Category Archives: Housing

Discernment for Long Term Care

Q: Can I allow myself to be carried, supported, upheld by others and the love of God?
PYM Faith and Practice, 2002

For individuals facing long-term health challenges and their loved ones, choosing residential health care can be one of the life’s most difficult decisions. The loss and emotions felt when one faces letting go of independence and a long time home may be complicated by the stigma associated with nursing homes or other care environments. Many people are not sure where to begin in the search for long term care.

Practicing discernment based in our values can assist us in making decisions that honor our individual priorities. We can employ Quaker clearness process to assist in discerning what is best for the individual and those involved in care. Knowing more about choices available can also help offset stigma. A useful first step is to assess both the individual and the available local options.

“Nothing about me without me.”

Memorize this phrase used by people with disabilities to remind us that if we are talking about someone, we should be talking with that person. Throughout any assessments or decisions, it is important the person who is at the center of the discussion is included and listened to!

Assessment of the Whole Person: See the person, not just the illness or challenge. Look for their capacity, likes, wants and values in addition to the immediate needs or concerns.

Assessment of Daily Needs: A professional assessment can help determine how well a person can function without assistance. The ability to perform tasks such as preparing food, getting to the bathroom, bathing, using a telephone, and any specific needs are evaluated. Your Yearly Meeting office can help identify professionals who can conduct such an assessment.

Assessment of Resources: Consider viable alternatives. A self care assessment may reveal, for example, that the person is not able to cook for him or herself. . However, is there a family member close by who can deliver meals that can be easily heated? How much help can local organizations such as the Meeting or Meals on Wheels offer? Is the person’s safety at risk—will they forget that they have turned on the stove? Are there adaptations that can be made—technology available to offset any risk? Finally, assess whether combined services and adaptations meet the person’s needs:

  • Will he or she be safe?
  • How well can he or she maintain reasonable physical well being?
  • How will the person stay socially, spiritually and emotionally connected?
  • What does the person most value and how can those values be supported?

A Clearness Committee can offer loving guidance during a time of uncertainty and crisis. This supports a meaningful decision making process that is grounded in spirit and faithful to the values of the individual and loved ones caring for him or her.

Your Yearly Meeting can help identify local resources for aging and care at home. If long-term care is determined to be the most suitable option, know that there are many good facilities to choose from and that many people, after an initial adjustment, find themselves more active and socially connected than they were at home.

“Friends do not take readily to being cared for…But many of us will find ourselves in need of full care in our old age. This will not be easy…But there are compensations and opportunities…And in the experience of living in a Home with others, a deep sense of sharing the darkness and the light can lead to a sense of community not known before…”
Margaret McNeill, 1990

Simple things to consider in choosing a long term care facility:

The basics: Is the home close enough to allow frequent visits by loved ones? Is it financially viable? Does the facility provide the appropriate level of care to meet the person’s needs, and if one’s condition changes, will they still be able to provide appropriate level of care? If not, what are the options – would one have to move to another facility or is it possible to stay there and receive supplemental services to meet health care needs? Once a few facilities are identified that meet the basic criteria, schedule visits to those facilities and consider:

  • What is important to the person who will live there—to be in a town or a city, to be close to nature or children?
  • What types of educational, creative, spiritual, fitness or other activities are provided and are they consistent with the values and interests of the person who will be living there? How much are residents involved in decision making and planning? What adaptations are made so that frail residents can pass time meaningfully?
  • Will the person be able to get to beloved activities outside the residence, such as Friend’s Meeting or other places of worship, family visits? How might this be supported?
  • Empowering self-care and mobility to the degree that is appropriate supports emotional and physical well being. Are residents encouraged to walk, as they are able, wheelchairs used only as needed, not for convenience or speed? Are adaptations made, such as opportunities for rest?
  • Do residents seem engaged? Do their rooms have personal touches? What do the interactions feel like between residents and staff? Does the environment feel home like?
  • Direct Caregivers are likely the ones who will spend the most time with residents. How is staff treated? Do they seem respected? Does it look like care workers have time to spend with each resident or do they seem harried and rushed? Is direct care staff actively involved in care planning? Are their interactions kind and friendly?
  • Overall, is there an atmosphere of kindness and warmth toward all?

