POTENTIAL BENEFITS OF COHOUSING FOR OLDER PEOPLE
A LITERATURE REVIEW
FOR THE NESTA FOUNDATION
A small but growing body of research and writing testifies to the benefits of the cohousing community as an intentional small-scale neighbourhood in Denmark and the Netherlands where it was first developed, in the United States where it has burgeoned and in the UK where it has struggled. Senior cohousing has flourished as an age-peer-group option in Denmark, Sweden and Holland alongside the inter-generational model of cohousing. It is slowly making its mark in the US. In Britain, the Older Women’s Cohousing group in London is, with the Lifetime Community in Yorkshire and the Vivarium group in Scotland, one of three forming groups for seniors. No senior cohousing group has yet managed to get established in the UK.
Much of the literature available in English on cohousing derives from members of the architectural profession, for whom a principal and defining feature of this lifestyle -the participation of future residents in the design of their community and their focus on a neighbourhood - offers exciting possibilities for interactive design. In the Netherlands and Denmark, the evolution of cohousing communities has had a ‘ripple’ effect on general housing development, so that key features of cohousing – such as communal facilities, design for ease of social interaction and planning for the ‘space between the buildings’ - are often built in as a matter of course to new schemes and senior housing. Foremost among the architectural writers is Charles Durrett, whose book (2009) gives ample testimony to the benefits of cohousing for seniors. In a cameo example, he contrasts (p12) the position of 70 year old American Margo Smith who lives alone among younger neighbours and has to drive for many miles to see friends, with that of 71 year-old Else Skov, living in a Danish cohousing community, where, though widowed, she is not lonely because she is part of a immediately available group that she belongs to. ‘I do wish’, says Margo, ‘I had a community based on proximity’. Place and proximity become increasingly important as people age. A common Dutch saying, ‘Better a near neighbour than a far friend,’ sums up the Dutch and Danish approaches to intentional community building in an ageing society.
This review of the literature finds that cohousing communities offer benefits to individuals and to the wider society in a two-way relationship. These benefits are considered here in the context of older people, but they may apply equally in various ways to other age groups. The review is in three parts:
- The personal and social benefits of senior cohousing
- The social capital and civic benefits of cohousing
- The environmental benefits of cohousing
References reviewed are the result of a desk-study only and are necessarily incomplete.
PART ONE: THE PERSONAL AND SOCIAL BENEFITS OF SENIOR COHOUSING
‘Community and independence can be even more important for older people than for other age-groups’ (Glass, 2009). A clear finding from the research literature on cohousing is that to support the development of senior cohousing is to make a positive investment in old age. The benefits of cohousing that make the most difference to older people are primarily at the personal and social level in close, reciprocal relationships with neighbours. Studies of Dutch and Danish senior cohousing communities (Peeters & Woldringh, 1989, Kruiswijk & Overbeek, 1998, Brenton, 1998 to 2008, Fromm 2006, Jansen et al, 2008, Fromm & de Jong, 2009), come mostly from a social science discipline and are attentive to the wider context of ageing and the needs of old age.
All these studies find that, where older individuals are concerned, the outcomes of living in cohousing can be an enhanced sense of wellbeing, reduction of loneliness and isolation, continued activity and engagement, the possibility of staying healthier for longer and, finally, continued personal autonomy and independence. These derive from:
- A sense of personal efficacy and satisfaction
- A sense of belonging to a community
- Participation in collaborative activities
- Mutual support and security
A fundamental underpinning for these outcomes is the positive view of old age that is intrinsic to the value base of senior cohousing. This is expressed very well on the website of a small company in Amersfoort, the Netherlands, (King Arthur Groep, 2010) dedicated to helping senior cohousing communities form and develop. They write:
‘Our starting point is ‘that it can be otherwise’. In our view, being old is not equivalent to needing care and support. Quite the opposite. For us, being old is: knowing what you want, being able to relax and enjoy life and having the knowledge and experience to still give meaningful support to others'.
