engage in relationship maintenance practices, but also that these are likely to vary by the multidimensional aspects that constitute commitment. How commitment in LA/CH is understood, acknowledged and enacted therefore becomes important to investigate, since responsibility for continuing and maintaining the relationship lies primarily with the visiting spouse.

On commitment

‘Commitment’ is broadly understood as rooted in a ‘presumption’, a ‘hope or desire’, a ‘belief’ that one’s intimate relationship will last a lifetime (Jamieson et al, 2002). Theorisations of commitment often build on Johnson’s (1991) multidimensional framework, which comprises three distinct sociocultural elements: personal, moral and structural. Any relationship could have all three commitment elements, a combination, or focus on one aspect.

LAT may be variously sought at different stages across the lifecourse (Duncan and Phillips, 2011; Coulter and Hu, 2017) to reconcile and/or balance couplehood with autonomous living and, especially among LLAT relationships, to actively resist traditional gendered arrangements (Connidis et al, 2017). Marriage is more complex, interweaving personal, moral and structural elements of commitment with gender norms and sexual exclusivity. For married older couples, who have a longer shared relationship history with specific elements of commitments developing over time (Smart, 2007), commitment may contribute to relationship durability in different ways. This includes persisting because of strong personal commitment to partners and relationships despite being based on traditional gendered norms.

Equally, even when personal commitment is weak or missing such relationships are tied by structural commitments that may include practical and emotional investments in children, housing, time, finances, friends and wider family. These structural elements can hold the relationship together (Johnson, 1991), as do the practical, financial and emotional costs of legally dissolving the relationship. Relationship investments in children introduce complex gendered responsibilities and commitments. As early to midlife stages of partnerships tend to focus on children, work and the couple, bad marriages may be endured for the sake of children. Divorce may reshape relationships with adult children, especially for fathers who are likely to receive less support from adult children compared with mothers (Brown and Wright, 2017), and this might also act as a structural constraint.

Moral commitments have an ‘ought to’ dimension, which may be person- or relationship-specific and (or) aligned to one’s (moral) self (Johnson, 1991). Married older adults are often presumed to reflect relationship and/or person-specific types of moral commitment – to the marriage and the marital obligation of ‘until death do us part’. Indeed, structural disadvantage over the lifecourse due to limited economic resources and access to labour/pensions may keep some older women in marriages, reflecting broader issues of class and gender.

Methods

Our pilot qualitative mixed-methods study carried out between 2017 and 2019 (pre-COVID-19) with a biographical focus (Merril and West, 2009) explored older couples’ relationship experiences following separation, offering insights into changes and continuities when living apart. Combining methods that included individual and joint interviews, observations, and emotion maps (Gabb and Fink, 2015) enabled sensitivity to each couple’s current living arrangements and the diverse cognitive and communication capacities of CH residents (Hubbard et al, 2003). The Social Care Research Ethics Committee (England) granted approval under the Mental Capacity Act 2005 (REC reference:18/IEC08/0008). CH partners lacking capacity to consent were enabled to participate via individually appointed third-party consultees who knew them well.

Self-identified couples (regardless of legal status, sex, ethnicity, or other factors) with one partner resident in a care home were eligible to participate. Eight couples were recruited from across four nursing care homes in one local authority area. Prior to participation, we explained the study, invited questions and emphasised its voluntary nature, confidentiality, anonymity and their right to withdraw. The consultee, usually identified as the CL spouse, was contacted with an information leaflet and a form inviting their opinion on whether their CH partner would have consented to participate in the study. Individual signed consent was obtained ahead of commencing fieldwork for all CH partners through consultees.

Data collection

We adopted a staged approach to fieldwork (see Table 1). An introductory visit to meet the couple together, usually at the care home, allowed us to assess cognitive and communicative capacities of CH partners. Given limited capacities, we mainly undertook observations (mornings, early and late afternoon) with CH partners, supplemented with short interviews where feasible and following a process of ongoing informed consent (Dewing, 2008). Two researchers then visited CL spouses to establish completion of emotion maps, reflecting feelings of everyday life at home. We then conducted in-depth biographical interviews with CL spouses lasting 1.5–2 hours at the care home or in their own homes, informed by a topic guide that explicitly explored: the couple’s relationship history; the personal biographies of each partner; the impact and implications of separation and living apart; and everyday life for both partners following separation. A visual ‘relationship intimacy’ instrument permitted exploring intimacies in the relationship, including: physical and sexual intimacy, caring about, doing things together, sharing, confiding and conflict resolution. Finally, joint interviews were conducted with couples in a quiet location in the care home to facilitate ethnographic and interview data about couple life (currently and previously) – how/where couples spent time together, interactive talk, gestures and displays of affection between the couple. G led the joint interviews and H/P recorded field notes about the couple’s interaction.

