HEALTH March 2016
A Healthy Age
Dr. Bill Thomas is one of the most influential Americans in changing attitudes about nursing home care, based on a small idea he initiated a quarter of a century ago.
According to a recent Washington Post story, Dr. Thomas feels we only hurt ourselves with negative attitudes about our aging. “Thomas believes Americans have bought so willingly into the idea of aging as something to be feared that it has become a self-fulfilling prophecy,” reported the article.
In 1991, Dr. Thomas was the medical director of an upstate New York nursing home. He didn’t like the negative attitudes among residents, and he found the atmosphere even more depressing. He was dumbfounded by the loneliness among those the home served.
The Eden Alternative® was born. According to their website, the Eden Alternative philosophy is not about decline but growth. Eden proponents believe personal growth can happen at any age. Homes which feature the Eden Alternative philosophy host pets, often dogs, cats, and sometimes even an aviary with colorful birds and plants. Residents can bond with the animals, feed and care for them.
Animals are the well-known hallmark of the Eden Alternative. Beyond the visible pets and plants lies an attitude of linking people with others. And it works. The Texas Long Term Care Institute studied Eden Alternative programs for two years and discovered:
- 60% decrease in behavioral incidents
- 57% decrease in pressure sores
- 48% decrease in staff absenteeism
- 25% decrease in bedfast residents
- 18% decrease in restraints
- 11% increase in census
While Eden initially focused on long-term care facilities, today it is global and offers programs for homebound individuals as well.
Half a century ago, I often accompanied my mother to the local “county farm” where elderly people lived. The women of the church made regular visits to these poor souls – many of whom were wheelchair-bound, some without limbs, others simply beaten down by life. The county farm was housed in a large, austere building with the charm of a pole barn. I have no sense of whether the care was good or not; I just remember the patients were happy to visit with my mother, who was a cheerful and positive presence.
The visits made an indelible mark on this tiny girl, and I suspect on the patients Mom visited. There was no such thing as patient-centered care at that time, and most facilities resembled something out of an old black and white horror movie.
Just Like the Waltons
Until the mid-1960s with the formation of Medicare and Medicaid, which pays for some nursing care, older adults were often cared for by family or in various forms of institutionalized care.
Large, older homes were often converted to nursing facilities, or communities provided care in an institutional setting. Single women often helped with aging parents or relatives. Church groups, veterans, and others had homes for their own members. With a Medicare expansion to those with disabilities in the early ‘70s, the first for-profit nursing home companies entered the marketplace.
It wasn’t 1986 when the first national nursing home standards were set under President Ronald Reagan in the Omnibus Budget and Reconciliation Act.
Because of Dr. Bill Thomas and his Eden Alternative approach, most modern retirement centers are vastly different from the 1950s-era county farm. Every state has an ombudsman program, charged to advocate for long-term care. Find your state’s representative at http://theconsumervoice.org/get_help.
Today in the latter part of his ninth decade, my father lives in an independent apartment in a senior complex. The center provides multiple levels of care for individuals with good health to those with dementia or physical problems. His mother, my grandmother, died in 1977 in a facility 40 miles away from where he lives today. She was only a year older than he is now. The family visited regularly, but the facility offered little beyond physical care.
Last night my father took a bus from the retirement home to watch a Big Ten basketball game. Dad’s home has weekly movie musicals, card tournaments, swing dances, yoga, and volunteer work. Dad packs backpacks with food for school children from impoverished homes every Thursday morning. There’s never a dull moment. Thanks to Dr. Thomas, my widower father has a rich social life that wouldn’t have existed 40 years ago in any facility.