Intentional Communities Can Prevent Institutional Angst, Connect Generations and Prevent the Medicalization of Aging

By Power, G. Allen | Aging Today, September/October 2011 | Go to article overview

Intentional Communities Can Prevent Institutional Angst, Connect Generations and Prevent the Medicalization of Aging


Power, G. Allen, Aging Today


For more than two decades, proponents of culture change in longterm care have worked on transforming the institutional nursing home model. More recently, the focus has turned to assisted living and even independent community housing.

What we see is that America falls short in all living environments when it comes to older adults engaging in diverse communities. How can we optimize the quality of life, across a multitude of settings, for our nation's elders?

In long-term care, most frail elders are housed in hospital-like institutions, where life revolves around medical and nursing interventions. Even in assisted and independent elder housing, the trend has been to "medicalize" aging, and to insulate people from the larger world. Even less recognized is the isolation elders often face while living in their own homes, as community planning does not accommodate aging adults.

This trend represents a loss for all generations: the lack of daily contact with children and younger adults creates a chasm in the lives of older adults, most of whom are parents and grandparents. But the younger generations also suffer when they lose the wisdom, history and life perspective of elders.

Aging in (Intentional) Community

The best solution for all is to change our dialog about aging in place versus residential care to talk about aging in community. Innovators such as Dr. William Thomas, developer of the Green House Model, have responded by creating intentional communities-groups of unrelated people who come together to share the rhythms of daily life, in pursuit of a noble purpose.

The Green House is not just a 10-bed nursing home. Beyond the physical design of a small house, there are important operational changes that create an environment where elders direct their daily lives.

In traditional long-term care, there is no rhythm of daily life, but instead a life artificially compartmentalized into blocks of time reflecting institutional staffing patterns and creating what psychologist Athena McLean, in a 2007 article for Alzheimer's Care Today, called "a cult of clock time and task." There is no individualized care in such an environment, and intergenerational activity only happens through sterile, discrete programmatic episodes.

In contrast, the intentional community embraces the spontaneity that regular contact with children and adolescents can bring. The small-scale and cross-trained staff creates an environment flexible enough to respond to the needs of the moment. Plus close, continuous contact between generations holds many benefits.

Dr. Vicki Rosebrook of the Macklin Intergenerational Institute in Findlay, Ohio, studied the effects on children's development of daily interaction between preschoolers and a group of adults with dementia. She found that, compared with children attending traditional daycare, these children entered kindergarten with personal and social skills nearly six months ahead of their peers. They were better able to express feelings, work cooperatively with others and had more basic social graces.

A Non-Medical Answer to Institutional Woes

The Eden Alternative movement (www.

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Intentional Communities Can Prevent Institutional Angst, Connect Generations and Prevent the Medicalization of Aging
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