Table 1:

Qualitative dataset and fieldwork timeline

*Pseudonym (with age)Emotion mapping (CL spouse)Individual in-depth interview (CL spouse)Individual short interview and observations (CH partners) where consultee consent received**Observations with CH partners in presence of CL spouse as per consulteeJoint couple interview
1Percy (85) and Penny (75)October–November 2018November 2018March 2019–September 2019 (6 observations including short interviews)n/aApril 2019
2Sally (72) and Shaun (82)December 2018–January 2019December 2018March 2019–September 2019 (6 observations)n/aNone as Sally does not visit
3Rita (80) and Roy (89)December 2018–January 2019February 2019April–September 2019 (6 observations)May 2019
4Ben (70) and Becky (78)May–June 2019March 2019March–July 2019 (5 observations)n/aMay 2019
5Terry (79) and Tina (81)October – November 2018October 2018October 2018 – April 2019 (3 observations only)n/aNone as passed away
6Danny (82) and Dina (80)October– November 2018November 2018March–September 2019 (6 observations including short interviews)n/aApril 2019
7Ken (79) and Kellie (86)RefusedApril 2019N/ANoneNone as consultee permission not received

Pseudonym: names in bold refer to the community-living partner

Permission granted for observation of CH partners but only in presence of their CL spouses

Observations with CH partners offered insights into their daily lives in the care home, but we could not directly elicit their perspectives on and experiences of marital relationship. We relied instead on in-depth interviews with CL spouses to gather accounts of individual and couple biographies and the relationship. Emotion maps completed by CL spouses offered insights into everyday life and the emotional experiences of living apart. Despite a joint interview and CL spouses trying to include their partners in the conversation, it was CL spouses who primarily responded on behalf of the couple. Observations were written up and interviews audio-recorded and transcribed.

Data analysis

A varied dataset for each couple was created (see Table 1). Data was analysed thematically following Braun and Clarke (2006). Each author first independently familiarised herself with complete datasets for at least two couples, coding (Creswell, 2013) written interviews and observations and triangulating this with completed emotion maps to enable exploration of couples’ experiences and relationship across the lifecourse. Since CH partners’ own accounts were absent, individual in-depth interviews with CL spouses were coded for their own ‘lived’ and partner’s ‘told’ life (Verd and López, 2011) to produce each couples’ relationship biography. The first author familiarised herself closely with the entire dataset for eight couples. Identified codes were collated and through a series of iterative writing and discussion, sorted into overarching themes. Themes were then reviewed independently by H and G against coded extracts within and across datasets before producing thick descriptions (Geertz, 1993) and a rich interpretive analytical account. We acknowledge that our interpretation of data is also informed and influenced by our positionality as married women (Walkerdine et al, 2003).

Sample and fieldwork timeline

The eight recruited couples were heterosexual, white British, and in partnerships ranging from 27 to 58 years prior to separation (mean marriage length 44 years) with two in remarriage partnerships. All except one had been separated for a minimum of nine months and a maximum of three years following the CH move. The mean age of CL spouses was 76 years. The mean age of CH partners was 79 years. A couple who had lived apart for 22 out of 27 married years (long-term care) was excluded from this analysis. Findings presented here are informed by reading of whole datasets for seven couples, with quotations drawn primarily from individual interviews with CL spouses and joint interviews. Table 1 sets out pseudonyms for the seven couples, fieldwork timeline and methods adopted.

Findings: what ‘commitments’ means now and how it is expressed

The fact of separation and living together apart in our sample stemmed from ill-health and the move to secure appropriate care. While these circumstances are interlinked, some couples were affected primarily by declining health for one or both partners, while others were affected primarily by being parted. Using the Johnson (1991) framework we look at how ill-health and separation affected commitment under three themes: strained relationships, living together apart, and impeded commitment.

Strained relationships

Two couples had persisted in largely unhappy marriages, remaining committed somehow because of the relationship.

