Community and Aging in Place

I spent 41 years living in intentional community. Though I left my long-established community home (Sandhill Farm) in an effort to save my marriage in 2014 (which didn't work out so well), and I've since relocated to Susan's well-established neighborhood in Duluth, my heart remains dedicated to cooperative culture. 

 

(Over the years I've become less attached to the specific form of community, yet very much committed to cooperation. If the incivility and mean-spirited boorishness of the Trump Administration does not convince you of the need for cooperative culture I cannot imagine what will.)

Although I moved out of intentional community just as I entered my senior years, that was an accident, not a strategy. As my cohort ages (we're talking Boomers), I've noticed that an increasing number of intentional communities are starting to have serious conversations about how to work creatively and realistically with an aging population.

While most communities did not think much for how they would handle growing older when they got started, that's not the case with all groups. For example, with the advent of "senior cohousing" (where no one south of 50 need apply), there are elder-friendly features built into the design—wider walkways, fewer stairs, additional space for live-in caregivers—and residents don't have to worry so much about kids screaming at mealtime or wayward Tonka toys on the pedway at night.

 

Regardless of how the community was designed, however, all communities will have to cope with an aging population if they are successful (that is, if they last long enough for original members to grow old). In the case of senior cohousing, they just don't have to wait so long to get there.

 

Because few, if any, intentional communities have been built promising members care through end of life, what we're talking about is aging in place—staying in the community for as long as possible. But what does it mean? What can members count on? Few communities define this ahead of need, and that's the main motivation for this essay—to get groups discussing this tender and important topic before the hard decisions need to be made and misunderstandings can lead to grief.

 

It's easy to understand the appeal of aging in place. Relationships are the lifeblood of community, and when groups are functioning well there is vibrancy, joy, and camaraderie among the members. It's a no-brainer that people would want to hold onto that in preference to a dubious future in assisted living.

With that in view, it is important for the community to start defining the limits of what it can provide for members, so you’ll know when it’s time to start talking about what help people can ask for, and when it’s time to start thinking about going somewhere else, because one’s needs have outstripped the community’s capacity to help.

—Hint: Don’t want to wait until you’re facing your limits to start determining them—these conversations should happen well ahead of need. 

Here are some things to consider:

A. Managing the Demographics

It will not work if everyone is infirm at the same time. While there are subtleties about where the limits are, and how to cope with a burst of needs that might blossom all at once (as if infirmity were contagious), it should be fairly obvious that the group will have a much easier time covering the care needs of 10 percent of the population, than it would if 75 percent needed that same level of attention. The former might be a powerful time of pulling together; the latter might be a horrific swamping of the boat.

—Special note for senior cohousing: This point is all the more compelling for you in that you've purposefully selected a much narrower age range to work with. Instead of a span of 75 years (in a fully-fledged multi-generational community), you're only working with 25 years. That means you have to stay that much more focused on a viable ratio of the healthy to the infirm.

 

Digesting this, there is a great deal that can be done by an active Membership Team to recruit new members that are healthier (and younger) if your community is starting to get long in the tooth.

—Word of Caution: Fair housing laws prohibit recruitment that is based on age, yet there is no law against targeting your recruitment efforts. So if you want families with young children, don't advertise for that in print; focus your outreach on Montessori and Waldorf schools, or the local chapter of the La Leche League. Go to the places where you are likely to find the values match you seek and the age range you're hunting.

 

B. Emphasizing Relationships as Security

To an amazing degree, it’s possible to substitute neighbor care for professional assistance. In most developed countries we tend to define security in terms of money or insurance. Yet community allows us to substitute relationships for money to a large extent. I’m not talking about asking your neighbor to perform surgery, but most care needs are modest and don’t require trained professionals. I’m talking about helping with physical tasks, being a buddy in going for walks (or to do gentle yoga), inviting seniors to social opportunities (like playing cards on Saturday night, or being part of a book club Tuesday afternoons), walking the dog, and driving people to town once a week.

Many will be able to live a lot longer in place if they receive a modest level of help in key areas. While extraordinary support can be sustained briefly (such as when a person is in a whole body cast for a month following a car accident), less heroic levels of support can be sustained for much longer—even years— if spread out over a large enough population, so it isn’t so much of a burden on any one individual or household.

C. Communication Support as Distinguished from Physical Support

Support can look like many things. While we most often think of physical aid (getting down high things for a person in a wheelchair; or feeding someone with broken arms), the group may commit to being a communication clearinghouse without committing to any particular level of physical support. I know one group, for example, that established a Care Committee (for any member in need, regardless of age), such that it would be available to help get the word out within the community about anyone's compromised health situation and what particular kinds of support that person was looking for. There is no promise that help will be forthcoming (individual members will respond as they are moved by the particulars of the situation); only a promise that the call will be put out, and that responses will be coordinated if the person wants that.

D. Balancing Social Capital

Because communities are comprised of individuals who have chosen to live together, you cannot mandate care. If it's “required” it will become a burden and the energy will be wrong. You want care to be given freely. This will tend to flow much more easily if the person in need has established social capital within the group—by having given substantially to the community (in terms of time and energy, more than money) prior to need. When a person has generously given of themselves to the community, the community naturally wants to support that person in return. If, on the other hand, a person arrives in the community with intent to run a negative balance (where they need more support than they can give) that doesn't work well.

E. Financial Safety Net

Despite what was said under Point B, there may be times when financial support is needed or helpful, and that too can be organized by the community. This can be done either through increasing dues to create a surplus to capitalize an Emergency Care Fund, or by asking those who are better off financially to donate to such a fund. This pot of money could then be administered by the Care Committee, working under guidance developed and approved by the plenary.

F. Trading Off One Kind of Support for Another

You cannot be all things to all people. Groups have to choose. The more money and time you give to aging in place, the less discretionary bandwidth remains for other worthy causes, such as supporting people with developmental disabilities, or providing transitional refugee housing. I am not advocating for any particular position when I state this; I am only pointing out that there are limits. The more you give to one thing, the less remains for anything else without risk of flooding the engine. 

I urge groups to discuss this and prioritize where they want their support to go, and how often they’ll review their decision.

G. Safety

When should limits be placed on a person driving, operating dangerous equipment, or even supervising others? When does it make sense to limit a person’s power in decision-making because of deteriorating memory or compromised cognitive ability? Talk about how you'll recognize, discuss, and communicate about these delicate moments, balancing the need for disclosure within the community with appropriate discretion about who that information is shared with outside the group.

H. Dignity and the Opportunity to Be Useful

Even with deteriorating abilities, people can often continue to be helpful to the group if thought is given to how to set it up well, and this can make a large difference in quality of life for a person with diminished capacity. No one wants to be made to feel useless or a burden. Perhaps by pairing the senior with a younger person, or only giving them tasks that do not depend on the particular ability that’s been compromised, it will be more possible to engage seniors usefully in community life well into their later years.

If you like this idea, it could be made part of what the Care Committee handles when they periodically canvass members for an update about their limitations and needs.