Neighborly Support vs Health Care, Co-Care Agreements

I include below a list of things that neighbors can and should not do for neighbors with who need support or health care. One of our residents put this together when we another resident needed more than we could provide and the family was not stepping in. In another instance, the community stepped up for what was expected to be a short term of support that extended to several years. Supporting the resident also became supporting family members who come to help. Meals for one or two became meals for four or five. It was unsustainable and created feelings of guilt and inadequacy.

It’s not easy to draw a line in the sand, and almost impossible after the tide has come in. Establishing guidelines in advance can be very helpful.

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. They are intended to clarify expectations between neighbors, family members living at a distance, and those considering living in cohousing who have special needs.

When presenting 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. This includes:

1. Picking up medications at the pharmacy, but not administering medications
2. Shopping but not being sole shopper
3. Bringing in some meals, but not becoming the cook or meal server
4. Accompanying, along with an aid, to a medical appt but not daily transportation
5. Not providing intimate body care or bathroom functions
6. Not assuming responsibility for making appointments or arranging for health care providers
7. Not 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.