“There is that near you which will guide you. O wait for it and be sure you keep to it.”
Isaac Penington, 1678, Quoted in PYM Faith and Practice, 2002

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LINKS TO MORE INFORMATION: Click on the blue text below to be directed to outside websites that offer additional information on this topic. Articles from this site will open in the same browser window/tab. Articles from other websites will open in a new window; when you are done, simply click out of that window and you will be back on this site.

More articles on this website:

Adaptive Advices
Housing Options
Slow Medicine

Other Articles/Links:

Friends Services for the Aging
Financing Long Term Care
Friends Life Care at Home

Hoarding

“I saw that a humble man with the blessing of the Lord might live on a little…”
John Woolman, 1743, Quoted in PYM Faith and Practice, 2002

Hoarding is a phenomenon that leads to social isolation, depression, anxiety, and reluctance to move in retirement. This reluctance often brings hoarding to the awareness of family and Meeting. By hoarding I do not mean simple clutter; a cluttered home may have piles of stuff here and there that are worked at and diminished from time to time.

Hoarding is a psychological issue that results in stuff everywhere, a home that can’t be walked through, a bathtub full of clothes, all correspondence for the past 20 years in boxes, a dining room table piled so high that no one has ever eaten there, appliances that don’t work and can’t be gotten rid of, half the bed covered with junk mail.

A way to distinguish between clutter and hoarding is the emotional distress or barriers thrown up at the thought of getting rid of anything. For hoarders their stuff is an extension, definition, or protection, of Self and cannot be eliminated. There are YouTube sites with videos of the homes of hoarders, and of the negative results of making a surprise intervention and cleaning the place while Mom is not home.

While hoarding may be treated successfully as an addiction, it is an anxiety based disorder and sometimes requires professional help. There is a network of social workers who specialize in this phenomenon. There are also a few workbooks that can walk the hoarder through making changes in small steps, a process best done with on-site assistance of someone with great patience, which usually means not a family member.

Due to the emotional need for their stuff, hoarders can be extremely reluctant to move. Trudy had severe arthritis but lived in a house with five levels; she needed to be some place that was all on one floor, or with elevators. Her children had shown her attractive places to move to, but she continued to refuse in spite of her constant pain. An Aging Services Specialist worked with Trudy weekly for 6 months, gaining her trust, helping her to decide what she truly wanted to save and what could be gotten rid of, and they worked together on one small area at a time. Once the most important things were boxed, Trudy agreed to move and leave behind the bulk of stuff to be cleaned out after moving. This order of moving first and then getting rid of stuff is more effective and easier on the hoarder than thinking that everything extraneous must go before a move can be contemplated.

The other learning for families or Meetings of anyone reluctant to move is taking the time to listen to the reasons, and then taking those reasons seriously. For Will it was that the house held all his memories of his wife who had died many years before. Offering Will a large box in which he could put the things most central to his memories would allow him a sense of control and respect.

Marta’s need was to know that everything she was leaving behind would go to a home somewhere. First Marta invited family and friends to take what they wanted, and then Marta identified the charity that would receive the proceeds of the estate sale held after the move. Marta’s needs were met and she could move.

However, neither Will nor Marta was a hoarder; both were merely savers. Hoarders need time and expertise to make moving thinkable.

Download this article in pamphlet form

LINKS TO MORE INFORMATION: Click on the blue text below to be directed to outside websites that offer additional information on this topic. Articles from this site will open in the same browser window/tab. Articles from other websites will open in a new window; when you are done, simply click out of that window and you will be back on this site.