Terry (79) and Tina (81) (married 56 years at interview) together experienced the death of their first infant. Terry believed that Tina’s mental health became fragile after this and she gave up work. He felt she could have continued working to relieve the financial hardship they experienced as a growing family, especially given his redundancies. Terry described the relationship as “floating along” with disagreements, little communication or trust, little real intimacy (and an opportunistic one-off infidelity by Terry). After 25 years of marriage, sexual intimacy ceased: after 50 years, Tina moved into a separate bedroom. She eventually had a stroke, leaving her doubly incontinent and unable to speak or move. In discussions with care professionals, Terry decided he was not well enough to care for Tina at home even with formal support.

Three years on, Terry visits Tina once weekly, marking her birthday and anniversaries with flowers and cards, updating her on family news. While she lives, he will keep her room and belongings at home undisturbed. “I made a promise. I made a promise before God that I would look after her to the best of my ability until death do us part.” The loving elements of the relationship appear to have faltered long before the separation. “I miss her up to a point but I don’t miss the hassle. I don’t know how we managed to rub along together but we did.” Terry’s commitment is now primarily moral, with a personal element in his relational identity, as Tina’s husband.

Sally (72) and Shaun’s (82) experience demonstrates how profoundly health issues can have an impact on already difficult relationships. Despite 50 years of marriage, Sally maintains no direct contact with Shaun, a CH resident for three years, now with advanced Alzheimer’s, bedbound and unable to speak. She does not want to visit, feeling no remorse, regret or guilt. With support from her wider family (and Sally working intermittently) the relationship survived difficult times through redundancies, financial hardship, postnatal depression, and raising children. Sally believes her developing multiple sclerosis in her early forties broke the relationship: “He always said it ruined his life. And I said, ‘What about mine?’” Subsequently, she felt unsupported and badly treated by Shaun. “I did think about it [leaving him] but it would have disrupted [children’s education].”

Formally diagnosed with Alzheimer’s at around 70, Shaun remained home for ten years with Sally caring for him, despite his non-conversation, following her around obsessively, accusing her of having affairs and stealing money. Feeling vulnerable and unsafe, she could no longer cope with his desire for physical and sexual intimacy. Her growing resentment turned into “wanting to get rid of him”. Eventually Shaun’s sectioning opened formal discussions with practitioners about a move. With family support, Sally decided she could no longer live with him.

Describing herself as a “dementia widow”, Sally notes: “I’m legally married. Until he dies, I shan’t be free. And he could outlive me,” clearly feeling structural commitment. Yet some element of moral commitment remains “[Leaving him now] it wouldn’t be right thing to do and it isn’t as if someone is waiting for me.” Although identifying as being part of a couple Sally no longer feels the need to enact commitment within it. Her sister, who lives locally, oversees Shaun’s welfare, visiting the care home as required, and their children also visit him infrequently when they can make it. LA offers Sally a space and a defence against the complications of proactively separating, and her own poor health helps her to avoid familial or social pressures for not visiting.

Terry and Sally explicitly and implicitly negotiated the extent of their felt and enacted commitment. Within their already emotionally distant relationships, LA became a de facto separation in terms of the relationship and living arrangements, with which both seem content.

Living together apart

Married for 46 years to Becky (78), Ben (70) describes how her stroke 13 years ago changed their relationship:

‘My life ended when she had the stroke, really […], and so did hers […] she’s not Becky anymore, she’s not the woman that I married, and I’m not the man she married either […] she’s totally different, totally dependent. When we got married she was totally independent.’

For Ben, the loss of highly valued personal intimacies is profound: the lack of joint decision making and sexual intimacy; the constraints on doing things together, including conversations (given Becky’s memory problems); and her lack of speech and mobility.

Across the two years of her CH residency, spending the day with Becky became central to Ben’s daily routine. “[I feel part of a couple] that’s why I come in every day to see her […] Yeah that hasn’t changed.” Intimacies the couple share now include kisses from Ben, a peck on cheek from Becky as directed by him, holding hands when she is in bed, spending time together in the care home lounge and occasional trips out for coffee or a meal.