The cohousing practices that lead to the benefits listed above include conscious community-building, shared responsibility and commitment, democratic decision-making and continued self-management, shared meals and some involvement in design of the group’s environment (the latter for the early residents at least). Senior cohousing groups are also usually based explicitly on mutual support. Beyond the community-building that evolves naturally when getting a project up and running, cohousing usually offers groups opportunities to skill themselves up through training in group processes, such as conflict mediation, consensus decision-making, facilitating meetings etc. Small committees exist for key functions, like maintenance, gardening, outreach or finance and sometimes for mediating conflict. Working together in these committees or sharing in the management of the whole community is not only a way of building social cohesion but also a way of learning new skills and learning new skills is a way to keep happy and healthy. These aspects are addressed more comprehensively in the section on social capital below.
Benefits to the wider society can be:
- Promotion of active, healthy lifestyles
- Reduced or delayed need for health and care services
- Reduction of dependency on the State
- Encouragement of social capital
- Enhancement of civic participation
- Sustainable, green lifestyles
Use by older people in cohousing of health and social care services
‘’Older people with relationships stay fit and out of costly health and social care for longer…Loneliness is reaching near epidemic proportions among older people: more than 50% of people over the age of 60 say they are lonely at least some of the time’. (Leadbetter, 2009)
In Denmark, Sweden and the Netherlands, successive governments, aware of the ageing of their populations, have encouraged the development of senior cohousing communities on the grounds that they keep people happier and healthier for longer and contribute to lower levels of demand on expensive health and social care services (Paulsson & Choi, 2004, Brenton, op cit. Kruiswijk & Overbeek, op cit). In Germany, Göschel writes,
‘collaborative housing produces a common good by reducing public expenses for health or care institutions and should thus stimulate a public interest in this form of living. In this view, the provision of public assistance to collaborative housing initiatives in order to extend this life-style seems more reasonable than granting financial support to single projects as is the concept in social housing’. (Göschel, 2010)
Göschel goes on to stress the importance of ‘communicating the necessity of this lifestyle to local authorities and pointing out that they will be gaining if they support collaborative housing’ for older people’.
It is a common sense inference, typically to be found in many other areas of British social policy, that the positive and demonstrable benefits that older people clearly derive from cohousing should lead to reduced use of formal services. It also stands to reason that, in a cohousing community where neighbours look out for each other, issueslike after-care or short-term illness can be well taken care of, reducing bed-use in hospitals. However, although the assumed reduction of demand for formal services is highly probable, it is very difficult to prove empirically. No research study of senior cohousing has been found that has made comparisons over ten or twenty years against a control group of similar older people living in ordinary housing to demonstrate what is intuitively assumed to be a lower rate of service usage from healthier, happier living in cohousing. Such a study would face huge methodological difficulties and would be extremely expensive.
Survey of a Danish senior cohousing community
In 1999, a Danish housing association, Lejerbo, working with a group of older people, built them a cohousing community. It carried out a survey at the start and followed it up ten years later. Asked to assess their own health in 1999 and 2009, the twenty three residents, aged between 60 and 90 years old, are reported as ‘feeling more positive about their health’ than ten years before. (Kähler, 2010). Before moving in, 85% had said that they often felt lonely. In 2009 the figure was only 10%. Before moving in, 70% had often needed help for small repair jobs, shopping etc. In 2009, none needed this. They also felt secure and were quoted as saying: "Here you will never lie for three days with your curtains drawn without somebody coming to see if you are OK".
Research studies on the link between social connectedness and health and wellbeing
The major benefit of cohousing to older people is its social connectedness. This is what cohousing excels at because it is specifically designed to deliver and sustain it. In the absence of specific cohousing research on service use, there is a wide body of research on social connectedness which demonstrates the positive impact of close relationships with others on people’s health and wellbeing (Allen 2008). Such benefits need to be set in the context of large and growing numbers of older people living alone in Western societies.
