Comment on Co-Housing as a Great Retirement and End of Life Alternative

Raines Cohen, Cohousing Coach, Planning for Sustainable Communities, Berkeley, CA,

Posted an excellent comment on co-housing.

Thanks for including cohousing on your list of options for alternatives to Nursing Homes. A lot of the types of "experts" you list probably won't be aware of it, because it is a member-led ground-up community movement, only recently forming communities specific for a senior population, and the idea that "we can do it ourselves" is threatening to some of the institutions and even to professionals established in the "industry of aging".

You are fortunate in the DC area to have a large number of built (multigenerational) communities, and a strong regional association: Mid-Atlantic Cohousing (MAC) , which links to communities in the area, both built and forming; the group's leader, Ann Zabaldo, was my classmate in learning about Denmark's "Study Group 1" model curriculum that has led to the proliferation of Senior Cohousing there and is doing some talks in preparation for offering such a class in your area.

Raines Cohen, Cohousing Coach, Planning for Sustainable Communities, Berkeley, CA
writing from the Positive Aging conference at Eckerd College in St. Petersburg, FL, where there's a lot of excitement about alternatives including cohousing and the Beacon Hill Village model I've also studied.

The Joy of Writing

Why does this written doe bound through these written woods?
For a drink of written water from a spring
whose surface will xerox her soft muzzle?
Why does she lift her head; does she hear something?
Perched on four slim legs borrowed from the truth,
she pricks up her ears beneath my fingertips.
Silence - this word also rustles across the page
and parts the boughs
that have sprouted from the word "woods."

Lying in wait, set to pounce on the blank page,
are letters up to no good,
clutches of clauses so subordinate
they'll never let her get away.

Each drop of ink contains a fair supply
of hunters, equipped with squinting eyes behind their sights,
prepared to swarm the sloping pen at any moment,
surround the doe, and slowly aim their guns.

They forget that what's here isn't life.
Other laws, black on white, obtain.
The twinkling of an eye will take as long as I say,
and will, if I wish, divide into tiny eternities,
full of bullets stopped in mid-flight.
Not a thing will ever happen unless I say so.
Without my blessing, not a leaf will fall,
not a blade of grass will bend beneath that little hoof's full stop.

Is there then a world
where I rule absolutely on fate?
A time I bind with chains of signs?
An existence become endless at my bidding?

The joy of writing.
The power of preserving.
Revenge of a mortal hand.

By Wislawa Szymborska
From "No End of Fun", 1967
Translated by S. Baranczak & C. Cavanagh

NURSING HOME SEARCH

A number of newspapers recently reported on the list of the worst nursing homes in the country. Only one was listed in the District of Columbia, but the list should remind us to do a thorough evaluation of all options for housing for the elderly and disabled.

The first line of defense is to start early preparing for later disability, whether for yourself or a parent or family member. This includes developing a network of family and friends whom you can rely on. If you are a child, helping your parents think out ahead. If you are the parent, thinking about how to create or find a network of like-minded support family members and friends.

The second is to begin exploring a lot of options while you or your family member is still able to get around and make choices for themselves. There are many resources on the internet, including co-housing, elder co-housing or finding a vibrant community -- some empty nesters even return to city center to be near shopping, movies, lively restaurants and community centers -- to move into or live near.

The third, when one hasn't been able to do advance planning, is to research the assisted living and nursing home options where you or your family member wants to live. One of the best places to begin is with the ombudsman in your area who monitors these facilities. That person will have tremendous knowledge of the facilities and what level of care they provide, especially what quality of care.

Be prepared to look at a number of places. Also, identify what you or your family member is most interested in in terms of social interactions, setting, environment. Cost is only part of the picture. Expensive places can be sterile and cold; "poor" places can be rich with life and a caring staff. Ask questions of the staff and ask to talk to people who live there. Ask many questions about the things in life you care about. My mother would ask "how many people read the New York Times?"

Consult with experts who may know a lot about the various choices, such as geriatric care managers, the area agency on aging, and elder law attorneys, among others. Perhaps there is a local citizen commission on aging and city office on aging. When you visit, all nursing homes are required to have a book that records the record of performance. Read that.

The two most important things to do are 1. define what kind of a life you or your loved one wants to live and 2. do a lot of comparison shopping as early as possible before your choices are limited by disability or lack of money. And, check on the many resources in your community.

Personal Religion and Professional Performance

Mitt Romney should have a simple answer, the same one for all of us whose professional requirements sometimes may conflict with a personal religious tenet, and that is:

* My religion is personal.
* All religions have the golden rule at the core: do unto others as you would have them do unto you (and variatons on that phrasing).
* That single value infuses my professional actions.
* If there is a conflict between my religious beliefs (and duties) and professional responsibilities and duties, actions in the professional sphere will (must)be guided by the reciprocal kindness rule and performed as required in the professional context.

Separation of church and state should inform the separation of professional actions from religious beliefs, observations and actions.

A deeply devout Christian who doesn't believe in the death penalty may still enforce it if that is the law. He or she can work to change the law, but must obey it until changed.

A pharmacist who doesn't believe in abortion must still sell morning after pills approved by the FDA to those qualified to buy them. The personal religious belief should not override professional actions and responsibilities.

A president of one faith may fully pracitice his or her faith, but must be religion-neutral in dealings with the world's people who hold diverse religions or no religion at all. Advancing a pinched view of religion serves neither religion nor public professional performance and leadership.

