Discussions about divorce, family stability, and the like typically focus on individuals and families in their normal childbearing and child-rearing years, and for good reason. Unstable or single-parent families have it tougher in all sorts of ways, and to the degree that their struggles affect future generations, solving their associated problems is all the more important. Indeed, it certainly is not uncommon to hear in conversation, even among those who think poorly of divorce in general, an almost audible relief when divorce occurs without children being involved, either because the couple has not had children or the children are grown and gone.

So perhaps it should not be a surprise that news that the divorce rate for elderly people in the United States has gone up significantly of late has not made much of a media splash. If Grandma and Grandpa get divorced, well, that certainly might make for a few more complications when planning a granddaughter’s wedding, but the harms seem fairly localized and minimal. What’s the fuss?

Perhaps the harms really are not all that significant, but the phenomenon is rather mystifying. Why would elderly people now be getting divorced at higher rates than in the past? Older Americans are, as a group, wealthier than other groups—and this is especially true for married couples. There isn’t the stress of raising children, starting careers, or even getting used to sharing a life with someone. Why would an elderly couple get divorced?

Well, think about the one factor disproportionately affecting older people that might induce the sort of life stress that contributes to divorce: illness. If there is one way in which the elderly in our society are certainly worse off than others, it is they are sicker. Of course, that’s always been true, and so the simple fact that the elderly are more likely to be seriously ill cannot explain their rising divorce rates. But when a physician friend related a story about a patient of his, I realized that the financial burdens associated with serious, long-term illnesses might be contributing to this change.

My friend treats mostly elderly patients afflicted with significant, degenerative diseases that often eventually require entering a nursing home or long-term care facility. One day, one of his patients arrived to an appointment with his wife of many years and began to explain that they had recently gotten a divorce. My friend related his sincere surprise since he had always thought of them as an especially close and committed couple. He had been impressed with the wife’s ability to care for her husband, even though she was not at all young herself.

The patient’s wife explained, with some emotion, that she didn’t want to get a divorce and that she felt terrible about it, but that it had, according to their lawyers, been the only way that they could afford the nursing home care her husband had come to require. They were of reasonably modest means and could not afford the thousands of dollars a month long-term care facilities charge. In order to qualify for Medicaid, they would have to spend down their savings and thus leave her in a financial lurch. Hence the divorce.

Long-term degenerative diseases really can leave people of modest, though not impoverished, means in quite the hard place. Nursing home costs can run upwards of $6,000 per month (as of 2010) and federal “spousal impoverishment” rules for Medicaid allow spouses to keep $117,240 in savings. That may seem like a lot (and spouses can keep much more in the way of home equity), but depending on where you live and whether you are able to work or have a pension to supplement your income, it may not be very much at all. Thus couples of decent but modest means, especially those who do not have a great deal of home equity, are sometimes confronted with a very difficult choice: try and make things work without the sort of nursing home care patients really need, or sacrifice the well-being of the healthy spouse who must continue to make ends meet with severely diminished resources.

It’s not that these sorts of policy choices do not make sense. In a world of budgetary restraint, it seems right that those who can afford to contribute to their care should do so. It would certainly be odd to have a system that—even more than it does so already—taxes those who are, generally, younger and poorer to fund those who are, generally, older and wealthier. But to the degree that these policy choices do, in fact, move some people toward divorce, it represents a problem.

It is possible, of course, that these sorts of rules are not at all related to the increase in the elderly divorce rate. So far as I can tell, there isn’t any research out there on the question, and it could hardly be the whole story even if a link were demonstrated. But people do respond to incentives, and as more Americans face both debilitating illnesses and overwhelming financial pressures, these policies might turn out to be an important factor pushing them toward divorce.