More articles on this website:

Anxiety and Change
Honoring the Individual Through Validation

Other Articles/Links:

Find Help With Hoarding
National Association of Senior Move Managers

Sources/Further Reading:

David F. Tolin, Randy O. Frost, Gail Steketee, Buried in Treasures, 2007, Oxford University Press, New York, NY.

Housing Options

Q: “What will this newfound present of old age and its unknown future demand of us?”
Mary Morrison, Without Nightfall Upon the Spirit, Pendle Hill Pamphlet 311

Retire according to your values: You will consult a pension specialist, call Social Security, and choose a Medicare supplement before you retire. Plans are made, goals set; you have been looking forward to this part of life for a long time.

Have you considered what you would like your spiritual life to be like in an intentional way? How do you intend to go deeper, discover meaning, be a gift to others? Thinking about this foundational part of your life will help other goals to fall into place, and will give you strength in challenging times.

Moving after retirement: Much as we would like to stay in our own homes, changes may make that impossible: you cannot climb stairs or drive, you feel too isolated where you are, your spouse dies and you do not feel safe alone. As you retire, imagine that you might move two or three times; first to a dream home or a smaller place, then to a place with more assistance, or closer to children. It may be unrealistic to say, “Don’t ever put me in one of those places.”

At some point in time, your physical and emotional needs may not be adequately met without additional support. Instead, consider educating yourself about available options, and let your loved ones know what you would prefer if you needed to live in a more supported environment. Maybe you will never need it, but it helps to prepare yourself emotionally if you do. Some options include:

  • Life Care and Continuing Care Retirement Communities (CCRC) provide a continuum of housing and services, such as independent and assisted living, and skilled nursing care. This usually involves a “buy in” fee.
  • Senior Co-Housing is a form of intentional community where people pool resources for care of one another and with attention to values.
  • Aging in Place entails staying in one’s own home with supports if needed.
  • Skilled Nursing Facility provides round the clock nursing care.
  • Assisted Living usually provides personal care such as help with bathing and medicines, sometimes with some nursing care.
  • Independent Living usually has separate units with shared meals and services such as transportation. Some support for other needs may be available.

Moving to another state: Some surveys have found that 50% of those who move to another state in retirement move back within three years. To learn more about a place you are considering, get the local paper, notice prices and political issues; evaluate medical care; plan how you would replace present activities and contacts, and how long that might take. If you have visited for vacation, have you considered what the community is like in the off-season? Would moving closer to children mean that you’d see them more often?

Aging in Place: It is increasingly possible to stay in your own home as you age. More in-home services are becoming available, such as aides to help with bathing, or chore services that will rake leaves or wash windows. Most places have at least one grocery store that will deliver. Senior Centers and Adult Day Health Programs offer opportunities for socialization and support.

If you decide to spend your retirement in your current home, look around the outside as if you were 10 years older. Could you still put up the storm windows? Paint the second story? What needs to be changed or improved now so that you might be able to stay in the same house? Now do the same on the inside. Do you need safety improvements like grab bars in the bath, banisters on both sides of the stairs, better lighting? Ask your local Office for the Aging for information on safety in the home and support services that are available in your community. Consider consulting a Certified Aging in Place specialist who can make recommendations for making your home more accessible.

In addition, some locales are experimenting with “nursing homes without walls” designed to keep seniors in their own homes with a myriad of support services, including day programs and transportation. Again, your Office for the Aging will know if such programs exist in your area. Please see the links below for more information about options.

“Make provisions for the settlement of all outward affairs while in health, so that others may not be burdened and so that one may be freed to live more fully in the Truth that shall stand against all the entanglements, distractions and confusions of our times.”
Advices, PYM Faith and Practice 2002

Download this article in pamphlet form

LINKS TO MORE INFORMATION: Click on the blue text below to be directed to outside websites that offer additional information on this topic. Articles from this site will open in the same browser window/tab. Articles from other websites will open in a new window; when you are done, simply click out of that window and you will be back on this site.