Relying on intimate knowledge of Becky’s tastes he does “small things” (painting nails, doing hair, helping to choose jewellery, coaxing her to eat). However, identifying sexual intimacy as an important relationship need, sexual loyalty (previously integral) is no longer part of his commitment to Becky. A year or so following the stroke Ben began a sexual relationship alongside his continued commitment to Becky. Although Becky’s recognition of Ben remains intact (as observed, she gestured enthusiastically, making excited sounds when she spotted Ben with researchers as she was being wheeled out for a bath), Ben thinks disclosing this affair to Becky is pointless given her cognitive incapacities.

Ben initially cared for Becky at home for ten years, dismissing formal domiciliary support as unreliable, but eventually felt they both needed a social life and stimulation: “I think it’s better for her to be here and there’s some stimulation. And I get away […], otherwise I’d go bloody stir crazy.” For them, cultural and social influences, proximate or distal, had been less important: commitment was personal between them, including the joint decision not to have children. From cohabiting, they married primarily to secure residency for Becky, then a foreign national. Despite Ben’s sense that Becky is not the same woman he married, and no evident external pressure to remain married, he demonstrates persisting personal and moral commitment. Arguably, living apart allows Ben to simultaneously maintain commitment to Becky and to live his own life as he wishes, although he admits to an ongoing moral dilemma of whether he has done the right thing by Becky.

Through LA/CH, Ben negotiated his emergent relationship context to balance his commitment to his partner and to himself. For the CL spouses introduced next, the breakdown of care arrangements at home due to their partners’ progressive cognitive illnesses, drove the separation by LA/CH.

For Ken (79) and Kelly (86), married 55 years, Kelly’s move to a care home nine months pre-interview came after nearly five years of home care with formal support. Kelly had mental health problems, including paranoia. Initially, Ken resisted the idea of a CH but gradually accepted it when Kelly lost physical mobility and he could no longer cope with caring responsibilities. He describes mixed emotions about the separation when Kelly resisted the move: relief, loneliness and guilt.

‘When Kelly did come in here I personally felt a great relief after she was here […] I don’t mean elated […], but I did feel like a burden had been lifted off of my shoulders; but then that burden lifted became a big void of not having Kelly at home. And I still have it […]. You get used to it, but that’s not changing it, you get used to it because you have to, not because you want to.’

After having five children, and long before she became ill, Kelly decided she didn’t want to sleep together anymore. Ken reflects on the “ups and downs” in their relationship, which he strongly believes all marriages have, yet he feels they supported each other through difficult times, and despite each thinking at times of leaving, they never separated. Indeed, Ken feels their relationship became stronger: “She’s my life, she always has been – she hasn’t always known it, though, that’s the thing.” Ken now has very practical ways of enacting commitment, overseeing Kelly’s care, caring about and for her including undertaking her personal grooming needs. He holds hands, shows affection and talks to her even though conversation is becoming increasingly difficult due to her memory loss. Much time together is spent in Kelly’s room as she cannot be seated comfortably in the lounge. Accepting physical separation, Ken bridges the gap by visiting daily, seeing it as a new routine within their long marriage. His commitment is primarily personal, to the love of his life.

Rita (79) and Roy (88) (married 58 years) often lived apart early in their marriage, communicating through letters. Roy’s work took him all over the world; Rita ran the household, raising two daughters and working part time. Rita describes a happy and trusting marriage, despite financial uncertainties. She moved into a separate bedroom 12 years ago following heart surgery that made her “restless in bed”, which Roy amicably accepted. They had got to a comfortable place where physical intimacy mattered more than sexual intimacy.

Rita cared for Roy at home for many years, eventually with formal support, feeling guilty at first about Roy’s move to CH as his dementia progressed. She has been visiting at least three to four times weekly for the past three years: “He can’t remember my name. Not always, anyway […] he’s safe and secure […] I say to him, ‘Do you like it here?’ ‘Oh yes.’”

“We’re still a couple. As far as I’m concerned and I think as far as he’s concerned. He just knows.” Personally committed to the relationship, she believes Roy is too, despite his condition. She emphasises that LA is not new for them. Like Ben and Ken, Rita adapted by remaining closely involved in Roy’s daily CH life. Spending much of their time together in the lounge, Roy does not initiate conversations, responding with ‘yes’ or ‘no’ when Rita speaks to him, actively leaning over, straining to listen and respond. Rita plans and thinks ahead about how to keep him engaged during the visit, bringing in food, photo albums and calendars (of his favourite dogs), touching and patting him frequently. Regularly decorating and updating his room with family photos, wildlife posters and souvenirs is an important relationship practice for Rita.

