MB 2015A Case for Mutual Support

    by Marianne Boyle

Here’s one thing we know for certain: The graduation of the largest generation in world history into their retirement years will present challenges for seniors and caregivers unlike those of any previous era.

The sheer enormity of the Baby Boomers cohort, born between 1946 and 1964, is the source of most of the concern. Social Security, Medicare, Medicaid and other entitlement systems weren’t designed to absorb such a large population, especially one expected to enjoy longer life spans than imagined by policy-makers decades ago. Add to the pressure of an expanded senior population the likely contraction of government support for at least some services that benefit the elderly, and the resulting squeeze generates a sense of urgency for new approaches to assure that older citizens will have access to the medical and psychological support they need when they need it.

Instead of merely hoping help will arrive in time, many health practitioners, caregivers and seniors themselves are turning to do-it-yourself strategies. A renewed emphasis on health maintenance and illness prevention is a promising change. Physicians, nurses, physical therapists, alternative medical practitioners and mental health specialists are emphasizing personal responsibility for wellness by encouraging healthy diet, moderate, consistent exercise with deep breathing, muscle stretching, stress management techniques and creating order, harmony and simplicity in the surrounding physical environment and within individuals’ minds.

What many studies affirm is that healthy aging and physical isolation work against each other. Isolation complicates every physical and mental health challenge in old age. The role of place, therefore, is getting increasing attention among those who seek healthy, connected lives in the later stages of life.

Many are finding that homes and neighborhoods that seemed convenient during their working years, connecting them by car to the practical and social needs of everyday life, aren’t nearly so convenient as they age and no longer have the desire – or the ability – to keep up the commutes. Despite the construction industry’s awakening to amenities that allow for “aging in place,” growing old in distant, disconnected suburbs often means aging in isolation.

One do-it-yourself strategy for repairing the disconnections is multi-generational cohousing, in which residents co-create their own neighborhoods and share responsibilities for maintaining them. A fast-growing sub-movement of that option is senior co-housing, in which residents actively embrace “aging in community.”

Aging in community decreases anxiety and fear, makes activities of daily living simpler and less stressful and keeps residents stimulated and alert through varied activities, hobbies, learnings and interchanges with others.

 


The ElderSpirit Model

In Abingdon, a small, historic, culturally rich town in southwestern Virginia, an ElderSpirit Community has emerged that provides a working model for resident-created co-housing and for new best practices for “aging in place.”

ElderSpirit is a mixed income community. Thirty-nine people live on its 3.9-acre campus, a short stroll from Abingdon’s commercial heart, eliminating dependence upon cars for every daily task and social opportunity. Currently, fourteen people who were neither eligible for rental support nor able to purchase a home live off-site. Every member has gone through an application process and pays a monthly fee. So it is very much a community connected by choice.

Since homes are clustered closely by design, people are always available for help, for hatching new ideas or just for impromptu conversation. While residents also respect one another’s privacy, the opportunity for casual, unplanned engagement with neighbors is a powerful antidote for feelings of loneliness and isolation. So it was natural in such an environment that a more formalized strategy for mutual care came into being.


A Mutual Support System created by a Care Committee

ElderSpirit Community (ESC) is member-created so several committees formed to handle varied aspects of the responsibilities to the community. Each committee is member-staffed and brings its proposals to the monthly members meeting for information and awareness. The Care Committee is one of the ElderSpirit committees. Its mission is to foster wellness and independence and to facilitate care for members in need of assistance. (See here for other ElderSpirit Committees )

Because of the strong spiritual orientation of the community, committee members at first focused on showing concern and praying for people who were ill.  ESC is not a long-term care facility, and is not able to give hands-on medical care.  Yet when someone suffered from minor injuries and illnesses, they could encourage each other to provide meals, transportation and help with other tasks. But there was always the danger of caregiver burnout if the same people ended up performing all the volunteer assistance. So the Care Committee developed a plan.  They asked each member to select two Health Care Coordinators, people with whom they felt comfortable and trusted.  When a person becomes ill/injured they call their Health Care Coordinators, and the three together tailor a plan for that person’s specific needs and wants. 

Meanwhile the Care Committee created a sign up sheet for neighborly tasks.  Everyone at ElderSpirit was encouraged to sign up for as many duties as they are willing to do. Examples of these are transportation, meals, light housekeeping, companionship, personal care, marketing, medication reminders, overnight hospital stays.

The Health Care Coordinators look at this list of volunteers and ask individuals to meet specific needs of their ill/injured member.  The person who is ill can focus on rest and recovering while their coordinators work with the community to provide the needed services.

No sooner than had they developed this plan when a member fell and broke her elbow. She had surgery and spent many nights in the hospital and months of recovery at home.  Here’s how she describes her experience:


The “Guinea Pig” for ElderSpirit’s Health Care Coordinator System.

“That would be me”, says Susan, the first resident to test the brand new Care system. 

At the January 2009 residents' meeting the new Care system was initiated.  I chose my primary care giver as Pat, my secondary as Elizabeth.  They both agreed.  About a week later, on the Sunday night preceding Obama’s inauguration, I fell on a patch of black ice on the pedway, shattering my left elbow and severely dislocating my left thumb.

