Cohousing-L Mailing List: Support vs Medical Care [was: Co-Ho as nursing home replacement

[Sharon Villines (sharon]

> On Jun 19, 2015, at 8:24 AM, 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? 

In addition to what others have offered, I include below a list of things that 
neighbors can and shouldn’t do. One of our residents put this together when we 
had a resident who really needed more than we could give and the family was not 
stepping in. In another instance, the community stepped up for what was 
expected to be a short term of care that extended to several years. It was 
unsustainable and created feelings of guilt and inadequacy. Supporting a 
resident can also mean supporting their family members who come to help but 
also expect meals, etc. Meals for one or two becomes meals for four or five.

It’s not easy to draw a line in the sand, and impossible after the tide has 
come in.

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 when a resident began 
needing more ongoing care than neighbors could provide. They are intended to 
clarify expectations between neighbors, family members living at a distance, 
and those considering living in cohousing. 

When we present 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:

1. Pick up medications at the pharmacy, but not administer medications.
2. Pick up shopping but not be sole shopper.
3. Bringing in some meals, but not being the cook or meal server.
4. Accompanying, along with an aid, to a medical appt but not daily help 
getting around.
5. No intimate body care or bathroom functions.
6. No responsibility for making appts or arranging for health care providers.
7. No responsibility for 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.

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