The Marmot Strategic Review of Health Inequalities observed in 2010, that ‘the extent of people’s participation in their communities and the added control over their lives that this brings has the potential to contribute to their psychosocial well-being and, as a result, to other health outcomes’. (P.30). It recommended interventions to promote cohesive social relationships and reduce social isolation as a key component of ill-health prevention but these failed to find a place in government strategy. (Plos Medicine, 2010)
A PSSRU study for the Department of Health evaluated the UK scheme ‘Partnership for Older People Projects’ which mostly addressed social isolation among older people but also inter-agency working. (Personal Social Services Research Unit 2010). ‘Small services providing practical help and emotional support to older people can significantly affect their health and wellbeing’ (op cit). The researchers calculated that, for every £1 spent on the trial projects, local hospitals would have saved £1.20 in emergency hospital care; overnight stays were reduced by approximately 47%, use of A & E Departments fell by 29%. Overall reductions in therapy and clinical services resulted in ‘a total cost reduction of £2,166 per person’. (op cit)
A recent meta-analyis (Holt-Lunstad, 2010) of research into the health impact of social relatedness finds a 50% better survival rate among the socially connected than among those who are isolated, stating that ‘Social relationship-based interventions represent a major opportunity to enhance not only the quality of life but also survival’.
A study (Kivipelto et al, 2009) of older people in Finland over a 21 year period found that people who either do not have a partner in their middle years, or whose partner dies, are three times more likely to end up with dementia than those who are married or cohabiting. People of the same age who live alone have twice the risk of developing dementia. The study cited other evidence (Karp et al, 2006, Barnes et al 1999, Saczynski et al 2006) that ‘a rich social network has also been linked to a lower risk of cognitive impairment and dementia’.
In a study of loneliness, Griffin, (2010), citing the work of Cacioppo (2008), notes that subjective isolation that becomes chronic ‘causes physiosocial events that wreak havoc on our health. Persistent loneliness leaves a mark via stress hormones, immune function and cardiovascular function with a cumulative effect that means being lonely or not is equivalent in impact to being a smoker or non-smoker’ (p4). Griffin comments: ‘Just aslonely feelings are nature’s way of telling us to seek out company, the problem of loneliness in society is a prompt to revitalise our communities, and better integrate their members. (p33)
Griffin sets her conclusions in the context of increasing trends towards living alone in modern society. Commenting on ONS statistics showing that married people of both sexes have better health, she observes: ‘But it’s not just relationships with a spouse or partner that count: people with a network of close friends also reap health benefits. In 2006 a study (Parker-Pope) of almost 3,000 nurses with breast cancer found that women without close friends were four times more likely to die than women with 10 or more friends. Clearly, relationships are worth investing in’. (p.7)
COHOUSING CASE STUDY
Annemiek de Waal, a divorced woman aged 75, lives in a cohousing community of 44 people on the outskirts of a village near Amersfoort in the Netherlands. She joined this mix of renters and owners some 13 years ago because of a wish to avoid isolation and loneliness. She said, in 1998, a year after moving in, ‘I have been here a year since my divorce. I feel it is a refuge for the divorced…This group is what I needed. What do I like most? When I open that door and I see someone who says ‘Hullo Annemiek! What are you going to do? Walk with me?’ It is easy to bump into people. That is enough for me. I have other ways to be happy outside – my children, hobbies, friends. I feel I am not alone here. I have never lived alone. If I didn’t live in a group like this I don’t know what would have happened to me. I have no regrets about joining this group. Perhaps I stay for the rest of my life here’. Visited in 2009, Annemiek reflected on her time there, the neighbours who had died, the new ones who have come – ‘This is still a thriving living group. We are all older; new people have different interests from the original group and we have turned the vegetable garden to grass - but we are still out there regularly keeping up our large garden. There is always someone to do things with.’ She considers that living in this supportive community setting, where everyone knows each other, has kept her involved and active and happy.
COHOUSING LITERATURE : PERSONAL AND SOCIAL BENEFITS
Abraham, N. & J de la Grange, (2007) Elder Cohousing – an idea whose time has come
Brenton, M, (1998) 'We're in charge’: cohousing communities of older people in the Netherlands, Policy Press, Bristol
Brenton, M. (1999), Choice, autonomy and mutual support: older women’s collaborative living arrangements, JRF/York Publishing Services.
Brenton, M. (1999) ‘Co-operative living arrangements among older women’ in Local Environment, 4(1), USA.
Brenton, M, (2002) Cohousing communities of older people, in S.Peace & C.Holland (eds) Inclusive housing in an Ageing society, Policy Press, Bristol.
