A co-living care home is based in a regular residence or a neighborhood living space. By combining home medical care, long-term care, and family companionship, it allows individuals with disabilities, severe illnesses, or those nearing the end of life to live out their final days surrounded by familiar relationships. As society rapidly ages, the concept of the co-living care home is moving from advocacy into pilot programs and practice. Though still in its early stages, this model invites us to rethink long-term care and a peaceful end of life—whether everyday life can still go on even at the very end of life's journey.
Originating in Japan, the "co-living care home" is a new care model based in neighborhood homes. This concept stems from the Japanese "Home Hospice" movement, first put into practice by "Kasan's House" (Mother's House) in Miyazaki. It allows five or six elderly residents who require intensive care to live together in a community setting. By integrating home medical care and long-term care support, residents can spend their remaining days in a familiar living environment, even at the final stages of life.
In Taiwan, the "co-living care home" is still a relatively new concept. Unlike the clearly defined systems of hospitals or the traditional care framework of institutions, it raises a different question: when people become disabled, grow old, and need care, can they still maintain their daily lives and social relationships?
Dr. Sang-Ju Yu of Home Clinic Dulan found the beginnings of an answer at Japan’s "Kasan’s House." Meanwhile, Yi-Ying Lin, founder of the Plahan Symbiosis Care Labor Cooperative, has been bringing this concept to life in Taiwan step by step, allowing co-living care homes to take root and flourish in their own language and soil in Taiwan.
Discovering an Alternative Vision for Care in Japan
Dr. Yu used to be a hospice and palliative care physician who accompanied many patients through their final moments in the hospital. However, one scene in the clinical setting always stayed with him: many elderly patients simply wanted to go home, but because of a lack of connection between the medical and care systems, they were forced to move repeatedly between hospitals, homes, and care facilities. Some finally made it back 
home by ambulance only at the very last moment of their lives.
As Taiwan transitions into an aging society, this scenario is becoming increasingly common. Dr. Yu kept wondering: if the medical system can only keep people in hospitals, can Taiwan truly handle the challenges when the population ages further? With this question in mind, he began researching Japan's home medical care system and visited Japan multiple times, hoping to find a care model different from hospitals or traditional institutions.
In 2015, during a visit to Kyushu, Japan, he stepped into a seemingly ordinary house called "Kasan’s House." Inside, a few elderly residents were living together—some chatting, some cooking, with staff members keeping them company. A medical team was nearby in the community, ready to provide support whenever needed.
"There was no smell of a hospital ward, nor the rigid discipline of an institution. It felt more like a household that was still functioning," Dr. Yu recalled, deeply moved. He further explained that “asan’s House” practices a life-centered philosophy of co-living. Typically, only five or six residents live together in a home, keeping each other company. The care approach is adjusted according to each person's rhythm of life rather than dictated by institutional rules. When life draws to a close, family members can naturally be there to accompany them, and the community also takes part in saying goodbye.
"End-of-life care isn't about how much doctors intervene, but about how capable the community is in providing companionship." For Dr. Yu, a doctor trained in hospital hospice care, this reminder from the Japanese practitioners was a profound, almost transformative realization.
He gradually understood that a true co-living care home does not rely on expanding medical care indefinitely. Instead, it places resources where they are most appropriate, bringing in doctors and nurses only when necessary. Most of the daily care is supported by caregivers and the community. "This way, when family members visit, they don't have to focus only on technical care tasks. Instead, they can spend their time on what is truly important—being there for their loved ones."
When Care Begins, the Feeling of "Home" Vanishes
Dr. Yu translated the concept of "Kasan’s House" as a "co-living care home" and introduced it to Taiwan through articles and lectures. However, he remained practical, knowing that Japan's experience could not simply be copied word-for-word. "Japan’s Home Hospice model could thrive because it is backed by a mature system of home medical care, home nursing, long-term care resources, and private foundation support. It has had rich soil to grow in."
He admitted that this was why he didn't dare to push for co-living care homes back then—after all, at that time, even home medical care had not yet truly taken root in Taiwan.
Later, it was Yi-Ying Lin who took the baton to make co-living care homes a reality in Taiwan. With 30 years of experience on the frontlines of long-term care, Lin had seen too many families fall apart at a moment's notice. It usually starts with a sudden emergency—a heart attack, a fall, a stroke, or a cancer test report. The person is rushed to the hospital, and acute medical care takes over quickly. But when the condition stabilizes and it's time for discharge, the real challenge begins.
"What do we do now?" This is the question Lin heard most often in her work. Lin noted that the true anxiety for many families begins with post-discharge care. Home care services often can't start until the patient returns home, and the hours are limited. While families might manage during the day, caregiving duties often fall back on family members during nights, weekends, or unexpected changes. "If the original family structure cannot cope, they often have only one option left: moving their loved one into a residential care institution."
Consequently, someone who once lived in the community slowly drifts away from their familiar surroundings and further away from "home." Lin reflected that it isn't that support systems don't exist, but that they are too disconnected from one another. "Hospitals handle acute treatment, long-term care handles daily support, and institutions handle residential care. Each segment seems complete on its own, but we lack a place that can connect the entire journey together."
This disconnect—the feeling that "no one is there to catch you in the middle"—is precisely the pain point of Taiwan’s current care system. Having witnessed these struggles firsthand, Lin understood how co-living care homes should begin: "A co-living care home needs more than just a single service; it needs an entire community care network."
In a Co-living Care Home, Everyday Life Never Stops
Dr. Yu pointed out that for a co-living care home to take root in a community, at least three conditions must be met: first, there must be home medical support in the community; second, there must be adequate long-term care resources; and finally, there must be enough staff to provide 24-hour care.
"That’s what I admire most about Yi-Ying," Dr. Yu said, his admiration clear. "She didn't just talk about the vision; she actually built these conditions in Taiwan, step by step."
In Yi-Ying Lin's vision, a co-living care home has never been just “a cozy little house." It is a living base that can embrace people at different stages of life. Some move in because of temporary disabilities, some stay for a short period because of family caregiving pressures, and others spend the final chapter of their life's journey here.
Inside this space, everyday life does not stop because of illness or approaching death. Someone is cooking in the kitchen, someone is sunbathing in the yard, and others are chatting or watching television. Medical treatment and care have not disappeared, but they recede into the background of daily life, becoming a source of support rather than a system that dictates everything.
"The most important thing about a co-living care home isn't the number of services it provides, but creating the feeling of home," Lin said firmly. Here, individuals are not just people being cared for; they remain people with roles, relationships, and a life of their own. "The true value of a co-living care home is not just offering an alternative care model, but allowing people to live as themselves, even on the very last stretch of life's journey."
As Taiwan officially enters a super-aged society, care is no longer just a matter of medical or long-term care systems; it is about how a society understands the choice of “living until the end.” The philosophy behind co-living care homes may still be in its exploratory, early stages, but it opens up another vision of a peaceful end of life for Taiwanese society—the possibility that the final stretch of life need not simply be about being placed somewhere, but about being accompanied within familiar communities and relationships, allowing people, even on the final journey of life, to continue living as themselves within the rhythms of everyday life.