A positive perception and memory of shared history partly explains Ben, Ken and Rita’s personal commitment. Expressed through daily acts of caring for and about their partners, they continue to reaffirm commitment, actively renegotiating shifts in connectedness with their partners and their own needs, despite challenges of illness, reciprocity and of LA/CH. Their willingness to visit and organise daily life around their partners is arguably aided by health and financial resources.

Impeded commitment

Dina (80) has been in a care home for three years. The commitment of her husband Danny (82) is bound up with love and a continued desire to live with her. “I still love her as much as ever [...] and much more really […] feel like I’ve lost something”. He describes being lonely, living apart experienced as physically and emotionally a hard loss: “I’ve been with her all that while, and all of a sudden bang, gone. And it’s the first time really in all that time that we’ve been apart.” Dina had been living at home with Alzheimer’s, but as this progressed it became very difficult for Danny, a long-term wheelchair user, especially when she started wandering outside. Initially Danny hoped they might move together into accommodation with care, but this was never discussed as a possibility.

A remarriage for both, each already had children: “We’d no children at all between us, but we got on well. We travelled the world [...] my physical disability didn’t help in that respect; I was curtailed as to what I could do and what I couldn’t do. But she put up with me.” Danny can no longer drive, or afford many taxis, so he depends on lifts when his own children from his first marriage (mostly his daughter) can help. But short, irregular visits are unsatisfactory for him, particularly as he finds Dina’s progressively growing distance and unresponsiveness highly demoralising. Dina likes to walk, rarely sitting down or making a conversation, leaving Danny to follow her around in his wheelchair when at the care home. Danny is beginning to wonder whether he should visit or spend precious resources on taxis only to feel rejected. For him doing and displaying his couple relationship amounts to taking pictures of Dina while he is there and sharing these with family and friends on Facebook. Unlike Rita, he is unable to accept the growing lack of recognition and responsiveness. He feels the only way to be fully part of someone’s life is “to live with them really – you’re actually in the room and things happen while you’re there. That’s the only way you can do it.” However, there is no current prospect of an arrangement that would enable them to live together in a CH.

In positive relationships especially, the inability to bridge the separation physically and emotionally hurts the CL spouse. “I think we had a good life together [...] I don’t see anything wrong with it at all, which makes it even worse for me.” Danny’s commitment is personal but cannot be enacted in ways that matter to him. LA/CH is creating a distance in their relationship with Danny working hard to avoid loneliness.

Percy (85) met and married his second wife Penny (75) about 30 years ago. His first marriage had eventually foundered on his wife’s mistrust regarding imagined infidelity while he worked away for extended periods. Penny was an entertainer and Percy describes them as a team: “We worked together. I don’t believe in the one way.” In contrast with his first marriage, in this remarriage Percy appears to have prioritised commitment to the relationship over work, keeping very close to his wife.

A decade ago, Penny’s only son from a previous marriage sustained serious injuries resulting in a long-term coma, affecting Penny deeply. A non-smoker/drinker himself, during this period Percy accommodated Penny’s heavy smoking and drinking. Over time she started showing signs of dementia. Percy tried to keep her engaged in her hobbies as his own health started deteriorating. Two years ago, his GP suggested a care home for Penny as Percy’s worsening heart condition now required avoiding the stress of coping and safeguarding her. Percy’s daughter and daughter-in-law undertook responsibility for managing the couple’s ongoing health issues and arranged a permanent care home place for Penny. Accepting this was hard for Percy, but he sees the move as essential for both. “I’ve got to look after myself to look after her. Because we were very happy, I know it’s cost me a lot of money to keep her in [CH] but I felt that she was being well looked after.”

At the time of interview, Percy was in fragile health awaiting a heart operation and visiting Penny only when he felt well enough to drive. Percy demonstrated strong personal commitment over many years and still regards them as a couple – “She’s never out of my mind, always in the conversations, like with my children.” Penny observably enjoys Percy’s company, exhibiting a degree of familiarity and making small comments toward him. Now unable to enact much commitment to Penny until after his operation, Percy thinks he may seem selfish putting his own health first, but he emphasises that illness is forcing him to prioritise and divide his commitment.

