Description of the Cooperative
Home Environment
(Last updated 2 February 1999) The Senior Home Care Cooperative would be a home in every sense of the word. The older adult residents would be able to participate in the ordinary activities of daily life and follow their usual routines, surrounded by family and friends. Pets would be welcome. Apartments would be furnished with the belongings of the residents. Residents would have their own bedrooms and privacy whenever they wished. Meals would be cooked and served in the apartments by the family members and paid caregivers. All decisions regarding home maintenance would be made jointly by the residents and their families. Tasks such as grocery shopping, house cleaning, and building maintenance could be done by family members, volunteers, or someone hired by the Cooperative for that purpose. All aspects of life in this cooperative home would be designed to meet individual resident's needs and preferences. In this setting, the older adults, with the help of their families, would be able to retain control over their lives and maintain their identity.
24-Hour Care and Supervision
Family members would help paid caregivers provide 24-hour care for the residents of the Senior Home Care Cooperative. Each family would be responsible for providing 16 hours of care per week and the remaining hours would be covered by paid caregivers hired jointly by the families. There would be two caregivers present at all times during the day to care for the 6 residents living in the two apartments. At night, there would be one caregiver.
Supportive Care
The care provided by the Senior Home Care Cooperative would be basic supportive care at whatever level each resident required, up to and including total care. The resident would never need to move to a nursing home unless they or their family wanted skilled nursing care and high-tech interventions, such as IVs, feeding tubes, and ventilators, which would not be available at the Cooperative.
The Senior Home Care Cooperative would not provide any medical care or assume any medical responsibility for the residents. Residents would retain their own doctor and continue their existing program of medical care, just as they did in their previous home. If a resident became ill, the family would be responsible for helping the resident to obtain medical care. If the resident required medical intervention, he or she would have to go to the hospital or to a skilled nursing facility to receive that care, returning to their home in the Cooperative when well. Hospice services could be brought in to the Cooperative for a resident who was dying and chose not to have any extraordinary measures taken.
Individualized Whole-Person Care
Each resident of the Senior Home Care Cooperative would be seen and cared for as the unique individual that he or she is. The care provided would address the needs of the whole person - emotional, social, and spiritual, as well as physical. The plan of care would be written by the resident and the family and would detail the daily schedule of each resident and the assistance required by each. The care would be flexible and creative and would be designed to maintain the well-being and dignity of each resident.
Elimination of Ageist Attitudes and Practices
At the Senior Home Care Cooperative, attitudes and practices would reflect a respect for, and a valuing of, the residents' experiences of aging and frailty. Residents would be included, to the degree of their ability, in decisions affecting the management of the Cooperative and their own care. They would be encouraged to make whatever contributions they were able to the life of the community and would be included in the conversations, plans, and activities whether or not they were able to be active participants.Involvement of Family and Friends
The Senior Home Care Cooperative would provide the interaction and involvement with family members and friends that occur at home. Family caregivers know exactly how their elderly person likes and needs to be cared for and would serve as an invaluable resource. It is in the eyes of family members and friends that older adults retain their history and identity, and the presence of family members would be a constant reminder of that personhood for the residents and the caregivers as well. It is with family and friends that the strongest bonds are formed, and their presence would help to meet the basic need of each resident to belong and to be loved. Family and friends of all ages would be welcomed. Maintaining a link to the next generation is one of the strongest motivations for an older person to remain interested in the future.
Support for Caregivers
The Senior Home Care Cooperative would provide much needed support for family caregivers. The responsibility and work of caregiving, the many tasks required to make and maintain a home, and the costs associated with all these things would be shared. The family members would be enabled to participate in caring for their elderly person and still have lives of their own. The physical presence of others would defuse the intensity and remove the loneliness that can be present when family members care for an elderly person in isolation. And the family caregivers would be nurtured by being in the company of other people who understand and value their desire to continue to provide care for their elderly person.The Senior Home Care Cooperative would recognize that the work done by paid caregivers is extremely demanding and of the utmost importance and that doing it well requires a high level of dedication and skill. The caregivers would be paid a just and living wage, (current plans call for this to be $10/hr) and they would be part of the decision-making process with regard to those activities for which they were responsible.
Communication
Regular meetings of residents, family members, and caregivers would be held to discuss all aspects of the group effort. The goal of the meetings would be to foster healthy communication and problem solving.
Affordable Cost
Every effort would be made to keep the monthly costs of the Senior Home Care Cooperative as low as possible without sacrificing any of the Cooperative's objectives. The cost of providing around-the-clock care would be more affordable because the families would be sharing the expenses and also contributing time as caregivers.
The estimated cost of belonging to the Senior Home Care Cooperative is $2,000 per month and would cover the expenses of both housing and care. The monthly housing costs (mortgage payment, utilities, phone and groceries) would be approximately $675. And the monthly cost of care, based on each family providing 16 hours of care per week, would be $1,325. The cost would be less for families who chose to provide additional hours of care. There would also be an initial one-time cost of about $8,000, used to make the down-payment on the building, which would be refunded whenever the family leaves the Cooperative.
The monthly cost of the Senior Home Care Cooperative compares very favorably with the costs of providing 24-hour care for an older adult in either a home or a nursing home setting. The monthly cost of providing care alone, at home, for 12 hours/day x 5 days/week at $10/hr would be $2,400, and that would require the family members to provide the other 108 hours/week of care themselves. The monthly rate (all costs) at a quality nursing home ranges from $3,000-$4,500. Assisted living situations typically cost about $2,000/month and do not provide anywhere near the same level of care.
Because of the lack of public subsidy of long-term home care, the monthly cost of Cooperative membership would limit participation, at this point, to middle and upper income families. However, the hope is to develop and demonstrate a model which would become an option for families of all income levels once public financial assistance is provided (as it ultimately must be) to help families cover the costs of long-term care at home.
Resources
(Revised 31 May 2011) An important resource for a Senior Home Care Cooperative would be the National Association of Housing Cooperatives (NAHC) [http://www.coophousing.org]. The NAHC could provide technical assistance in starting up and maintaining the housing component of the cooperative.
More Information: The Need for a Cooperative Description of the Cooperative Accomplished in 1997 Accomplished in 1998 Accomplished in 1999 Accomplished in 2000 Home For more information please contact:
shca at spaces.org (email) or
Claudia George at (773) 248-2072.
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