What Is Lear's Legacy?

A gruel thin legacy or a basket of love? Bill Thomas asks the question of intergenerational transfers of wealth. My answer:

It all depends on what kind of capital the parents have built up to pass on.

Amassing physical wealth, property, glories, riches, requires constant vigilance to protect. Offspring are held in thrall to the prospects of inheriting some or all of that earthly glory.

Building, nourishing, cultivating family and friendship bonds, links to loved ones, old stories told and retold, are human and spiritual capital that can't be given away and that keep offspring coming back for more.

I was lucky to have parents who continued to earn our love and affection and trust and eager connection until death. They both continued to grow into more full, more exciting, more engaged humans until, so far, only my mother's death. We children vied for who could visit when, with limited bed rooms. We travelled in bunches, carrying our sailing canoes and kayaks to beautiful places where we played and ate and continued the conversations, well into my parents old age.

Now, with my step father still telling amazing stories as he sinks into a wheelchair that we are keeping away from him so he retains his muscletone, he has invented a novel of 24 chapters. A filmmaker son in law will record the telling of those chapters, all about the Civil War, rewritten to a more satisfying outcome.

That is a transfer of wealth that can never be exhausted and that nourishes each one of us.

My biological father, on the other hand, pursued wealth and glory. He died a pauper, having disinherited two sons and shortchanged a third because they "were a disappointment to him". These sons, who will never recover, argued for months that the will should be contested, that the stepmother had poisoned him and stolen all of his money. A gruel thin legacy.

Which basket should one lay one's eggs in?

File Letters of Conservatorship with the Register of Deeds

After all the agony and hoopla of getting appointed conservator of a person lacking capacity to manage their affairs, remember to file the Letters of Conservatorship with the Recorder of Deeds. Should anything happen to the property under your control, you, your ward, and your ward's property are protected.

Disasters can occur when the Letters of Conservatorship have not been filed. Title companies may claim that they didn't find the Letters in the land records, so they were justified in going to closing on what in fact is a fraudulent transfer. Recovering the property requires litigation, expert witnesses, time, money and heartache.
Office of Tax and Revenue: Recorder of Deeds

AND ALL HE HAD WERE ROAD FLARES TIED TO HIS BODY

The tragedy that ended peacefully in New Hampshire today -- unlike those where mentally ill people get guns and end up killing others and/or themselves -- reveals much about our great difficulty in dealing with mental illness.

As Hillary Clinton said, he probably wanted to talk to her to ease his pain. We know the grimy details, a mentally ill man, going through a divorce (marriage apparently characterized by a lot of violence), drinking for 72 hours. He blew over the top.

The prominence of the location -- Hillary Clinton's local campaign office -- contrasted with the repeated pictures of police in counter-terrorist garb and guns together with the media frenzy, is a metaphore for how tragically limited our capability is to assess and deal with a man who went over his threshhold of pain. The word "overkill" doesn't begin to measure the gap between the ailment and the, our, response.

Many obviously don't achieve the heights of aberrational, dangerous and self-destructive behavior as that of Leeland Eisenberg. But the grinding contrast between their desire to reach out and touch and the dysfunctional ways in which those suffering from schizophrenias and bipolar disorders carrom from one failed interaction to another, all have the same pattern.

Intensities, deafness to others, lack of affect, lack of ability to connect, internal demons that at the least distract and at the most produce grandiosity, serious obsessions, impairments of all kinds, all spill over onto the caregiving and responsible families, doctors, caregivers and police.

The core understanding has to start with the knowledge that these manifestations of mental illness are not subject to will, punishment, redirection or any ouside or internal force other than the dis-ease itself. They can't help it. What such a person feels, thinks and does are impervious to control.

And, because in so many cases the person sees him or herself as not only normal but possibly gifted and only suffering from some physical ailment, he or she often refuses medication.

The definitions of behavior that trigger intervention by the law (commitment to a facility or in this case, jail) -- "a danger to himself or others" or a stronger formulation, do not give us a strong hold on helping either the person or the caregivers and restrainers.

The interpretation of "danger to self or others" focuses primarily on a physical danger. Police and hospital personnel will let a deranged person go back on the street if they aren't behaving wildly and can communicate just enough coherence to show a small hold on reality, in that immediate moment. The fact that it is predictable that he or she will proceed to binge on delusions and possibly harm themselves or others, again, doesn't enter into the evaluation.

We are constrained by our laws. But the laws only reflect the prevailing consensus of the society. And the fact is that in the face of intractable mentall illness, if the person (I hate to say victim) doesn't want help and doesn't want to be on medication, there is nothing we can do. Tragic as it is. Yes, we can nudge and try to convince. But the disease is too strong.

So, acceptance of the inevitable roller coaster built on a merry-go-round is the only real place to start. Accepting that society can't really respond if the person doesn't want help. And accepting, painful as it is, that they will continue to behave in dysfunctional ways that will weigh heavily on family or caregivers and sometimes end in tragedy.

Then the questions: what is the right reaction? how does one communicate or work with him or her? what is the right level of intervention? what will possibly be healing?

Was placing the man face down on the road and handcuffing him and then steering him from police car to police car and wheeling away with numerous commandos holding onto the van, the right response?

The answers are still out of reach. Our only tools are acceptance, understanding, patience, not judging, and being there, holding our ground. And hoping they will take their medication.

Can't we find better ways?