Brenton, M. (2002) Choosing and managing your own community in later life, in K. Sumner (ed) Our homes, our lives: choice in later life living arrangements, CPA.London
Brenton,M. (2008) The cohousing approach to lifetime neighbourhoods, Factsheet 29,
http://networks.csip.org.uk/_library/Resources/Housing/Support_materials/Factsheets/Factsheet29.pdf Housing Learning & Improvement Network, Dept of Health.
Brinke van Hengstum, A. & M.Stegink, (1987) Het bouwen aan een woongemeenschap van ouderen: een onderzoek naar de problemen en realiseren van de huisvesting. Landbouwhogeschool, Wageningen.
Durrett, C (2009) The Senior Cohousing Handbook: a community approach to independent living. New Society Publishers, Canada
Fromm, D (2006) ‘Aging Together: self-planned cohousing communities of seniors’ in Urban Land, 65(5), 72-77.
Fromm, D. & E de Jong (2009) ‘Community and Health: immigrant senior cohousing in the Netherlands’, Communities, 145, Winter, 50-53
Glass, A, (2009) ‘Why Aging in Community?’ pp 255-272, in Durrett (above)
Göschel, A. (2010) Collaborative Housing in Germany, International Cohousing Conference, Stockholm, May 2010.
Kähler,M. (2010), Collective Housing and Wellbeing, International Cohousing Conference, Stockholm, May 2010.
King Arthur Groep (2010) www.kingarthurgroep.nl 9
Kruiswijk, P. & H.Overbeek, (1998), Van Idealisme naar Realisme, VROM NL, Vervey-Jonker Instituut.
Jansen, H et al (2008) Gemeenschappelijk wonen op leeftijd: zorg posities en sociale netwerken van ourderen in woongemeenschappen, Vervey-Jonker Instituut, The Hague.
Paulsson, J & Jung Shin Choi, (2004) Senior Cohousing in Denmark and Sweden Characteristics of Residents, Motives for Moving To and Evaluative Outcomes
School of Architecture, Chalmers University of Technology, Sweden
Peeters, J & C.Woldringh, (1989) Groepswonen van Ouderen, Inst.voor Toegepaste Sociale Wetenschappen, Nijmegen.
2. SOCIAL CONNECTEDNESS LITERATURE
Allen, J (2008) Older People and Wellbeing, Institute of Public Policy Research.
Barnes L. et al. (2004) The relation of social networks, social engagement, and cognitive decline in an older bi-racial population. Gerontologist; 44:330, (cited in Kivipelto, 2009)
Cacioppo, J. & W.Patrick (2008) Loneliness: Human Nature and the Need for Social Connection, NY, Norton & Company, (cited in Kivipelto, 2009)
Griffiths, J. (2010) The Lonely Society, Mental Health Foundation
Holt-Lundstad, J et al, (2010) ‘Social relationships and mortality risk: a meta-analytic review’ Plos Medicine,7(7) July.
Karp A, et al. (2003) Leisure activities and the risk of dementia in the elderly. NEngl JMed. 348:2508-16. (cited in Kivipelto, 2009)
Kivipelto et al (2009) Association between mid-life marital status and cognitive function in later life: population based cohort study, BMJ, 339:b2462
Leadbetter, C. (2009) ‘State of Loneliness’, The Guardian, 1 July.
Marmot Commission (2010) Fair Society, Healthy Lives
Parker-Pope, T. (2009) ‘What Are Friends For? A Longer Life’ in The New York Times 21 April (cited in Griffiths, 2010)
Personal Social Services Research Unit for Dept of Health (2010) National Evaluation of Partnerships for Older People Projects: final report.
Plos Medicine (Editorial, 2010) ‘Social Relationships are key to Health and to Health Policy, Vol.7: 8, August. 101 0
Saczynski JS et al. (2006) The effect of social engagement on incident dementia—the Honolulu-Asia aging study. Am J Epidemiol;163:433-40, (cited in Holt-Lundstad, 2010)
Young Foundation (2008) Neighbourliness + Empowerment = Wellbeing: is there a formula for happy communities?