Immediately the new plan went into play.  Pat got people to come to the hospital even before surgery.  Elizabeth put into motion a plan for meals. And pretty much every single person at ElderSpirit got involved in one way or another.  I had capes and ponchos loaned to me; large shirts brought to fit over my brace; rides to the surgeon’s office; someone helped bath me; someone shampooed my hair.  It was amazing.  I’d say the system was stellar and something ElderSpirit can be very, very proud of.” 

The plan worked. It called for and provided a structure of creative response that energized the community. 

 


Asking, Giving, Receiving

As with most communities like this, the experience at ElderSpirit is that people like to give, but to ask and receive is more difficult. So the value of these actions is discussed often as the components of mutual support: asking, giving, receiving. The relationship between these three abilities is described in the Mutual Support value:

“Members develop face-to-face relationships through which they offer and receive support.  They express their needs and convictions, listen to each other and strive to act responsibly, considering their good and the good of the other.”

The Care Committee’s philosophy is to encourage members to do for themselves and to ask for what they need.  While volunteers help as much as needed during the illness, they encourage, stimulate and facilitate a way for the person to return to personal independence as much as possible and as soon as they are able.  Caring members are available for the families who are an important part of the care of each member. 

At times people have been hospitalized and there is understanding that if the ill/injured person wants it, an advocate from the community will be with them.

The Care Committee developed a system of education in that there are monthly speakers, who come after a weekly community meal, to speak on wellness practices and disease prevention, to encourage health maintenance and good daily health practices.  There are also round table discussions with members sharing their own experience of coping with aging, limitation, self-care (e.g. good sleep practices, etc.) The educational focus is diet, exercise, stress management, de-cluttered living space and mind, the five wishes, emergency cards, power of attorney, etc. There is a health bulletin board to pass on recent interesting articles and pertinent health information. The Care Committee supports all members to fill out end of life documents. 

Because this mutual support model works well in this contained intentional community, it is believed that it can be a model of co-created care planning for others.

(Marianne Boyle is a member of the ESC Care Committee with Margaret, Fran, Rebecca, Sally, Carolyn and Anne Leibig.  Sally and Anne gave support to Marianne through interviewing her.)


Stories of some of the members of ElderSpirit Community (ESC)

Marianne and Tom
“My husband Tom and I moved to Virginia in 1989 from New Jersey to accept a job.  He retired in 1991 and we lived at Smith Mountain Lake, Virginia.   We belong to a Secular Franciscan fraternity. In 2003 while on a group retreat at the Abingdon Jubilee Retreat Center we found an ESC flier that interested us.   Weeks later we came to the Abingdon ESC office and met Catherine Rumschlag and Dene Peterson.  We heard the vision and got excited.  We especially liked all the values--the smaller homes, the simplicity of living, the support and care for each other, the emphasis on spirituality, the respect for the earth and environment, the honoring of creation and creativity, and the openness to dialogue on the process of aging, illness and dying. 

The neighborhood is lovely: ESC is located on the Virginia Creeper Trail and in the neighborhood of Kings Mountain.  ESC is the 1st of this kind in the US.  Tom and I were always involved in community service so we lived that value already. It was not yet built but we could imagine ourselves living there and creating a new way to age in community. 

We decided to buy a home.  It took 3 years to build ESC.  By 2006 we were completely ready to downsize and to be on the ground level of the development of this way of living.  We closed on our ESC house: then had to wait because our house in Smith Mountain Lake did not sell.  Finally, in June 2007 we moved into ESC and have loved it since.”  

Sally
  “I was living in California. My husband had died after a long illness.  Most of my family is on the East coast.  I wanted to live more connected.   I found out about ElderSpirit Community through information on the Internet.  I liked the emphasis on late-life spirituality.  I visited twice.  I was impressed by the natural beauty, the ease of walking to shopping and cultural events, the sweet little house, and interesting people.  I purchased a house in 2010 and moved east.” 

Anne
 “I moved here in 2011 from a nearby farm.  Although I greatly loved my place there, I wanted to be near others, to experience mutual support and to share late-life spirituality in my elder years.  My husband and I are off site members, living a half block down the road.”

Molly:
“ I'd like to say first, that I see the Health Care Coordinator plan as a way to provide ongoing concern for all.  I, for instance, do not drive. I can walk to   several shopping areas, the library and doctor's appointments.  Recently, I awoke feeling tired and not well. I called my HCC and asked for a ride to my area doctor's appointment.  I didn't have to lose my time slot and was able to rest for the remainder of the day.”

“Two years ago, on a sunny morning, I was coming down the outside stairs and I fell off the bottom step.  Coincidently, my HCCs were in the Common House and came to help immediately.  We realized my upper arm was not right, so they drove me to the hospital.  I had cracked my humerus and had a cast, which restricted some movement.  I found I was able to do most of the “activities of daily living” for myself. Odd things, like opening a jar, or some chopping and putting on some tight clothes were too difficult.  Betty and Loretta, my HCC’s and I felt the best plan would be to have a volunteer do a daily check in. I was very motivated to do what I could and after two weeks I no longer needed any extra help.  I was given larger clothes and could dress myself easily.  I felt very safe and secure with all the caring attention.”

October 2012



This is the official website of ElderSpirit Community at Trailview. We welcome all, regardless of race, color, religion, sex, handicap, familial status, elderliness, or national origin.

 

ElderSpirit Community is entirely smoke-free, including the grounds.

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