Re: Neighborly Support vs Health Care in Cohousing [was Need from Manzanita Village in AZ: We are developing an "aging in place" protocol - can you help us?
From: Peter Orbeton (peter.orbetongmail.com)
Date: Fri, 15 Jan 2021 15:17:44 -0800 (PST)
>From Nubanusit Neighborhood & Farm (NN&F) aka Nubi. The interest group in
the last sentence is dormant.

Individual members have used the CaringBridge website to keep the community
(and others outside Nubi) informed and to request services, allowing
information/needs posted once, and to see when a request for a service is
filled. This website does not, however, differentiate between caring vs.
caregiving within our community, which the Caring Principles Guideline
attempts to address.

Caring Principles Guideline

Owner: Steering [BoD]
Date: October 8, 2017

Purpose
To describe how we care for our neighbors and to help clarify expectations
among neighbors, family members outside the community, and prospective
neighbors.

Context & Reflections
Intentionally designed to support the values of an old-fashioned
neighborhood, Nubi has experienced patterns of caring and helping typical
of many co-housing communities: Caring is a thread woven through the fabric
of the community and helping is an integral part of neighborhood life.
Caring is best when given and received sincerely.

   - Understanding and accepting the difference between caring and
   caregiving is fundamental to setting clear expectations. Responsibility for
   caregiving is beyond the scope of neighbor help.
   - Neighbors come with differing levels of capacity to provide and need
   for receiving caring and help; accepting differences among neighbors as
   well as clarifying and expressing individual boundaries are highly
   recommended.
   - Caring can be intangible (a smile, a kind word, an attitude) as well
   as concrete (dog walking, preparing a meal, running an errand).
   - When neighbors first move in, they usually do not yet have established
   networks within the community, and so it may not be reasonable to expect
   the same kinds of care that might be expected when longer-term connections
   have been developed over time.


Nuts and Bolts
I. Caring is Voluntary
Caring actions are voluntary for the giver and receiver. There is diversity
among neighbors regarding levels of availability and desire to reach out
and help. Care is given to the extent the giver is able according to their
own current life and household situation.

There is diversity among neighbors in terms of ability to ask for help,
especially in a way that is easily heard and responded to. Similarly,
desire to receive help varies among individuals.

II. Caring is Temporary
Helping activities can end at any time—not just when the need abates.
Our community is healthiest when no judgment is associated with nor
explanation needed for not giving care or ceasing to give care.
(Conversely, when we say we will help, we need to follow through as best we
can.)
It would be unwise to make plans based upon an expectation of receiving
help, or moving to the community or adding a family member with an
expectation of support, especially over the long term.

III.  Caring is Limited
Do not expect to receive unpaid skilled assistance from community members
who are professionals unless it is specifically offered and clarified as to
its limits.

Caring at NN&F typically does not include taking on responsibilities for,
(1) matters of a private or intimate nature that would normally fall to
family members and/or professional caregivers or, (2) activities that could
cause harm or incur liability to a community member if left undone or not
done properly.

Resources
The Caring Coordination and Communication interest group will be forming in
order to help with negotiating and facilitating access to caring that is
comfortable for both the individual member and the community as a whole.


On Fri, Jan 15, 2021 at 4:12 PM Sharon Villines via Cohousing-L <
cohousing-l [at] cohousing.org> wrote:

> > On Jan 13, 2021, at 2:34 PM, Nan Henderson <nhenderson [at] resiliency.com>
> wrote:
> >
> > We are requesting any documents/policies/suggestions from other
> communities that have dealt with older, single, failing members that have
> no immediate family.  Have you developed anything that can help us?
>
> This should be on the CohoUS site in my blog entries but I wasn’t able to
> find it.
>
> —————
>
> 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 that involves dependency and risk.
>
> 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
> transportation.
> 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.
>
> ————
>
> Some members who have developed more intimate relationships may do more of
> these things but In general, I think these are good guidelines for
> distinguishing between being a good neighbor and allowing another person to
> become dependent on you. And to prevent family members living at a distance
> from expecting cohousers just to take care of everything.
>
> Sharon
> ----
> Sharon Villines
> Takoma Village Cohousing, Washington DC
> http://www.takomavillage.org
>
>
>
>
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