PART TWO: THE SOCIAL CAPITAL AND CIVIC BENEFITS OF COHOUSING
This theme is potentially applicable to all who participate in cohousing. Where it is of real relevance to older people is in empowering them against the ageist stereotypes that render them ‘invisible’ in the wider society. Durrett (2009) remarks how ‘the senior cohousing movement fundamentally changed the general perception of seniors in Denmark. Seniors taking responsibility for their own future led to this change.’ (p247)
Social capital is an overarching concept embracing networks, shared norms and values which facilitate co-operation for mutual benefit and contribute to social cohesion and civic identity. Creating and running a cohousing community and building social cohesion equips cohousers to participate effectively in wider society. The experience of shared decision-making and conflict resolution inherent in the cohousing model is seen by a number of researchers and commentators as offering positive benefits to society.
This effect on cohousing members is echoed by Meltzer (2005) who comments:
‘Groups…in some cases not only politicise their own members but the surrounding neighbourhood as well. Individual and collective engagement with their circumstances is a palpable outcome for participants in cohousing development and management. Members gain a profound appreciation of their power to bring about change and to align their lives with their values – they become empowered. ‘(p152)
Poley’s doctoral research on cohousing in the USA found ‘comparatively high levels of civic engagement among cohousing residents’ based on learning through committee structures, consensus-based decision-making and conflict resolution procedures. ‘These 111 communities are not developed for the purpose of fostering capacities related to public citizenship’, Poley comments, but her research indicates that ‘a combination of physical design and carefully devised governance structures can indeed have a significant influence on the development of social capital and civic practices of Cohousing community residents’.
‘Cohousing residents require many variances and approvals to carry out their projects, so they tend to become skilled at influencing public officials. This may benefit the overall neighborhood’. (Langdon, 2005)
Cohousing requires specific skills and competences of members – the wide range they cover is illustrated in different ways by Leafe Christian (2003, 2007), Leach (2005), Hansen (1996) and Field (2004), all of whom lay out the detailed steps cohousers must take through group processes and physical development. This mutual learning and sharing of skills, combined with flat, non-hierarchical structures, also enhances individuals’ sense of personal efficacy. Torres-Antonini’s research (2001) found that cohousers felt they were valued members of their communities, involved in decision-making processes and delivery, which increased their feelings of empowerment and well-being. Glass (in Durrett 2009) records that her interviewees in the ElderSpirit Community, in Virginia, ‘reported feeling affirmed through the sense that they are valued and capable of being productive, worthwhile, and important to others, no matter what their condition’. (p267) ‘Being able to self-govern instead of having someone tell you what to do is also a radical idea for this age-group in our society, when you look at other senior housing options,’ she comments.
LITERATURE: SOCIAL AND CIVIC BENEFITS
Field, M (2004) Thinking about Cohousing, Diggers and Dreamers.
Glass, A, (2009) ‘Why Aging in Community?’ pp 255-272, in Durrett, C. The Senior Cohousing Handbook: a community approach to independent living. New Society Publishers, Canada
Hansen, C (1996) The Cohousing Handbook, Hartley & Marks
Langdon, P. (2005) ‘Cohousing bolsters new urban neighbourhoods’, New Urban News,
Leach, S. (2005) Head, heart and hands, Leach, Colorado. 12 12
Leafe Christian, D. (2004), Creating a Life Together, New Society Publishers.
Leafe Christian, D. (2007), Finding a Community, New Society Publishers.
Poley, L. (2007) ‘Community, trust and the habits of democracy: an investigation into social capital and civic engagement in U.S. cohousing neighborhoods’ American Political Science Association, Chicago.
Meltzer, G. (2000) Sustainable Community: Learning from the cohousing model, Trafford, Canada.
Putnam, R (2000), Bowling Alone: The Collapse and Revival of American Community. Simon & Schuster, NY.
Torres-Antonini, M. (2001) Our common house: using the built environment to develop supportive communities, unpublished PhD thesis, Graduate School, University of Florida.
