My partner and I are in a committed relationship, but are not married.How will this affect us?

Non-married partners may face added challenges when one person is diagnosed with cancer. These challenges can be broken down into several categories: interpersonal, legal, and financial.

First, define your relationship to yourself and ask yourself practical questions, such as: How involved are you going to be in your partner’s medical care and decisions? Have you spoken to her about her wishes on these matters? Are you going to be a primary contact for the doctors and nurses, or is someone else in her family? Are you going to be able to provide personal care to your loved one if she becomes too debilitated to care for herself (temporarily or permanently)? Think about these important issues, and then discuss them with your partner. A cancer diagnosis can make both people think about the level of commitment in their relationship and hopefully discuss these issues openly.

Partners of patients, whether they are in a heterosexual or same-sex relationship, may sometimes feel ignored in the medical setting or marginalized by the patient’s family members. If you feel that you are being overlooked by the medical staff, or by other involved family members, speak with the patient first, if possible. If you and your partner agree that you are the primary caregiver and/or should be privy to medical information, your partner should make this clear to her doctors and family.

At many hospitals visitors are restricted to spouses and “family members,” particularly in critical situations, and hospitals may not provide medical information over the telephone. Family members not supportive of your relationship may try to exclude you from discussions with the doctor, decision making, and even prevent you from visiting the patient. Protect yourself and the patient by establishing your relationship and involvement with medical decisions from the very beginning. Patient confidentiality concerns limit what medical professionals can tell people other than the patient about the patient’s medical care. If your loved one agrees, she or he should ask the doctor to clearly indicate in the medical record that you are able to receive information about the patient’s condition or medical details in person or via telephone and have visiting privileges. Additionally, you should always carry a copy of the signed healthcare proxy if you are identified as the surrogate decision maker.

Same-sex couples sometimes face discrimination by medical professionals. In addition to the financial and legal protections mentioned in this book, you may also want to talk with a community agency specializing in gay/lesbian/transgender concerns. Advocates there may have additional suggestions on how to protect yourselves legally (since this can vary from state to state), financially, and emotionally.

Both married and non-married couples need to budget for unexpected costs related to the cancer diagnosis, such as transportation, insurance premiums and copays, and reduced income if the patient is unable to work.Whether or not you and your partner keep your finances separate, the two of you should discuss the level of financial responsibility you are able, and willing, to contribute. Financial issues are among the most stressful issues with which couples coping with cancer grapple, and more planning can reduce tension in your relationship.

You want to be sure that your stake in any common property or combined finances is legally recognized. For example, domestic partners sometimes have their home in just one person’s name, even though both contribute to the house payments. If something should happen to either one of you, your investment in this property may not be recognized if your name is not on the title or lease. In other words, you may lose money and property if you are not legally protected. Each state has unique laws pertaining to nonmarried partners, and you should speak with a lawyer to discuss ways to protect yourselves. For example, property may need to be in both of your names, and each of you should have a last will and testament. You may also want to discuss other financial issues with an accountant or financial planner. Some people choose to put finances in a living trust, transfer funds into the well partner’s account, establish financial power of attorney, or open joint banking accounts so that finances are less likely to be contested by other people.

There are other non-financial legal considerations that you may discuss with a lawyer. If you serve as your partner’s primary caregiver and/or he wants you to serve as his healthcare surrogate decision maker, you should make sure that he has identified you as such in writing—in some states this is called a healthcare proxy form. He may also see a lawyer to give you his power of attorney regarding his health care. If your partner does not specify you as the surrogate decision maker, you may not have this right. In fact, in most states, family members may have the legal right to perform this role, thus potentially excluding you from any involvement. You may also want to make sure that relevant family members know that you are identified as the surrogate and what your partner’s wishes are. This may prevent crises and tensions between his family members and you, particularly if your partner is ever mentally incapacitated and medical decisions need to be made.