Mutual Support in Senior Cohousing

The issue inevitably comes up — how, when and to what extent do we help our neighbors? People move into cohousing in a spirit of togetherness, camaraderie and caring for one another. But what exactly does that mean? Doing a favor for a neighbor? Helping them out with meals or chores when they are ill or temporarily incapacitated? What about doing their weekly shopping when they are no longer mobile? Where do communities draw the line between what’s reasonable and what is not?

Many seniors in cohousing want and expect to live out their lives in their communities. But what happens if they are no longer fully able to take care of themselves or participate in community activities? Some communities already have policies or agreements in place that define the parameters of mutual support. Others handle it informally. Still others are working to spell out what it means for them.

Some communities have used the term “co-caring,” but it can be fraught. “Care” means health care in the medical field, so there’s room for confusion as to what kind of care cohousing members should offer each other. For example, can it include giving medication? Most communities draw the line at anything that can be construed as medical care, partly because of potential liability issues.

It can get complicated

Putting into practice a mutual support agreement can run into some thorny issues. For example:

  • Privacy is a very sensitive issue for some people. They may be reluctant to share any information about their health — information that may be needed to determine how the community might be able to support them.
  • Many people find it difficult to ask for help or even to receive it when it’s offered.
  • A member can be in denial about how much their physical or mental condition is affecting their health and safety.
  • There may not be any family members nearby who can help make decisions about what kind of care is best for their loved one.
  • Family members may expect a community to provide more help than it actually can.

Some communities draw the line between short-term and long-term needs. For example, a person may appreciate help with meals and tasks for a week or two after having surgery, and community members may be happy to provide that. But needing transportation to dialysis three times a week — an ongoing, long-term need — can’t reasonably be fulfilled by the community.

Ultimately, community members are responsible for themselves, and this should be made clear when they join cohousing. If a member reaches a point where they need daily help with basic life activities — like getting dressed or bathing — they have the option of hiring an in-home caretaker as an alternative to moving to assisted living. That may allow them to continue aging in place. These can be difficult decisions, and a community may be able to help the resident and/or family make the best choices.

Three examples

The following examples describe how three senior cohousing communities have structured mutual support. A common element is for residents to choose one or more persons in the community to coordinate support when it’s needed and keep the community posted.

Quimper Village, Port Townsend, WA. This community has written guidelines for “Neighborly Help, Not Health Care,” including clear examples. The community has a “buddy” system — you choose another community member to act on your behalf if you are unable to care for yourself due to illness or injury. Buddies have access to key information like your emergency contacts outside the community. They periodically check to see if you’re OK and, with your permission, can keep the community informed of your status. The guidelines say that, “Ultimately, neighborly care is voluntary, temporary and limited.” Nevertheless, members who have developed a more intimate relationship may do more for one another if mutually agreed.

Oak Creek, Stillwater, OK.  Oak Creek’s “Community Care Partners Agreement” asks each member to choose a primary and secondary “care partner.” In case of an illness or injury, these partners may communicate with the community about a member’s condition and needs, to the extent the member wishes. Care partners help coordinate care and support from inside and/or outside the community, as they are able and as the member desires. Each member is asked to provide key information (like emergency contacts) to be kept in a secure file cabinet or designated location in the member’s home. Oak Creek doesn’t rule out care and support during a longer-term medical recovery but asks members to discuss with their care partners what level of support and communication they would want — and the care partners could coordinate — in both short-term and longer-term situations.

ElderSpirit, Abingdon, VA. ElderSpirit has established a mutual support committee that encourages members “to learn ways of taking care of self, asking for, giving and receiving help, without offering medical or health care.” The community has a “mutual support system” that asks members to find two people in the community (or nearby) to act as their “neighborly support coordinators.” If a member suffers an accident or illness, a coordinator can discuss with them their needs during recovery and ask for volunteers from the community to meet those needs. If a member can no longer live independently within the community, the coordinator (and the member’s family, if available) will discuss options, if any, for additional help from inside or outside the community. Download ElderSpirit’s mutual support brochure here

 

Join us at the Cohousing Institute on April 10 for Starting an Aging in Community Conversation, presented by the CohoUS Seniors in Cohousing Committee

Wednesday, April 10, 5–6:30 p.m. MT, Cost is $45 or free for CohoUS members

 More information and registration here

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