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Obama's Order on Hospital Visitation Rights Affects Many Older Unmarried Couples

Faye Hellman and George Thomas have been each other’s closest friends and confidants for about three years. Both widowed, they live at the Hebrew Home retirement community in Riverdale, N.Y.

They share everything—stories, issues, good times and bad. “If I have a problem, she’s always there to help out,” says Thomas, 74.

Hellman, 91, couldn’t be there for Thomas two years ago when he was hospitalized with pneumonia. By policy, the retirement community wouldn’t tell her which hospital had admitted Thomas. “They don’t tell you anything,” she fumed. ”If he’s in the hospital, and I’m not there and I’m not seeing him, you have all these visions about what would be happening,” she said.

Soon, Hellman couldn’t be left in the dark. An April 15 memorandum from President Obama directed that nearly all hospitals extend rights for visitation and information to patients’ close friends—giving them the status that, before now, was often reserved for spouses and blood relatives.

Most of the publicity surrounding Obama’s memo noted that it applies to gay couples, who often haven’t been treated the same as married couples of one male and one female. But a lesser-noticed aspect of the directive applies to older unmarried couples—heterosexual or gay—who often may be a hospital patient and a best friend or close buddy. In 2000, the U.S. Census found 9.7 million unmarried partners cohabiting, with 266,600 couples in that group age 65-plus. Many experts expect the numbers to rise dramatically in the 2010 Census.

Obama’s memo instructs the U.S. Department of Health and Human Services to develop new rules to ensure that hospitals “respect the rights of patients to designate visitors” and to choose the people who will make medical decisions on their behalf. The process could take several months.

“The directive is wonderful,” said Daniel Reingold, president and CEO of the Hebrew Home at Riverdale. “It opens the door for people to be involved in health care decision making who otherwise would have been excluded.”

Reingold says that friends, even those not living as closely together as Thomas and Hellman, often have more information about a patient’s wishes, desires and relevant medical problems than family members, who are sometimes far away and visit occasionally.

Obama’s order isn’t meant to take away the legal aspects of durable powers of attorney or advance directives, in which you name a trusted person to make medical decisions for you in case you’re incapacitated. But because less than half the population has the proper paperwork, according to surveys, hospitals and other facilities are often left to make the decisions.

The “spirit” of Obama’s new policy will “send a message that says use common sense and compassion when you are making decisions on who can visit and who can have information,” said Martin Gorbien, M.D., director of geriatric medicine at Rush Presbyterian Medical Center in Chicago. Rush has allowed unrelated individuals into hospital rooms for years, he said, but this will spread the policy nationwide.

The directive also applies to younger unmarried couples, such as Jodi Reid, 54, and Bruce Livingston, 56, of San Francisco. They have lived together for 30 years without being married. “We’re completely committed to each other, but we saw no reason to get married,” Reid said.

Living in San Francisco, with a large gay population, it seems that Reid and Livingston might benefit from laws that govern same-sex couples and allow them many rights in that city and in California. But ironically, those domestic partnership laws don’t apply to them.

“You do have visitation rights if you are domestic partners, but we can’t register as domestic partners because we aren’t the same sex,” Reid said. “The response was, why don’t you just get married? Well, we made the decision we don’t want to get married.”

Now they have the same rights to see each other in the hospital as married people or even domestic partners in San Francisco. Reid says that would have been nice when her mother was dying in intensive care in a Chicago hospital that barred Livingston from visiting her mom because Livingston and Reid weren’t married.

“We actually had to lie to get him in to visit her,” Reid said. “At least in a hospital setting, that’s what we’re asking for.”

There might be other relationships that fall under Obama’s directive, said J. Mary Sorrell, ombudsman program director of Highland Valley Elder Services in Florence, Mass. She noted a woman in her 90s who recently listed as her closest friend a neighbor in his 50s. The relationship raised red flags of possible exploitation, but looking into it, Sorrell discovered that the two have been neighbors since the older woman baby-sat for the younger man.

“He has taken care of her as she aged and she took care of him as a small child. It’s just as real and important as many blood families,” Sorrell said.

Elaine S. Povich is a freelance writer who lives in Maryland.


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