< Culture Change

Building a Collaborative Elderhood

"Most people wish to age in place," remarks Zev Paiss of Boulder's Abraham Paiss & Associates, "what we are offering is the opportunity to age in community." A year ago, Paiss and his partner, Neshama Abraham launched the Elder Cohousing Network, an organization devoted to helping adults 55 and older create elder cohousing communities.

Cohousing had its U.S. debut in the late 80's when Charles Durrett and Kathryn McCamant introduced the Scandinavian concept in their seminal book on the subject. The idea caught on, and today, there are roughly 5,000 people living in 80 cohousing communities across the country.

Blending elements of autonomy and community, cohousing may be mainstream society's answer to communal living. Shared facilities, such as vegetable gardens, play areas, greenhouses, and the Common House, serve as extensions of privately-owned homes. Residents gather in the Common House for meetings, celebrations, and optional common meals shared several times a week.

While there is no common source of income, as in other kinds of intentional communities, other resources are shared wherever possible. Homes are clustered around a pedestrian common area, with cars parked discreetly on the neighborhood's perimeter - a design that is both environmentally sensitive and conducive to spontaneous socializing.

The defining characteristic of cohousing, however, may be the strong sense of ownership that residents develop through community building. Unlike developer-driven projects, community members actively participate in designing a neighborhood that reflects their needs. Sometimes lasting months or years prior to construction, this process helps build relationships long before the physical neighborhood exists.

"When we create housing for people, we just aren't as successful as when we create it with people, " explains Durrett, who has facilitated the creation of thirty-eight U.S. cohousing communities since 1991. While residents may hire a developer to guide the planning process, ultimately, the community's mission and character are in the hands of the community.

After moving in, community members continue to manage the daily functions of community life. Decision-making is non-hierarchical and usually involves consensus. Joining a cohousing community is usually a self-selection process. As cohousing is not for everyone, prospective members usually move through a learning process designed to help them determine whether cohousing in general, and the specific community in question, is a good choice for them. Each community develops its own unique culture - while one community may not resonate with who you are, another may seem like a perfect fit.

Elder-specific cohousing embodies most of the benefits of its intergenerational counterpart and includes a few of its own. "People who are interested in elder cohousing really want to change the current culture surrounding aging," notes Paiss. Emphasizing elderhood as a period of growth and reflection , elder cohousing may incorporate aspects of social activism, community service and late-life spirituality in a supportive, peer-focused environment. Reflecting on his visits to Danish elder cohousing communities, Durrett adds, "The reality is, I'm not sure I've seen folks have more fun."

Elder cohousing has been a presence in Denmark since the late 1980's. Three years ago, Charles Durrett returned to Denmark to glean material for his new book, Senior Cohousing: A Community Approach to Independent Living. His research revealed that 20 of the last 25 cohousing neighborhoods built in Denmark have been elder-specific communities. In the U.S., four elder cohousing communities are currently in various stages of development.

What sets elder cohousing apart from other retirement options is scale and personal investment. Cohousing neighborhoods rarely exceed 40 households per neighborhood, with elder-oriented communities running a little smaller. Contrast this with Del Webb retirement communities, which range from 500 to 10,000 households per neighborhood. The intimate scale of cohousing neighborhoods offers residents the chance to develop closer relationships. Residents also develop deeper connections as co-participants in the community envisioning process, which is harder to come by in pre-planned communities, such as continuing care retirement communities (CCRCs) and other retirement villages. "Knowing each other deeply and sharing common interests," says Durrett, " really fuels and enriches the caregiving exchange."

Unlike retirement options focused solely on active lifestyles, elder cohousers are committed to a holistic view of aging. Group process isn't limited to decisions regarding the day-to-day affairs of community life, but also deals unflinchingly with significant meta issues, such as illness, dying, and exploring what caring for each other will look like in individual communities.

"When it comes to life and death," notes Durrett, "I have never in my life come across a group of people less in denial than senior cohousers." Elder cohousing typically affirms living and dying at home. Through an organic process, community members boldly discuss and collectively decide how they will provide care for one another over time. While it lacks the certainty that prescriptive models like CCRCs share, this grassroots approach offers flexibility should residents need to respond quickly to changing needs within the community.

Each community group must grapple honestly with how they define mutual care: What are they willing to do and what are they not willing to do in the way of caring for one another? What documentation will they require of each other, how will they advocate for and honor each other's wishes? The defining quality here, however, is that they are doing it together, on their own terms. "Elder cohousers have not been plopped into an outcome that has been defined for them," notes Zev Paiss, "they are collectively creating it together."

Skeptics still wonder if the country's fledgling elder cohousing movement is taking an honest look at its long-term ability to age in place. Questions revolve around handling the needs of many frail elders at once or actively addressing more complicated health care issues within the community.

The answer may lie in marrying the support systems inherent to cohousing with existing home health care services. Borrowing the best from both worlds, the result would be an integrated approach to providing care that is both efficient and comprehensive. "Because cohousing offers so much emotional support," Paiss mentions, "it will shift what kind of services are ultimately required from the outside."

With this in mind, the Elder Cohousing Network and Total Longterm Care (TLC), a Denver-based managed care organization, have been putting their heads together. TLC is the Denver home for Programs for All-inclusive Care for the Elderly (PACE), a totally integrated system of home health care services designed to keep frail elders at home for long as possible. Recognizing a potential synergy, they've only just begun to discuss how a future relationship might develop.

"We believe that elders fare better in community," explains Sue Radcliff, Vice Chair of TLC's Board of Directors, "When our clients have good community support, we can work collaboratively with that community to better meet the elder's needs." Radcliff points out that having a single organization handle all of the integrated care needs makes it easier for the cohousing community to develop a strong collaborative relationship with the care providing organization.

Creative possibilities like this beg the question: Can elder cohousing eventually provide a lifespan solution to the health care needs of American elders? Only time will tell. Elder cohousers in the U.S. are only just beginning to discover what the Danes have had years to practice and refine. What elder cohousing currently lacks in the way of a blanket guarantee, it more than makes up for in rich social, emotional and spiritual support systems - a benefit that may pay off substantially in quality of life and better overall health over time.

Laura Beck is the Program Director for The Eden Alternative's new initiative, Eden at Home. She also lives at Ecovillage at Ithaca, a cohousing community in Ithaca, New York.

Other Resources

Durrett, Charles. Senior Cohousing: A Community Approach to Independent Living. Berkeley, CA: Ten Speed Press, 1-800-841-BOOK. Release date: September 2005.

Durrett, Charles and McCamant, Kathryn. Cohousing: A Contemporary Approach to Housing Ourselves, 2nd Edition. Berkeley, CA: Ten Speed Press, 1-800-841-BOOK, 1994.

Walker, Liz. Ecovillage at Ithaca: Pioneering a Sustainable Culture. British Columbia, Canada: New Society Publishers, 2005.

The Cohousing Association of the United States
Phone: (314)754-5828
Web site: www.cohousing.org

The Cohousing Company
Phone: (510)549-9980
Web site: www.cohousingco.com

The Elder Cohousing Network
Phone: (303)413-8066
Web site: www.abrahampaiss.com/ElderCohousing/

The National PACE Association
Phone: (703)535-1565
Web site: www.npaonline.org

Total Long Term Care
Phone: (303)869-4664
Web site: www.totallongtermcare.com