Contextual constraints of health, material circumstances and the institutional system are in different ways shaping Danny and Percy’s enactment of commitment. Adult children have stepped in to bridge the gaps but, as in Danny’s case, their efforts may not be enough to maintain the relationship in ways that matter to the CL spouse.

Discussion

Despite CH partners progressively losing ability to reciprocate, CL spouses maintained relationships. However how relationships were maintained and practised varied widely.

The concept of commitment offers a useful lens to help interrogate these variations. In LA/CH circumstances, the shape of commitment is now very often one-sided. We find that enacting and navigating commitments does not automatically stem from being married, but likely evolves and changes in the context of the relationship. A relationship history approach to exploring experiences of LA /CH couples offers insights into how very different and individual experiences and consequences are in these circumstances. Their histories affect current relationships but are not the whole story of how and why CL spouses remain committed.

Kapinus and Johnson (2002) argued a need to attend to the multifaceted nature of commitment alongside the balance of commitments in different types of relationships and over time. Although partnerships were rooted in structural and legal commitments of marriage, most CL spouses tended to emphasise the personal aspects of commitment holding the relationship together. Two CL spouses no longer treasured the relationship, stressing a minimal or a binding commitment, largely moral and/or structural, but enough for self-identification as ‘a couple’. For these spouses, care homes acquiring primary responsibility for CH partners’ care enabled them to renegotiate their obligations, challenging the discourse and expectation of (gendered) care as an aspect of marital commitment.

Specific partnership histories, perceptions and future considerations (as partners may never again cohabit) can not only relationally shape CL spouses’ ongoing acknowledgement and display (or not) of commitments, but also influence whether and to what extent CL spouses participate in relationship maintenance. Some CL spouses continued to organise daily life around the life of their CH partners, putting in more emotional and embodied relationship work to sustain intimacy and connectedness. Others fitted their partners around their own daily life and in comparison, were less (or not) involved. CL spouses also varied in the extent to which they felt guilty and/or ambivalent about agreeing their partner should move into a care home, even as they were in their second or third year of living apart.

Viewed as a process, ‘commitments’ are fluid, developing and changing over time (Smart, 2007). Although heard through the voice of the CL spouses, this was evident in the personal and relational biographies of couples where entering the relationship set the context for commitments to develop. Personal commitments were facilitated or hindered, thereby surfacing moral and structural aspects. We note that personal commitment may persist despite other aspects of commitment (for example, to sexual fidelity, or joint decision making) consciously or unconsciously disappearing, without ending the relationship.

While somewhat disturbed, commitment endures in one form or another (personal, moral or structural) with continuity (of history, memories and biographies) within relationships, informing understandings that contribute to present interactions. If positive, and where financial and health resources enable, shared histories can fill in gaps created by loss of crucial intimacies such as communication, or partners’ growing lack of recognition and responsiveness. Instead of being lost (Forsund et al, 2015) couplehood takes on different forms, coming through different perceptions and practices of commitment.

Our findings challenge previous ideas that LA/CH separation may not always be voluntary since it can sometimes be actively sought. Further work is required to explore differences in behaviours here between men and women. Living apart can become a mechanism, by default or design, to balance commitments to partner/relationship and self – or it can become a hindrance to enacting commitment. Where relationships have already deteriorated and do not improve, LA/CH may offer CL spouses an amicable alternative to dissolving a relationship, avoiding the stress and complications of legal dissolution. Where actively sought, LA/CH enables flexibly reconciling own interests with commitment to the CH partner and relationship. Living apart therefore offers opportunities to renegotiate the balance of commitment and its enactment, in turn offering a more individualised way of living for some CL spouses, although not carefree. For others distance becomes a problem when serious health conditions and/or resource constraints impede visiting; and place becomes significant because of the mediating role of both the domestic home and care home.

Unlike LAT and LLAT involving an intention for future marriage/cohabitation or an alternative to it, LA/CH occurs within the context of well-developed long relationships and to continue the spousal relationship in late life. Findings suggest that when we consider relationship commitment in these circumstances, we need to understand how relationships can change over time, with potential shifts in emotional intensity, meaning and expression. Whereas at other lifecourse stages (Carter, 2012), commitment is about building up the relationship, here commitment is more about tenacity and choices in the face of extremely challenging circumstances. Contrasted with other lifecourse stages, the balance of commitments likely involves negotiations around commitment to a partner/relationship and emerging commitment to self (rather than to family and work).

