Cohousing-L Mailing List: Re: Caring for Cohousing members

[Sharon Villines (sharon]

I sent a PDF of this document for Fred to post. I pasted in the text but the 
PDF will be more printable.

Sharon

Neighborly Support vs Health Care, Co-Care Agreements

By: Sharon Villines, Takoma Village Cohousing, Updated 28 October 2025

When a few neighbors at Takoma Village Cohousing, young and old, needed more 
care than we could comfortably provide, we established guidelines on what 
neighbors could be expected to do when a person needed ongoing care. We found 
that when neighbors needed memory care, their family did not understand the 
depth or the constancy of the problem. Sometimes, we had expected to provide 
short-term support, but the need continued for several years. Some also 
included support for family members who moved in as helpers. Providing meals 
for one or two became meals for four or five. It was becoming unsustainable and 
created feelings of guilt and inadequacy for everyone. What were reasonable 
expectations? Were there any legal concerns?

We interviewed professionals and developed the following guidelines, which have 
been updated several times. It’s not easy to draw a line in the sand, so 
establishing guidelines in advance can be most 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, how do we distinguish between what 
is temporarily sustainable and what can be provided continuously? And when does 
neighborly support change to health care with medical repercussions? 
The general recommendation is that neighbors in cohousing can provide helpful 
services, but are advised not to provide critical services or services that 
create a dependency. 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 could cause harm to the patient or liability to the neighbor if not 
done or if not done properly.

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