Aging Better Together

I recently visited an 82-year-old relative. I had been with her five months earlier when her husband died from pancreatic cancer. She says she is doing “all right.” She continues to live in the same large house that has been her home for 54 years. It is on a busy road with no sidewalks. She has not missed a Sunday at church since her husband died, and she attends a “senior group” there once a month. Her son and his family are nearby, and she goes out for breakfast or lunch with her friends periodically. Despite these supports, there are weeks when she does not see anyone, other than at church. She showed me a book of word search puzzles that she had bought and said she used them to pass the time.

Opting for old age on their own terms, the residents of Glacier Circle in Davis, CA,
|conceived and designed the community themselves, right down to its purple gutters.

I could not help but reflect upon how different her life might be if she was living in an elder cohousing community. Elder or senior cohousing has flourished in northern Europe for decades but it is new in the United States. The first three elder-only cohousing communities opened during a two-year period between late 2005 and 2007, in Davis, California; Abingdon, Virginia; and Boulder, Colorado. The communities are small, with 12 residents in the smallest to less than 40 in the largest. These self-directed intentional communities represent an innovative type of living alternative in the United States. Older adults proactively choose how and where they want to live, and who they want to live with, in a close-knit community where neighbors look after each other. It is a radical “do-it-yourself” approach that older people themselves envision and implement, with no administrator telling them what they can or cannot do.

I have been fortunate to have had the opportunity to visit each of these communities and interview the residents.(1) At one, I have a longitudinal study continuing in which I have collected data every year since the community opened in 2006. In these communities, I have observed neighbors helping each other and looking out for each other in a way that stands out in stark contrast to the neighborhoods in which many of us live — where we drive home at night, pull into our garages, and never even see our neighbors.

We know very little about the role of older friends and neighbors in helping and supporting each other. Our society has largely focused instead on assuming that old age is a time of dependence when people can only be on the receiving end of assistance. Both long-term-care policy and the vast body of caregiving studies assume that the family will be responsible for providing that care when it is required. There are at least two problems with these assumptions. First, this image of old age does not fit with the reality. Not all older people are dependent; most will have many years in which they are healthy and actively engaged in life. Simultaneously, they may have more unstructured time than they have had at any other point in their lives to spend as they choose. They want to have a sense of meaning and purpose in life. The second issue is that when the day comes that some help is needed, not all older adults can depend on family members to provide care — either because they are not close (whether physically or emotionally, or both), or they just do not have families. This gap will only increase with the aging of the baby boomers, as they are more likely to be single(2) and to have only one or no children,(3) compared to previous generations.

The concept of elders helping take care of each other has been little studied, but it offers a way to provide caregiving outside of institutional or traditional structures. It opens the possibility for provision of mutual support that encourages and allows independence at more advanced ages. Establishing the delicate balance between independence and accepting help when needed is one of the challenges that ultimately often comes with age.

These self-managed communities hold the potential to enrich residents’ lives in many ways. Cohousing communities are physically designed with shared common spaces to facilitate social contact. When you move into a cohousing community, you can know all your neighbors within a matter of days. The design promotes a sense of community and mutual support. The concept and potential of mutual support assume even more significance for older adults, with many finding that giving assistance can be as rewarding as receiving it.
Mutual Support

Living in such a community is not without challenges, but a distinct sense of a close-knit neighborhood evolves over time, and mutual support occurs. The model of mutual support developed by the ElderSpirit Extension Team in Abingdon, Virginia, has three elements. Residents must be willing to (a) ask for help when needed, (b) accept help when needed, and (c) give help to others, to the extent that they are able. Additionally, residents also have the responsibility to take care of themselves. As part of their mutual support model, each resident in this community has named other residents to be their “care coordinators,” who will step up when help is needed and organize the necessary assistance. These types of assistance have included grocery shopping, preparing meals, visiting, accompanying a neighbor on physician visits, dog walking, and even personal care. In addition, there is the invaluable knowledge that there is someone to call on, even in the middle of the night.

Dene Peterson, pictured above (right), was the “burning soul” behind the establishment of
ElderSpirit, one of the first senior cohousing communities in the U.S.

Beyond assistance when people are hospitalized or recuperating from illness or injury, there is another even more basic level of mutual support that is occurring: people are watching out for each other in this neighborhood, and this familiarity helps residents feel safe. They value the combination of having their own homes but not feeling alone, having the security of knowing that a neighbor would notice if something happened to them. One female resident stated that when she lived in her prior condominium, there was no sense of community or mutual support and that people just exchanged pleasantries. She then continued graphically:

One of the reasons I wanted to live in community, rather than isolated in my condominium [was]…just ‘cause I thought, you know some morning I’m going to wake up dead and nobody will know for two weeks until they pass my door and say, “It really smells funny in here.” And here, we’re going to do like [others have] done, and check on one another.