We recognise our sample is uneven, with more male CL spouses than female. This may have influenced our findings as gendered repertoires can affect what commitments are accepted and enacted – although not definitively. Despite actively recruiting couples to the study (departing from previous work), CH partners were unable to articulate their perceptions of the relationship, although we observed at length how they interacted (or not) with their spouses. Methodologically, however, inclusion of the ‘couple’ uncovered new knowledge. Unlike previously, we could capture spouses who were ‘more and less’ involved in daily life of their CH partners. We noted that adult daughters stepped in to support commitments where CL spouses’ experienced health or financial constraints. But exploring why or how these commitments were negotiated within the wider family was beyond the scope of this study.

While no readily available UK data exist on the numbers of LA/CH couples, it is likely that as couples live longer with progressive conditions, more may find themselves in this situation. We were unable to reach partners who have stopped visiting, whether or not they still regard themselves as part of a couple. However, given the varied nature of commitment seen in this study, we cannot safely conclude that if partners do not visit there is no commitment. Prevailing external circumstances, lack of emotional or practical support, and the CL spouse’s own deteriorating health can make expressing and enacting commitment difficult.

As evidenced from this study, long-standing marriages of older adults may signify the lifelong but multifaceted nature of commitment, suggesting the need for nuanced understandings rather than seeing commitment as a straightforward generational expression of marital obligations and duty. The nature of felt commitment tended to be reflected in the extent to which and types of relationship practices CL spouses engaged in (for example, demonstrating affection, holding hands or taking care of bills) (Canary and Dainton, 2006). We note that personal and relational biographies, material, and contextual constraints relationally shape (Burkitt, 2016) the felt nature and enactment of commitment. Further exploration is required of how meanings ascribed to commitment between partners in these final years of the relationship are influenced by age with reference to health, the finitude of life, adult children (if any), and the differential financial and legal impacts of separation. More consideration is needed on what this varied nature of commitment means in practice for care homes, social workers, and the wellbeing of LA/CH couples.

Notes

1

We acknowledge that the concept of ‘older’ is not definitive. For the purposes of our study it is defined as age 65 and over.

2

The term ‘care home’ is used for both residential care homes and nursing homes with registered nursing staff present in the latter. Although both types of care home are financed through means testing, nursing homes gain some financial support through the NHS.

3

What might constitute a ‘long-standing’ marriage is lacking definition. However, some, for example (see Lauer and Lauer, 1986; Alford-Cooper, 1998), define marriages lasting at least 15 years and over as long term.

Funding

This work was supported by the British Academy/Leverhulme Small Research Grants 2017 under Grant SG170463.

Acknowledgements

We thank our study participants for sharing their life stories, our advisory group for their timely inputs, and the reviewers for their invaluable comments on this article.

Conflict of interest

The authors declare that there is no conflict of interest.

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  • Beaujouan, É. and Ní Bhrolcháin, M. (2011) Cohabitation and marriage in Britain since the 1970s, Population Trends, 145(1): 3559. doi: 10.1057/pt.2011.16

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  • Bildtgard, T. and Oberg, P. (2017) Intimacy and Ageing: New Relationships in Later Life, Bristol: Policy Press.

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    • Export Citation
  • Boyle, G. (2013) Still a woman’s job: the division of housework in couples living with dementia, Families, Relationships and Societies, 2(1): 512. doi: 10.1332/204674313X664671

    • Search Google Scholar
    • Export Citation
  • Braithwaite, D. (2002) ‘Married widowhood’: maintaining couplehood when one spouse is living in a nursing home, Southern Communication Journal, 67(2): 16079. doi: 10.1080/10417940209373227

    • Search Google Scholar
    • Export Citation
  • Braun, V. and Clarke, V. (2006) Using thematic analysis in psychology, Qualitative Research in Psychology, 3(2): 77101. doi: 10.1191/1478088706qp063oa

    • Search Google Scholar
    • Export Citation
  • Brown, S. and Wright, M. (2017) Marriage, cohabitation, and divorce in later life, Innovation in Aging, 1(2): igx015, doi: 10.1093/geroni/igx015.

