Can two households be better than one? In a trend called "living apart together" (LAT), a growing number of older adults are experimenting with committed relationships that also allow for autonomy.

These are people who prefer intimacy and companionship in their lives. At the same time, marriage—or even living together—brings more entanglements than they want to take on. For instance, some have already nursed a spouse through dementia or cancer and done the "in sickness and in health" role; they don't care to do it again, especially when the window for good health may be limited.

Instead, they agree to be romantically exclusive but keep their own homes.
They may eat most dinners together but sleep over only a few nights a week, alternating houses.

Here are some of the benefits such couples describe:

• Companionship, intimacy, and emotional support
• Freedom and "space" to maintain existing friendships and interests
• Absence of conflict about domestic chores, finances, and other logistics
• Greater focus on the joy of the relationship ("keeping the romance alive")
• Protection from the responsibilities of caregiving

Experience suggests interested couples should discuss these issues first:

• Finances. How will you pay for expenses relating to your shared activities (groceries, restaurants, concert tickets, travel expenses)?
• Family obligations. How do you spend holidays? Birthdays? Do you expect to interact with each other's kids, grandkids, etc.?
• Caregiving. What happens when your partner's health starts to decline? How much are you willing to do or not do? (What sounds good in theory can be difficult to implement, given the emotional bond that develops.) Who will handle the bulk of the caregiving? Adult children? Paid caregivers? (Does your partner realistically have a budget for that?)
• Long-term care. What about decisions regarding assisted living, memory care, or nursing homes? Will you participate in the discussion of your partner's living arrangements, or will that be up to their family members only?

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Looking to age on your own terms?
Consult with the experts in aging well: 203-826-9206.

If you are used to having an "annual physical" and ask for that, original Medicare won't pay for it. That is, original Medicare won't pay doctors to do a general physical exam "to see what turns up"; you'll pay out of pocket. (Medicare Advantage might have this as an "extra." Check with your plan.)

Medicare does offer two types of "wellness visits"
Medicare is invested in prevention and in managing chronic conditions, but be careful about the words you use when making an appointment. "Wellness visits" are available through original Medicare and Medicare Advantage. Beyond measuring height, weight, and blood pressure, however, these visits will be more of a conversation than an examination of your body.

The Welcome to Medicare visit happens only once
The Welcome visit is available only the first twelve months after you start Medicare. Think of this visit as setting your baseline, with future annual wellness visits serving as updates of key risk factors. This first visit covers many of the same topics as the annual wellness visit. But it's a more in-depth look at your medical history, your family history, and your lifestyle habits and risk factors. It also includes extra observational assessments concerning things such as vision, hearing, balance, and your risk for falls.

The annual wellness visit includes discussion of the following:

• Your medical history
• Your lifestyle habits (drinking, smoking, exercise, drug use, opioid use)
• Your mental health (depression, dementia)
• Other health factors such as loneliness, anger, stress, pain, and life satisfaction

​These appointments rely on your self-report of how you are doing and what you are doing. From this discussion, you and your doctor may agree on plans to lose weight, quit smoking, or get more exercise over the coming year. And the doctor may order screening tests to rule out other issues. You may also choose to discuss your preferences for end-of-life care so your doctor understands your wishes should you ever be unable to speak for yourself.

If you have a physical concern at any time
By all means, make an appointment if you have worrying symptoms. Get them checked out! Just don't plan to bring up new aches or pains in the context of a wellness visit. You may end up responsible for 100 percent of the visit.

Want to learn more about Medicare and wellness?
Give us a call at 203-826-9206.