PART THREE: THE ENVIRONMENTAL BENEFITS OF COHOUSING
Cohousing offers rich possibilities for a sustainable lifestyle, but there is no necessary connection between the cohousing model and sustainability, and significant variations exist between cohousing communities. Early studies of senior cohousing in the Netherlands (Brenton, op cit) found little or no concern with sustainability either in terms of physical fabric or group behaviours – but it is likely that research into more recently established communities might find a very different ethos. Interest in sustainability is certainly cultural – an awareness of ‘living lightly on the earth’ is a marked characteristic of many North American and most forming UK cohousing communities, although Sargisson’s description of it as ‘environmentally conscious (in the ‘shallow’ conservationist sense)’ in her study of 50 North American cohousing communities (Sargisson,2010) strikes a cautionary note.
Abrahams and de la Grange’s statement (2007) that: ‘Cohousing is a return to a sustainable model of living where neighbors typically participate together in recycling, composting, sharing and consuming less resources, growing and eating organic produce at community meals, living in
smaller-than-normal clustered energy-efficient homes, obtaining passes for and using public transportation, consuming less water and electricity.’ reflects an admirable but not totally universal preoccupation of North American cohousing that is also reflected to an extent in UK cohousing.
Cohousing in the US and UK developed much later than in continental Europe - from the 1990s, in an era when awareness of the urgent need for careful stewardship of the planet’s resources was slowly diffusing. Writers such as Lietaert (2010) conclude that the cohousing model offers fertile scope for ‘anti-growth’ through co-operative effort and learning by example and mutual encouragement to adopt a low-carbon lifestyle.
Williams (2008) writes:
―With concerns about carbon emissions and energy savings, there has never been greater impetus for housing that offers low-carbon lifestyles. If the development models emerging in the US were adopted in the UK, the market for cohousing could be substantially expanded here. This could add to our options for shrinking our carbon footprint as well as meeting social needs.’
Williams found in cohousing communities in the USA considerable reductions in energy use through work at home, reduced travel, car sharing, good insulation, shared consumer goods – all of which behaviours tend to be reinforced by group learning and mutuality.
Graham Meltzer (2005), in twelve cohousing case-studies conducted in five countries, found considerable evidence to link the cohousing model with a potentially sustainable lifestyle – both in terms of physical design and fabric and group behaviours. He views the compact nature of cohousing with its ‘social ties that enable it to act as a single entity’ as offering real potential for optimising energy reduction technologies – but finds that this has not yet been fully realised in cohousing. His positive findings were that housing densities and average dwelling size in America were conducive to sustainability - ‘In America, cohousing dwellings are about half the size of typical new-built houses’. There was evidence in every community of reduced driving and car ownership; a ‘consistent 5-6% improvement in energy conservation practices across all the communities surveyed and a 9% improvement in water conservation behaviour’. These improvements are measured against the cohousers’ previous lifestyles, and Meltzer notes that they will have had a ‘high environmental awareness before moving in to cohousing’. ( p135). Meltzer’s excellent study demonstrates above all the promising potential of the cohousing community form to work towards sustainability:
‘Through daily contact with neighbours, learning is constantly reinforced; a condition that residents suggest is conducive to lasting change in their environmental attitudes and practices’ (p132)
Abraham, N & J de la Grange (2007), ‘Elder cohousing – an idea whose time has come’
Lietaert, M. (2010) Growth, recession or degrowth for sustainability and equity? Jnl of Cleaner Production, 18(6) 576-580
Meltzer G, (2008) Cohousing – A Carbon Reduction Strategy, CIFA, Findhorn
Meltzer G (2005) Sustainable Community: Learning from the Cohousing Model' Trafford Publishing
Meltzer, G (2000) Cohousing: verifying the importance of community in the application of environmentalism, in Jnl Architectural & Planning research, 17(2) 110-132
J Williams, (2008) Predicting an American future for cohousing, Futures, Vol 40 (3) 268-286
Maria Brenton is a cohousing development consultant and the UK Cohousing Network’ s Senior Cohousing Ambassador (www.cohousing.org.uk). She supports and is a non-resident member of the Older Women’s Cohousing group in Barnet (www.owch.org.uk). She is also a trustee of Care and Repair England, a national body seeking to influence policy on older people’s housing.