More articles on this website:

Downsizing and Spiritual Practice
Senior Co Housing and Intentional Communities

Other Articles/Links:

Friends Rehabilitation Program
Friends Life Care at Home
Naturally Occuring Retirement Communities
Friends Services for the Aging
Financing Long Term Care
Communities Without Walls

Downsizing and Spiritual Practice

“We have a testimony about simplicity and we need to think about what that means in the world we’re living in right now. What does it mean to be lean and disciplined and not dependent upon our things?”
Kara Cole Newell, 1982, as quoted in PYM Faith and Practice, 2002

Downsizing…or, Rightsizing

Your home is a work of art created by you, an expression of who you are and what is important to you. If there comes a time that you need to move to a smaller place, the emotional ties to home can be difficult and painful to unloose. It is also a time of spiritual opportunity, an invitation to live out Friends’ beliefs and testimonies, a time of grace and gratitude.

Moving from reluctance or refusal to gratitude is not a journey of chance, but one that should be planned, with directions, rest stops, and view points.

First, it’s helpful if we have been downsizing all along. One couple begins every January going through every closet, drawer, and bookshelf, deciding what is no longer needed, what could be passed on to someone who needs it more. Spending no more than an hour once a week keeps the job from becoming a chore; having boxes or bags at the ready marked ‘Meeting garage sale’ or ‘library book sale’ simplifies the decision making and the clean up.

If you are moving it can be helpful to move first, bringing just what fits your new home. Then dealing with what is left behind is simpler. Consider doing a floor plan with cutouts of pieces you want to take with you so you will know what fits where. It is much harder emotionally to move something and then find that it doesn’t fit. Remember to take what you need, and a few things that say who you are.

Some Friends find that the most difficult decisions involve family pieces that the younger generation does not want. We feel a responsibility to keep that antique bed, the patchwork quilt, in the family. Extend your search for a suitable home for such treasures to more distant family members, ask a museum if it is valuable enough to be included in their collection, or decide what good cause to donate the money to from its sale. Do not allow your life to be held hostage by things.

Sometimes it is a Friend’s children who insist that something be kept: “Dad’s papers are just too important!” Ship the papers to that child. Shortly after he bought his first house one Friend saw a moving van outside: his parents had bundled up all his stuff and sent it to him with no warning.

Taking pictures or a video of your house or particular items may ease the pain of moving. A Friend’s brother arranged similar items together, took a picture, then passed the items on. Having a last party or family gathering in the house allows time to express the feelings involved and the special memories. Another Friend wrapped items she wasn’t moving and everyone chose one as they entered the door.

One week a grandmother put out fancy dishes, another week tea cups, and invited each visiting grandchild to choose one, allowing the grandmother to see where things were going and how much pleasure her grandchildren took in receiving them. A mother handed each adult child a pad and pencil during their visit and asked them to write down what they hoped to inherit; another wrote the child’s name on the item.

One couple remained cheery about their downsizing knowing that all the proceeds from the estate sale were going to their Meeting.

Now, the spiritual part: letting go of what is, in the end, just stuff is a spiritual opportunity to live out the Testimonies of Simplicity and of Stewardship. It can be an outward act of inward removal of that which is not of God. It is an occasion of expressing gratitude for the plenty that we have been given, and for receiving the grace inherent in giving to those in need. It demonstrates to those around us how to live a life, how to deal with life’s diminishments in a gracious spirit.

Take the time to notice your feelings. Don’t do it all in one mad dash to move. Spend time in daily worship offering both your things and your attachment to them to the Creator. Be blessed.

Download this article in pamphlet form

LINKS TO MORE INFORMATION: Click on the blue text below to be directed to outside websites that offer additional information on this topic. Articles from this site will open in the same browser window/tab. Articles from other websites will open in a new window; when you are done, simply click out of that window and you will be back on this site.