Another expressed, “Here we are to some degree interdependent. That’s the way it should be. That’s the difference to me what a community is as opposed to just a bunch of neighbors.”
Benefits of Aging Together

The “solidarity in aging” gained through living in an elder-only community helps individuals to accept their own aging and encourages a willingness among many residents to consider and discuss aging issues. They have purposefully chosen to live in an adult-only community. Most residents would agree with this statement: “It helps being with people who understand because the same things are happening to them.” Some residents also mentioned that they found older neighbors to be excellent role models for aging. For example, a 70-year-old respondent expressed that she learned a lot about aging from observing residents in their 80s. The theme of role models was also expressed in another way: Some residents recognized that what they were pioneering was being viewed as a model by others in the larger community.

As residents age in the community, another significant benefit is support for the caregiver within the community. For example, there have already been cases of couples in which the husbands have been diagnosed with Parkinson’s disease. Certainly it would be an enormous comfort to you as a caregiver whose spouse or partner is dealing with a life-threatening illness to know that you are not dealing with it alone, but have only to go out your front door to reach out for social support.

Respondents have exerted positive influences on each other in a variety of ways, such as encouraging exercise. Another theme many residents mentioned was the ability to have a sense of humor and laugh together about their limitations. Finally, living in this community was energizing to many respondents, simply from the sheer excitement of being part of pioneering a new model of how the later stage of life could be lived.

Thus, the mutual support is part of a larger phenomenon that is helping residents have a better experience with aging by going through the experience together. All the residents know each other, which facilitates convenient companionship and a sense of looking out for each other. This familiarity is important, as there is a strong connection between social networks and improved health outcomes,(4) and friends can play a significant role in well-being and mental health.(5)

A self-directed elder cohousing community is the ultimate example of residents being proactive and taking full responsibility for what happens in their retirement community. Pride in what they have accomplished in these elder cohousing communities is evident.
Creating a “Family of Friends”

Many older people are happily ensconced in a network of family and friends and meaningful activities and have all the support that they will need to help them deal with whatever the future holds. For others, however, especially those without close family, the aging process can be frightening if they see themselves walking that path alone. In fact, too many people face their older years solitary, isolated, and in denial about their own aging. We know now that isolation itself can increase health risks for individuals.(6) Some people, particularly the baby boomers, have witnessed with dismay the experiences of their aging parents and are hungry for a new approach. Building on a concept that has emerged from my work documenting the experience of these elder cohousing communities, my future research will explore an innovative approach for older adults and baby boomers to consider: forming a “family of friends” as an intentional way to build a sense of community and solidarity as a path toward resilient aging. People choose where and with whom they wish to share this journey.

Silver Sage Village, a senior cohousing community in Boulder, Colorado,
was developed by Jim Leach, whose firm, Wonderland Hill Development Company,
is the largest developer of cohousing communities in the United States.

The intentional “family of friends” community model is built upon the idea that older adults are capable of taking a proactive role to share the experience of aging together. Mutual support in this model is based on the concept developed at ElderSpirit Community. The fact that some individuals will eventually also need more formal services is recognized, but it provides an essential “social safety net.” The “family of friends” idea would provide a supportive environment in which individuals grow old in solidarity, thereby enhancing their quality of life through this communal aging process.

The potential for older adults to experience this kind of arrangement is only beginning to emerge. Based on my research, if a group of individuals jointly commits to this idea, they will see each other regularly and often, and share a dedication to mutual support of each other. This mutual support could extend to each individual naming a “care coordinator” among the other members. This self-directed “intentional community” can exist in cohousing specifically designed for it, and some groups may follow the examples of the pioneers who have established the first elder cohousing communities in the United States. Indeed, a fourth elder cohousing community opened in 2010 in New Mexico, and others are opening in California and Oklahoma. However, I believe this “community” can also be created in a variety of existing sites, such as people organizing in an apartment building, a condominium association, or even a traditional neighborhood. Another possibility would be to explore the use of the new concept of a “pocket neighborhood,” as described by Chapin in another chapter, within a standard subdivision or even within a retirement community.

Increasing the likelihood of older people helping each other and sharing information to improve their levels of knowledge about health and aging all lead to healthier older adults. Choosing to live with an enhanced sense of community cannot guarantee that an individual will completely avoid the need for nursing home admission, and it does not preclude receiving help from one’s family, if available. With additional help, if necessary, however, the support provided by one’s “family of friends” certainly increases the likelihood that one can remain longer in one’s home. As one respondent in Colorado expressed:

I think it’s less scary if you think you’ve got support, people are going to be dropping in or bringing you some soup or whatever, and it just makes you feel, I can get through anything better because I’m not frightened of being alone or isolated or ignored or something like that. So I think it definitely does help.

Individuals can remain independent in their housing and be part of the larger community, but still have the support and comfort provided by interdependence among a group of their peers, which can facilitate their ability to remain in the community longer. There are too many older adults who, like my relative, are spending too many days lonely and isolated. It is time to give thoughtful attention to innovative and creative ways that elders can build a sense of community in a way that will help them create solidarity and resilience in dealing with the aging process. Sharing the experience with a “family of friends” is a powerful way for elders to take back control of their own aging from the medicalized bureaucracy that sees aging as a disease and older adults as dependent.