Re: What if an aged neighbor...? (was "Cohousing as nursing home replacement")
From: Beth Baker (bethbakerstarpower.net)
Date: Mon, 22 Jun 2015 08:37:32 -0700 (PDT)
In my books Old Age in a New Age (which looks at transformative ways to do 
nursing homes such as the Green House which Gwande also covers) and With a 
Little Help from our Friends--Creating Community as We Grow Older, I did 
extensive reporting and interviews on these topics.  I found no cohousing that 
including assisted living or nursing homes, and there were varying degrees of 
openness to allowing people to age in place (which I write about in With a 
Little Help--there's a chapter on co-housing and a section on having a Plan B 
if we grow frail).  At ElderSpirit they told me that between the supportive 
community and some paid home health (and presumably hospice) they hoped that 
people will be able to live there till the end.  Others pointed out that 
perhaps guest quarters in cohousing communities could be used for paid 
caregivers to help frail community members.  But I think this is uncharted 
territory, and it remains to be seen how far many of these alternative living 
models can go in embracing folks through conditions such as dementia or extreme 
frailty.

Great topic for discussion.

Beth Baker



Beth Baker
12 Sherman Avenue
Takoma Park, MD 20912
(301)270-8969 (office)
(301)537-1597 (cell)
bethbaker [at] starpower.net
www.bethbaker.net
Facebook.com/withhelpfromourfriends
My So-Called Book Tour blog

Author, With a Little Help from Our Friends--Creating Community as We Grow 
Older (Vanderbilt University Press, May 2014)

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On Jun 22, 2015, at 10:42 AM, Christine Johnson wrote:

> 
> Rita Bullinger <ritabullinger [at] gmail.com> wrote:
> 
>> Our book club group at Germantown Commons Nashville is reading Being
>> Mortal by Atul Gawande. I'm just wondering if anyone has any stats or
>> anecdotal info on the care of elder co-hos w/in communities as an
>> alternative to nursing homes?
> 
> Joanie Connors <jvcphd [at] gmail.com> replying to Rita Bullinger, noted that:
> 
> ….In my understanding, senior cohousing is limited to folks who are able to
> be independent (not sure of the right terminology)…..
> 
> ————
> 
> _Being Mortal_ is an eye-opener - a terrific book - one my book club is also 
> reading.  Incidentally, my book club members come from two of the three 
> Tucson cohousing communities and I bet that we’ll have an interesting 
> conversation about our own experiences and expectations.   
> 
> I hope that folks presently living in senior cohousing communities will jump 
> in !  Please.
> 
> “Independent” is a judgement call and a tough one!   The operators of 
> Continuing Care Retirement Communities (CCRCs) which offer the greatest scope 
> of care through Assisted Living facilities which offer limited assistance 
> through Retirement Communities which offer independent living alone, codify 
> the definition of “independent” and “assistance” in contract.  This allows 
> the administration to manage the terms with residents who lose their ability 
> to take care of their own affairs but deny that it is happening.    
> 
> If individuals living in cohousing enjoy friendships that extend to those 
> friends providing support (repairs, errands, cooking, cleaning, etc.) or have 
> supportive family nearby and/or can afford in-home care either through a 
> long-term care insurance or private pay, I don’t see any reason that these 
> folks will not be able to age and die in place in their cohousing 
> communities.  
> 
> The individuals who either have lost the capacity to recognize the scope of 
> their own needs (i.e.,  that they are not taking care of themselves and so 
> don't arrange for assistance) or do not have supportive and directive family 
> members nearby or lack the resources ($$$) to pay for the in-home assistance 
> needed, present a dilemma for their neighbors.  Then we are forced to assist 
> or not assist. With consequences all around!
> 
> My 11 year-old community has a good percentage of folks in their silver 
> years, of which my husband and I are two.   We would both love to stay right 
> up until the end, dying here in our own bed, but are working on a plan ‘B’….. 
> just in case.
> 
> For example, two situations that I think our community navigated with minimal 
> upset:  1)  neighbors skillfully stepped in to help one of us who was totally 
> out of touch with his own needs (dementia-like behavior), finding a daughter 
> that the neighbor himself could not/would not contact.  The daughter stepped 
> in to do all the heavy lifting, moving our neighbor to a CCRC near her 
> out-of-state home.   2) A second aged neighbor, who died shortly after an 
> acute illness & hospitalization,  fortunately had a loving and competent 
> daughter who managed her needs with minimal assistance from us in the form of 
> rides, food prep, etc.  
> 
> What do we do if we are faced again with a neighbor who’s out of touch with 
> their own needs and is unable to come up with a plan for assistance?  What if 
> he or she puts him or herself and/or other people and/or property at risk 
> (for ex., walking away from running water, flooding their own and neighbors’ 
> units; walking away from food cooking on a stove which leads to a fire at the 
> worst, smoke damage, at the least; through fear, her or she behaves 
> aggressively towards others who are attempting to help; neglects required 
> maintenance and repairs to his/her own home and surrounds; neglects to take 
> care of themselves to the point of putting their own life at risk,  etc., 
> etc.)?
> 
> Love to hear what others have done to resolve, or are doing to plan for, such 
> likely scenarios.  
> 
> Christine Johnson
> Stone Curves Cohousing
> Tucson, AZ 
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