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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

My mother lives in Carrboro — which hospital would she most likely use, and who handles Medicaid applications for her county?

Carrboro residents are typically served by UNC Medical Center in neighboring Chapel Hill, part of the UNC Health system, for hospital-level and specialist care. Medicaid applications, including long-term-care Medicaid and CAP/DA waiver applications, are processed through Orange County's Department of Social Services, the local point of contact for both Medicaid eligibility and Adult Protective Services in that county. For general aging services referrals and options counseling, the Central Pines/Triangle J Area Agency on Aging (1-800-310-9777) also covers Orange County.

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.

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