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

[R Philip Dowds (rpdowds]

With respect to supporting the elderly in a cohousing setting, Sharon’s list 
(1-7 below) of opportunities and limitations is pretty realistic.  But here’s 
the real senior cohousing dilemma:

In theory, there’s something to be said for communities consisting entirely of 
seniors:  More opportunity for adult engagement without the interruptions of 
children; more options for connecting with someone of one’s own generation 
(e.g., someone else who actually lived through the Vietnam controversy); and 
potential “economies of scale” as community services concentrate on the needs 
of a particular age group.

Against these possible advantages, however, are significant downsides:  As 
everyone frails away together, the possibilities of reciprocal support 
diminish.  Think of an entire community where everyone needs a ride to the 
doctor, and nobody can drive.  Meanwhile, the relatively energetic recently 
retireds, say 65 to early 70s, come visit Graybeard Cohousing and say, No way, 
all these people are too damn old!  It happens in retirement housing and 
assisted living, and it can happen in cohousing too.

So Yes to all sorts of wonderful ways of aging in place in multi-generational 
cohousing.  But watch out for senior cohousing, it may be harder to sustain 
than it first appears.

R Philip Dowds
175 Harvey Street, Unit 5
Cambridge, MA 02140

land:     617.354.6094
mobile: 617.460.4549
email:   rpdowds [at] comcast.net <mailto:rpdowds [at] comcast.net>     

> On Jun 22, 2015, at 9:13 AM, Sharon Villines <sharon [at] sharonvillines.com> 
> wrote:
> 
> 
> 
>> 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
> 
> 
> 
> 
> _________________________________________________________________
> Cohousing-L mailing list -- Unsubscribe, archives and other info at:
> http://www.cohousing.org/cohousing-L/
> 
>