A Commitment to Aging Well

I live in Phoenix Commons, a 41-unit senior cohousing community in Oakland, California. As a Medicare-age, still-working freelance medical journalist, I have found my best contribution to my community's well-being is through its Wellness Team, helping to spark an ongoing conversation within the community about what it means to age well.

Like most cohousing communities, Phoenix Commons is intentional, self-governing and cooperative. Members own their individual residential units, share co-ownership of common spaces like the community kitchen, dining room, living room and laundry room, and engage in various shared activities. This model of cooperative living was imported from Denmark in the 1990s.

We make important community decisions by consensus. Our teams address topics such as common space management, common meals, social events, civic engagement, building security and disaster preparation — along with wellness, broadly defined. And we request a volunteer commitment of about 10 hours per month from each member to complete their tasks.

Many cohousing communities are happily multi-generational, but Phoenix Commons, which opened in 2016, was designed and built for older adults. With a few exceptions, we are all 55 and older, currently up to 92 years old. We are a mix of retired and employed, singles and couples, physically vigorous and living with physical limitations.

What makes Phoenix Commons different from many models of senior housing is that there's no facility manager or office nurse with a clipboard instructing us all on how we could be living better. This is not a health facility, and we are autonomous older adults with lives and minds of our own. We don't provide health care for each other, although we rely on the support and consideration of our friendly, caring neighbors.

As the PC community's founding members were busy planning for its opening in March of 2016 —activities that ranged from choosing flooring and appliances for our units to selecting art work and furniture for common spaces to writing a governing set of community agreements for our shared spheres of living — they also realized that it made sense to talk about health and wellness and what "aging well" might actually look like in our setting.

I have shared my journalistic experience to help the Wellness Team evaluate topics in terms of their potential relevance and interest. The team agreed that residents would be eager to gain a better understanding of what underlies the changes that come with aging. We opted to plan monthly one-hour educational talks aimed at providing information at a level that was engaging and useful —things we might actually put into practice.

The team began by compiling lists of subjects and then voting on which topics seemed most important and timely. Some of the more popular presentations have covered advance care planning, getting other important papers in order, caregiving concerns, falls prevention and hearing issues. Then we discovered that identifying a topic was only part of the job. We also needed to find a knowledgeable person to speak to us about the topic. And they had to be willing to do it for free as we have no budget for honoraria.

Sometimes the expert was a resident within our community. With members including an estate attorney, physical therapists, nurses, social workers, public school teachers, a hospice chaplain — and me — we have a lot of knowledge to share among our neighbors.

We eventually decided it would be more efficient to have just one person — me — lead the way in finding and communicating with possible speakers, maintaining the calendar, posting flyers in the elevator, introducing the speakers and offering key questions for them to address. That said, ideas and suggestions are always welcomed at our monthly Wellness Team planning sessions and from anyone else in the community.

For this article, I contacted three of the 20 other operational senior cohousing communities listed on the website of Cohousing USA and found that they are doing many of the same things as Phoenix Commons in sparking wellness conversations. PDX Commons in Portland, Oregon, has had a series of health-related teams over its 7-1/2 years in existence, member Karen Erde said in an email.

Their work has included a film program that chooses movies showcasing health issues in aging well, and an ongoing speaker's program. Topics have included "dying legally" and hallucinogens, as well as exercise, healthy eating, scam protection and the driving dilemmas that confront older adults.

Silver Sage Village in Boulder, Colorado, one of this country's first senior cohousing communities, has brought in occasional speakers as well as talks by its members. "We do have a care network for coordinating discussions, activities and mutual assistance," says member Rahima Dancy. And Village Hearth Cohousing in Durham, North Carolina, pulled together a care team originally to provide practical supportive services. It eventually expanded to offer programs on health-related topics of interest to members — such as the local transportation system, legal and end-of-life documents, and green burials.

At Phoenix Commons, the topic for a wellness talk can arise directly from something that happened here. For example, after several of our members fell and fractured limbs, we brought back a physical therapist to talk about how to prevent such falls. She also taught us what to do after a fall. Take a breath, the therapist said, and do a quick scan to see whether and where you have pain. Then get something solid like a chair to grasp and, with a friend standing by your side, slowly raise yourself, first to your knees and then to standing. If you can't do that yourself, it's time to call 911.

Another example of timely topics based on PC member experiences relates to the end of life. When facing a life-limiting illness, a few of our neighbors have chosen hospice care. At least one turned to medical aid in dying (MAID), which is legal in California. Emotions around end-of-life choices run high, and the Wellness Team recognized the importance of addressing them via presentations from community experts who could explain the provisions of MAID and define hospice care. We have also scheduled a local death doula to talk about her work with the dying.

As a community of older adults, we are well aware that aging brings an accumulation of chronic health complaints, along with physical and mental limitations — loss of mobility and the need for walking aids, hearing loss, failings of short-term memory, the impact of a stroke or cancer or a heart condition. Through wellness talks we have gained a greater appreciation that many issues of elder health come down to four key elements — diet, physical activity, stress management and social connection — including the preservation of a sense of purpose in your life.

PC has developed its own practices: all-vegetarian, gluten-free entrees are becoming more common at our twice-weekly communal meals; walking groups help neighbors get out our door to the Oakland waterfront; Tai Chi meets twice weekly in the dining room; and a personal trainer is teaching those who want more advanced instruction.

From the beginning, at our board and team meetings, over communal dinners and in the hallways, PC residents have turned to discussions about aging, the limitations it imposes and the role of the community as a whole in helping with the needs of individuals. The Wellness Team lecture series has served to inform and expand these discussions and encourage the sharing of life experiences.

Larry Beresford is a freelance medical journalist specializing in hospice and palliative care, hospital medicine and emergency medicine. He is also a published poet and harmonica player and makes a mean red beans and rice. He lives at Phoenix Commons, a 55+ cohousing community in Oakland, California, with his wife, Rose Mark, also a writer and a retired special educator. At Phoenix, he plans and facilitates educational presentations for its Wellness Team. Read More