More articles on this website:

Aging with Peace
Housing Options
Senior CoHousing and Intentional Communities

Other Articles/Links:

National Association of Senior Move Managers
Vitality Magazine
Minimologist green professional organizer

Senior Co Housing and Intentional Communities

Q: What concrete steps can we take as a meeting to open awareness of new ways of living in and sharing our world and its resources?

Q: How am I helping to develop a social, economic and political system which will nurture an environment which sustains and enriches life for all? PYM Faith and Practice, 2002

An Intentional Community is a planned residential community whose members share resources and responsibilities, often organized around a common idea or value. For some older adults, moving into an Intentional Community or shared “Senior Co Housing” is an option to traditional retirement communities. An Intentional Community formed around common values allows one to live in a manner consistent with what one’s beliefs, for example an eco-village where practices support a sustainable environment. As we consider options for housing in our later years, Intentional Communities may present an option for living in an inclusive environment and in a way that is aligned with our testimonies and values.

A movement in intentional communities is growing among older adults. Senior or Older Adult Cohousing is a form of Intentional Community where residents participate in the planning and design of villages and live cooperatively, mutually supporting one another through the changes that aging can present. These communities allow residents to age in place while sharing resources for caregiving, property and home maintenance, and transportation. Neighbors look after one another and each member contributes his or her strengths to the community.

“…regardless of the future, man must enter into the possibilities of the present moment and let himself unite with the everlasting yet everchanging elements of the world in which he finds himself.” Elsie Marion Andrews, Facing and Fulfilling the Later Years, Pendle Hill Pamphlet*

In 1998, Jimmy Carter wrote in The Virtues of Aging, “Only 30% of American families are accumulating any long-term savings or pension benefits, while almost 45% are spending more than they earn.” With the more recent decline in our economy, even among those who have saved, many lost significant portions of their savings. Other have used retirement funds for more urgent needs while unemployed or underemployed. While Continuing Care Retirement Communities have been the option for many older adults, it is predicted that such options will not be affordable to the majority of us. For some, aging in place at home or with families will be an option. Others of us will need to consider new ways of living in our older years.

Statistics may be alarming, but might we take this as an opportunity to live our values? Can we honor our the truth of our interdependence and learn to rely on one another? Are there models from the past from which we may learn? Is it possible to live in harmony with a sustainable environment? While we consider how we will be cared for, are we also mindful of the world we will be leaving behind?

“…joy is the awareness of a harmony, a perfect fit, between the form of our life and its shape…” Howard E. Collier, Experiment with a Life. Pendle Hill Pamphlet*

Download this article in pamphlet form

LINKS TO MORE INFORMATION: Click on the blue text below to be directed to outside websites that offer additional information on this topic. Articles from this site will open in the same browser window/tab. Articles from other websites will open in a new window; when you are done, simply click out of that window and you will be back on this site.

More articles on this website:

Adaptive Advices
Discernment for Long Term Care
Housing Options
Living at Home Forever

Other Articles/Links:

Fellowship for Intentional Community Website
FIC: Quaker walkers visit Rosewind Cohousing and Port Townsend Ecovillage
YES! Magazine: Of, By, and For Seniors: Japanese Senior Cooperatives
Friends Rehabilitation Program

Sources/Further Reading:

Diana Leafe Christian, Finding Community- How to Join and EcoVillage or Intentional Community, 2007, New Society Publishers, Canada.

Charles Durrett, The Senior CoHousing Handbook, 2009, New Society Publishers, Canada.

David Wann, Reinventing Community-Stories from the Walkways of Co-Housing, 2005, Fulcrum Publishing, Golden, Colorado

*Elsie Marion Andrews, Facing and Fulfilling the Later Years, Pendle Hill Pamphlet, Pendle Hill, Wallingford PA. and Howard E. Collier, Experiment with a Life. Pendle Hill Pamphlet, Pendle Hill, Wallingford PA. are available through the Pendle Hill Bookstore.