Re: co-care agreements?
From: Sharon Villines (
Date: Wed, 25 Jan 2017 08:09:00 -0800 (PST)
> On Jan 25, 2017, at 12:41 AM, Muriel Kranowski <murielk [at]> wrote:
> My takeaway was that, at least in the abstract, we're willing to provide
> and to accept various kinds of concrete shortish-term help and some
> medium-term help, but most people didn't want to give or accept very
> personal or quasi-medical care or to make open-ended commitments except of
> a trivial kind. [snip] It was evident from this exercise, and we agreed, that 
> we're not a
> cradle-to-grave community. At some point, residents with serious physical
> or cognitive issues should expect to sell their house and move to senior
> living/ assisted living,

This is wonderful, a workshop on an important question facing all cohousing 
communities and one with an actual conclusion. 

One of my blog posts on defines what such care should be and not 
be from both the neighbor’s self-preservation and the legal liabilities of 
providing care.

Guidelines for Neighborly Support vs Health Care in Cohousing

I include below a list of things that neighbors can and should not do for 
neighbors with who need support or health care. One of our residents put this 
together when we another resident needed more than we could provide and the 
family was not stepping in. In another instance, the community stepped up for 
what was expected to be a short term of support that extended to several years. 
Supporting the resident also became supporting family members who come to help. 
Meals for one or two became meals for four or five. It was unsustainable and 
created feelings of guilt and inadequacy in community members.

It’s not easy to draw a line in the sand, and almost impossible after the tide 
has come in. Establishing guidelines in advance can be very helpful.

Guidelines for Neighborly Support vs Health Care in Cohousing

These guidelines were developed at Takoma Village Cohousing in consultation 
with medical, psychiatric, and religious professionals. They are intended to 
clarify expectations between neighbors, family members living at a distance, 
and those considering living in cohousing who have special needs.

When presenting cohousing as a caring community that encourages aging in place, 
it becomes important to distinguish between what is sustainable on a temporary 
basis and what can be provided on a continuing basis. And when neighborly 
support becomes health care. 

Neighbors in cohousing can provide helpful services but not critical services 
or services that create a dependency. This includes:

1. Picking up medications at the pharmacy, but not administering medications
2. Shopping but not being sole shopper
3. Bringing in some meals, but not becoming the cook or meal server
4. Accompanying, along with an aid, to a medical appt but not daily 
5. Not providing intimate body care or bathroom functions
6. Not assuming responsibility for making appointments or arranging for health 
care providers
7. Not changing bandages or other health care devices

Neighbors should not expect support for themselves in activities that would:

(1) interfere with the normal household functioning of others on a continuing 
basis, or
(2) that would cause harm to the patient or liability to the neighbor if not 
done or not done properly.

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