    • Search Google Scholar
    • Export Citation
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    • Export Citation
  • Burridge, L, Winch, S. and Clavarino, A. (2007) Reluctance to care: a systematic review and development of a conceptual framework, Cancer Nursing, 30(2): E919. doi: 10.1097/00002820-200701000-00002

    • Search Google Scholar
    • Export Citation
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    • Export Citation
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    • Search Google Scholar
    • Export Citation
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    • Search Google Scholar
    • Export Citation
  • Cash, B., Warburton, J. and Hodgkin, S. (2019) Expectations of care within marriage of older couples, Australasian Journal on Ageing, 38(1): E19E24. doi: 10.1111/ajag.12590

    • Search Google Scholar
    • Export Citation
  • Chambers, P., Allan, G., Phillipson, C. and Ray, M. (2009) Family Practices in Later Life, Bristol: Policy Press, pp 3951.

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    • Search Google Scholar
    • Export Citation
  • Coulter, R. and Hu, Y. (2017) Living apart together and cohabitation intentions in Great Britain, Journal of Family Issues, 38(12): 170129, doi: 10.1177/0192513X15619461.

    • Search Google Scholar
    • Export Citation
  • Creswell, J.W. (2013) Qualitative Inquiry and Research Design: Choosing among Five Approaches, 3rd edn, Los Angeles: Sage.

  • Dewing, J. (2008) Process consent and research with older persons living with dementia, Research Ethics, 4(2): 5964. doi: 10.1177/174701610800400205

    • Search Google Scholar
    • Export Citation
  • Duncan, S. and Phillips, M. (2011) People who live apart together (LATs): new family form or just a stage?, International Review of Sociology, 21(3): 51332. doi: 10.1080/03906701.2011.625660

    • Search Google Scholar
    • Export Citation
  • Forsund, L.H. and Ytrehus, S. (2018) Finding a place to connect: a qualitative study exploring the influences of the physical and social environments on spouses’ opportunities to maintain relationships when visiting a partner with dementia living in long-term care, Dementia, 17(7): 85879. doi: 10.1177/1471301216656087

    • Search Google Scholar
    • Export Citation
  • Forsund, L.H., Skovdahl, K., Kiik, R. and Ytrehus, S. (2015) The loss of a shared lifetime: a qualitative study exploring spouses’ experiences of losing couplehood with their partner with dementia in institutional care, Journal of Clinical Nursing, 24(1–2): 12130. doi: 10.1111/jocn.12648

    • Search Google Scholar
    • Export Citation
  • Gabb, J. and Fink, J. (2015) Couple Relationships in the 21st Century, Basingstoke: Palgrave Macmillan.

  • Geertz, C. (1973) Thick description: toward an interpretive theory of culture, In The Interpretation of Cultures, C. Geertz (ed), 330, New York: Basic Books.

    • Search Google Scholar
    • Export Citation
  • Gilleard, C. and Higgs, P. (2013) The fourth age and the concept of a ‘social imaginary’: a theoretical excursus, Journal of Aging Studies, 27(4): 36876, doi: 10.1016/j.jaging.2013.08.004.

    • Search Google Scholar
    • Export Citation
  • Glasier, W. C., and Arbeau, K. J. (2019) Caregiving spouses and the experience of involuntary separation, The Gerontologist, 59(3): 46573. doi: 10.1093/geront/gnx163

    • Search Google Scholar
    • Export Citation
  • Hackstaff K. (1999) Marriage in a Culture of Divorce, Philadelphia, PA: Temple University Press.

  • Hawkins, N. and Booth, A. (2005) Unhappily ever after: effects of long-term, low-quality marriages on well-being, Social Forces, 84(1): 45171. doi: 10.1353/sof.2005.0103

    • Search Google Scholar
    • Export Citation
  • Hayes, J., Boylstein, C. and Zimmerman, M. (2009) Living and loving with dementia: negotiating spousal and caregiving identity through narrative, Journal of Aging Studies, 23(1): 4859. doi: 10.1016/j.jaging.2007.09.002

    • Search Google Scholar
    • Export Citation
  • Hinchcliff, S. and Gott, M. (2004) Intimacy, commitment and adaptation: sexual relationships within Long-term marriages, Journal of Personal and Social Relationships, 21(5): 595609. doi: 10.1177/0265407504045889

    • Search Google Scholar
    • Export Citation
  • House of Lords (2013) Ready for ageing?, Select Committee on Public Service and Demographic Change, Report of Session 2012–13. HL Paper 140, London: The Stationery Office.

    • Search Google Scholar
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