I've seen a few people wondering about the spouse/mate who doesn't seem to work either, so figured I'd give my experience on it.
Might not be a thing everywhere, but in my area you can certified as an hha or stna and get paid to take care of a loved one. A friend of mine is employed full time, caring for her eldery aunt in this way.
The pay isn't great, ofc, because the real point is that the patient is being cared for by a loved one.
I suspect a number of the spouses we see on the show are doing this. If the patient is receiving disibility... Well, y'all see the point lol.