Care Agreements Document for Couples

Contributed by: Sandra Adams, CFP® Sandy Adams

In the last several months I have been a part of several client conversations, many of which left me feeling a sense of great concern for at least one member of the couple. You see, these conversations all involved client couples that were dealing with one spouse having been diagnosed with some form of cognitive impairment, and the other serving as the primary care giver. In all of these cases, the caregiver expressed a multitude of emotions: responsibility, stress, worry, grief, and even a sense of being lost – as if they didn’t know where to go from here and they didn’t want to let their loved one know how they were feeling.

We all want nothing more than to love and care for our partners, to our best abilities, for the rest of our lives. At least that is what we vow when we marry on our wedding days. Little do we know what lies in our futures—chronic health issues or possible long term cognitive impairment—that may require intensive caregiving. What do we expect of our spouse in those cases? Will we want our spouse to provide personal care and will we want to remain at home, no matter the personal and financial sacrifice?  We have all heard and read that caregiver stress is a very real issue in the U.S., as many spouses and families strive to keep their loved ones cared for at home; unfortunately, this “I can do it all” approach leads to many caregivers falling ill and passing away before the “ill” spouse (or just giving up the quality of life once hoped for). So, how do we prevent this from happening?

I propose that when we are writing all of our other estate planning documents—our Wills, Patient Advocates, and Durable Power of Attorney Documents—that we consider writing a Care Agreements Document with our spouse or significant other.

What would this agreement include, you ask?

  • If I get ill, or become cognitively impaired, how do I want to be cared for?
  • If I am cognitively impaired/what do I expect of you as a caregiver and do I expect you to care for me at home (is there permission for you to make a move to a facility for safety reasons)?
  • If I get ill or become cognitively impaired, do I expect you to provide the care, or do I give you permission to hire care and do I prefer that you visit with me and spend quality time with me.
  • Any other items that seem important (i.e. whether or not it is important to keep pets, and or other items that are important to you if you become ill).

Having a Care Agreements Document between spouses/partners in advance of an illness does a couple of things:

  1. It helps both partners make clearer decisions in times of stress if/when the time comes. It also takes away any feelings of guilt because you have had the conversation advance of an illness.
  2. You have in writing what the care wishes are for your partner in the case of any disagreement from children (whether your children or from a second marriage, etc.). 

While a Care Agreement Document is not a legal document, it is something that helps express wishes for the person that is named in charge of making decisions for you (Durable Power of Attorney, etc.) and can be a great way to begin a conversation about those end of life issues that we don’t like to talk about, but need to. 

In next month’s blog, I will write about using the Care Agreements Document for family caregiving, so stay tuned!

Sandra Adams, CFP® is a Partner and Financial Planner at Center for Financial Planning, Inc. Sandy specializes in Elder Care Financial Planning and is a frequent speaker on related topics. In addition to her frequent contributions to Money Centered, she is regularly quoted in national media publications such as The Wall Street Journal, Research Magazine and Journal of Financial Planning.


This material is being provided for information purposes only and is not a complete description, nor is it a recommendation. Any opinions are those of Sandy Adams and not necessarily those of Raymond James. The information has been obtained from sources considered to be reliable, but Raymond James does not guarantee that the foregoing material is accurate or complete. You should discuss any legal matters with the appropriate professional.