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Posted: November 24, 2004

Professional Caregiving

The Kibbutz -- A Housing Model Worth Looking At

The other day I was riding with some colleagues to the Assisted Living Task Force meeting in the state capital. The two-hour ride afforded us a chance to shmooze and we found ourselves discussing what type of long term care residence we would want when we got "there."

Of course, assisted living was on our minds, as we had spent over 30 hours in a two-month period processing and discussing regulations that we would recommend to the legislative task force assigned to promulgate our state regulations. Protective Oversight is a biggie. Of course, we want the oversight when we need it, but we don't want it before we need it as that brings on the slippery slope of dependency on others to attend to our needs. Like an invitation to let go, and let others assume the management of our care. Learned helplessness.

Others don't want to move at all, and just want to figure out a way to stay in their homes even if they are two-story and not yet readied for the time they would have a need for a bedroom on the main floor. One of the passengers in our car, who just had his second hip replacement, casually declared he crawled up his steps after returning home from the hospital, and he just stayed up stairs until his therapy was done and he could come down stairs again.

Another mentioned the age segregation issue she has with all of the options within the continuum of care. Residential care, skilled nursing care, assisted living. They are primarily homogeneous in scope. Older adults, many with different conditions that landed them there, but nonetheless, mostly aged.

She said her idea of her last move would be to an intentional community. What's that you ask? Many contemporary communities are groups of people who have chosen to live together with a common purpose, working cooperatively to create a lifestyle that reflects their shared core values. These can be as broad as a commune at one end to a neighborhood of homes in the suburbs with a value commitment that fosters relationships and the broader philosophical concept of community.

I never really studied this concept, but in the ?70s I lived on a kibbutz in Israel for a year.

That was a cooperative community, based on a socialist model, where all jobs were assigned by skill or need, all resources were pooled together, all expenses were shared. If one had a phone, all had a phone, if one worked in the kitchen, their children had the same opportunities as the one who ran the furniture factory on the kibbutz.

It was a wonderful experience in cooperative living. I remember then saying to myself that when I get old, I want to live on a kibbutz. Do you know why? Even at the age of 20, I could appreciate the old (very old) ladies who came to the dining room every day and filled the salt and pepper shakers, polished the napkin holders and visited with the members who came for meals or worked in the kitchen. They weren't retired or put out to pasture. No matter how slow, no matter how often they didn't come to work due to severe arthritic conditions, for example, they had a place, they had a job and they had a purpose. That for me was intentional living.

They also had the wonderful opportunity to reach old age and infirmity within a heterogeneous mix of ages, the babies, toddlers, children, teens, young couples, middle aged adults (their children) and others as old as they. That, it turns out, is what my colleague was talking about. She doesn't want to age with only one cohort in her daily life other than those hired to assist her.

She wants the variety, the chaos, the peek into modern culture that is bound to be part of living within a multi-intergenerational community. Yes, there might be more noise, and distractions, but she would prefer that over boredom and loneliness. If we could combine those components into our continuum designs and also incorporate the work opportunities that stay with a person as long as they are able, then we would have healthier people and healthier communities in which to live out our years.

What would be the benefit of this model for the younger folks? It would for those who hearken back to a time when grandparents were around, give them and their children a truer glimpse into the concept of community than our present neighborhoods do. They would benefit from the child care opportunities... as in, It Takes a Village.

My community has much more age-segregated areas. Congregate living in one part of town for seniors, or Naturally Occurring Retirement Communities, NORCS where those in their early 60's moved and now 20 years later, they have aged in place, but so have their neighbors and fewer and fewer young families were drawn to these apartments.

On the other hand, you have homes, town houses, condos and apartments that house mostly young students, couples or young families wherein the supports are not available for those who are aging. Maybe no elevators, no decent public transportation, no way to walk to the store. Many of our "intentional communities" are intentionally segregated and this has created a dearth of life experiences that span the ages.

Exploring our own desires for housing as we plan for our own infirmities, help clarify what is still lacking in our efforts to build comprehensive continuing care communities.

_____

Sylvia Nissenboim is a licensed clinical social worker and who has been working in the field of adult day services in the St. Louis area. She is the director of four adult care and enrichment centers for the American Red Cross and also operates a personal and professional coaching firm, LifeWork Transitions, specializing in caregiving concerns, adult day care management and other aging services, such as virtual coaching and family care giving support groups. She co-authored The Positive Interactions Program, is a national speaker, and has served as president of the Missouri Adult Day Care Association and as a member of the Missouri Governor's Advisory Council on Aging..

© 2004 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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