Homes where old people and disabled people can help each other out

The U.S. surgeon general’s 2023 report on loneliness documents a scourge of isolation at national scale, with demonstrable negative outcomes on physical health and wellbeing, including increased risk of cardiovascular disease, stroke, and early mortality. Isolation and loneliness rates are particularly high among senior citizens, posing a problem for service providers that goes beyond just attending to their medical needs. Keeping seniors safe and physically cared for doesn’t shield them from the intangible loss of a gift that makes life joyful: friendship in everyday life together.

Loneliness and isolation are also intractable challenges for another population: adults with cognitive disabilities. The most sophisticated special education services can’t meaningfully tackle this problem. It’s known in the field as “the cliff”: the moment in young adulthood when school-based services for disabled people drop away, and the preparation for independent living and job readiness blossoms — or not. But even in the so-called best scenario for this population — paid work and living independently — what are the goods we live and work for? Friendship, depending and being depended upon, lending and borrowing, domestic advice: this is the social glue of relationships for all of us, and even a group home for these adults in the suburban cul-de-sac cannot guarantee it.

A way to help solve the loneliness problem for both of these groups is to build a system — both architectural and institutional — for bringing the two groups together.

As formal housing partners and neighbors to adults with disabilities, senior citizens could offer them simple coaching in meal planning, job performance, or deciphering bills and emails. Adults with disabilities might, in turn, offer support wrangling digital devices or carrying loads too heavy for older adults. Proximity to one another — perhaps with some overlapping meal times, a shared swimming pool or garden — would allow these relationships to grow as the best ones do: organically and unscripted.

There is a precedent for this kind of idea in a similar intergenerational housing project in the Netherlands. The Humanitas nursing home in Deventer houses half a dozen university students for free in its complex in exchange for thirty social-service hours per month. Nursing home director Gea Sijpkes posed the idea to Humanitas’s board with a broad aim for creating more joy among her residents. Skeptics were plentiful: aren’t students too mired in sex, drugs, and rock ’n’ roll?

But an early pilot program was a clear success — the good friction of unlikely housemates. The Humanitas model is now celebrated and replicated elsewhere. And a key feature is the informality of the project: students assist with meals or other light-duty tasks that vary according to personality and preference; they may, in turn, ask a senior for career advice or the long-view perspective on heartache from an old-timer. Sharing life with people unlike ourselves, giving to and receiving from those in other life stages, creates the immeasurable leaven of community.

The multi-family housing sector needs a much more capaciously imagined idea of good density — where distinct populations can form communities of strong friendship not in spite of, but because of, their differences. Instead of separating seniors from disabled adults, institutional leaders should think across a spectrum of human needs, and let that needfulness spark creativity.

Making intentional neighbors out of these two groups would help mitigate the vulnerabilities of each. It would also model ordinary neighborly friendship for an isolated nation.