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My spouse needs more care than I can give

Options that keep a couple together, and the spousal protections Medicaid provides.

Quick answer

Options that keep a couple together, and the spousal protections Medicaid provides.

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Home›By Situation›My spouse needs more care than I can give

Caring for a spouse is different from caring for a parent, financially and otherwise. North Carolina's Community Spouse Resource Allowance protects between roughly $31,584 and $157,920 in assets for the spouse who stays home.

Short answer

Options that keep a couple together, and the spousal protections Medicaid provides.

What to do, in order

  1. Understand the spousal protections. North Carolina's 2026 Community Spouse Resource Allowance runs $31,584-$157,920, and the Minimum Monthly Maintenance Needs Allowance runs roughly $2,643.75-$3,948.00/month before shelter adjustments.
  2. Look at communities that keep couples together. Several campuses offer more than one level of care on one site.
  3. Be honest about your own health. Spousal caregivers routinely under-report their own decline.
  4. Get an objective assessment. The Area Agency on Aging serving your county can assess both of you at no cost.

Questions families ask

What senior care resources exist in Johnston County, and is Clayton served by the same hospital as Smithfield?

Johnston County, including Clayton, Smithfield, and Selma, is served by the Central Pines Regional Council (Triangle J) Area Agency on Aging at 1-800-310-9777. UNC Health Johnston operates the county's primary hospital system, with a main campus in Smithfield and a separate campus in Clayton, so residents of both towns generally have local access to inpatient and emergency care without traveling to Raleigh. For Adult Protective Services concerns, contact Johnston County DSS directly, since APS reporting in North Carolina is handled at the county level rather than through the regional Area Agency on Aging.

Are there fewer assisted living options in Johnston County compared to Wake, and what should families in Smithfield expect?

Johnston County generally has a smaller inventory of assisted living and memory care facilities than Wake County, reflecting its more rural and lower-density character outside of fast-growing Clayton, so families in Smithfield may need to widen their search radius or consider facilities in Clayton or even into Wake County. UNC Health Johnston's Smithfield campus can connect families to skilled nursing and rehab referrals locally, and the Central Pines/Triangle J Area Agency on Aging (1-800-310-9777) maintains information on licensed facilities countywide. Checking NC DHSR's facility search tool by county is the most reliable way to see the full current list of licensed adult care homes and family care homes in Johnston County.

What's the process for reporting elder abuse in Chatham County, and what hospital serves Pittsboro and Siler City?

In Chatham County, suspected abuse, neglect, or exploitation of an older or disabled adult should be reported to Chatham County DSS Adult Services, since Adult Protective Services in North Carolina is administered at the county level; call 911 if someone is in immediate danger. For hospital care, Siler City in western Chatham is served by Chatham Hospital, part of the UNC Health system, while Pittsboro-area residents in eastern Chatham are typically within 20-30 minutes of both UNC Health facilities in Chapel Hill and Duke Health facilities in Durham. Chatham County falls under the Central Pines/Triangle J Area Agency on Aging (1-800-310-9777) for general aging services and options counseling.

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