Cohousing-L Mailing List: Re: Subsidizing a health care provider on site - dose it attract the already frail?

[Sharon Villines (sharon]

On Apr 25, 2006, at 12:59 PM, Martin Sheehy wrote:

>  CoHousing is an excellent milieu for piloting a healthCARE delivery 
> system that truly meets the needs of the communities---elderly and 
> not-so-elderly, as all are underserved by the current health"care" ' 
> system '.
>   Even affording some healthcare providers some use of the Common 
> House, eiither to remain onsite, in community, lodge ( at least 
> part-time) to meet the needs of the frailer members of some 
> communities would not only be ' cutting edge ' but surely better than 
> the alternative,

This is a similar issue to "accessible" features like level floors -- 
no unnecessary steps or high thresholds or '"creative" surface changes. 
These features are important for parents with strollers, teenagers with 
broken legs, babies learning to walk, etc.  Things like double 
handrails on stairways -- one for adults and one for children under 
four would make stairs much, much safer for all.

While accessibility may be permanently important to people with MS, 
missing limbs, arthritis, etc, it is temporarily important to everyone.

Subsidized health care provider onsite would also be helpful for all 
ages -- caring for sick children, for example.

But the size of cohousing community necessary to subsidize such a 
person would be larger than the ideal 25-30 units. The community would 
have to build a unit as part of the common elements, thus adding to the 
cost. Chuck Durrett discusses this as part of Senior Cohousing 
communities where the guest suites are larger so they can accommodate 
extended stays by health care aids and family members. In the instances 
he mentions, they come and go, however. They are not permanent 
residents.

I tried designing a parent-cooperative day care center within the 
community to care for the kids under school age, those home sick for 
the day, and those off for teacher conference days (which become more 
numerous every year). The idea was to hire a full-time person and use 
common space or rent a vacant unit (we had one) and have a parent also 
present. We have a lot of parents with flexible or non-9-5 schedules 
even though they work full-time.

The inspiration was a shared nanny for the first two babies born into 
the community who used the kids room in the commonhouse. It was 
wonderful because everyone could stop in and say hello to the babies 
(and teach them tricks like how to high-five) and it was much less 
isolating for the nanny who became a part of the community. The 
commonhouse was much more alive then.

But the emphasis on diversity that cohousing values also means that the 
parents parenting styles and preferences are diverse. Finding a nanny 
that was acceptable to all was impossible. And financially we needed 
buy-in from all of them to make it work. Perhaps in a community where 
all the kids had been born into cohousing and in a community where 
there was less diversity, it might work. The parents would have to be 
committed to working it out. In an urban area where parents had many 
alternatives, not enough of them were.

I think the same thing would be true of a relatively permanent on-site 
healthcare provider.

Sharon
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Sharon Villines
Takoma Village Cohousing, Washington DC
http://www.takomavillage.org