There are many things we all have in common. Aging is one of them. In Western society, we’ve come to view our elders as no longer productive members of our families or society as a whole and have pushed them to the perimeter of our active lives. This can have a profoundly negative impact on a loved one’s mental and physical health.
As people age, their health often fails. Given the inability and/or unwillingness of younger generations to care for ailing seniors, institutions have been created to provide them with regular care and treatment. Many of these “retirement homes” are marvelous places that provide social activities, promote autonomy, serve healthful foods, and provide care commensurate with residents’ needs. Unfortunately, that’s not always the case.
The Doctor Who Changed the Concept of “Retirement Home”
Bill Thomas, MD is a Harvard-trained physician who has come to specialize in geriatrics. This is (surprisingly) not a popular specialty, as only about six thousand doctors in the U.S. are certified geriatricians. He is on the faculty of the University of Maryland-Baltimore County’s Erickson School, which has programs in aging, management, and policy. (1)
In 2008, Dr. Thomas was billed by The Wall Street Journal as one of twelve pioneers who are shaping the way Americans live, work, and play in later life. (2)
In 1991, Dr. Thomas became medical director of an elder-care facility in upstate New York. He told an interviewer from the Washington Post:
“the place [was] depressing, a repository for old people whose minds and bodies seemed dull and dispirited.” (3)
From Thomas’ point of view, the concept of interdependence among generations-so intrinsic to his own up-bringing-“runs smack dab into the idea that old age is a train wreck and that older people are not contributing, that they’re a burden on us.” He decided to change that notion, beginning with the retirement home under his direction.
By their very nature, senior facilities foster isolation of individuals, taking from them their autonomy, privacy, and links to the past that come with the absence of people and possessions accumulated throughout their lives. The result can be loneliness, depression, illness, and even premature death. (4, 5) But who’s to say the big institutional model is the only way to care for the oldest of us? There must be other options.
The Eden Alternative
Deemed “the Eden Alternative”, Thomas introduced dogs, cats, parakeets, hens, rabbits, and vegetable and flower gardens to his facility. In addition, on-site day care was added for children of staff so residents could interact with young ones. The approach is based on the idea that caring for another living thing provides one with a purpose for living, which in turn raises the spirits and makes one feel productive and independent. Living in garden surroundings is much more pleasant (and healthy) than living in a rigid institution.
While bringing the animals into the building broke a New York law, the result of his experiment proved worth it: within a short time, many people began to dress themselves, leave their rooms, and resume normal eating habits. Moreover, the number of prescriptions for residents was cut in half and the death rate decreased. (The law prohibiting animals from retirement homes has since been repealed.)
Encouraged by the extremely positive effects of the Eden Alternative, Dr. Thomas set up smaller residences that he called Green Houses. These buildings contained private bed- and bathrooms, respectfully providing privacy and dignity for its tenants. Within six weeks, Thomas had to hire a truck to take away all the wheelchairs from one of the Green Houses; residents found it possible to navigate the smaller building much more easily than a large one and no longer needed wheels to get from one place to another.
As word of the success of these programs spread and Thomas received multiple awards for his innovations, he hoped he could spur a change in how the elderly of our society are viewed. It hasn’t come easily:
“In a contest between doing difficult cultural-transformation work and doing nothing, doing nothing wins, over and over…I learned that even if you put up compelling proof, the structure of the nursing home is tilted strongly toward not changing.” (6)
Clinical studies have shown that our attitude about aging directly correlates to our experience of it. (7)
With the perception of post-middle age as a time of illness and disability, it becomes a self-fulfilling prophecy. Changing that perception to accept aging as a natural stage of life with its own rewards (and simply different from other stages of life) is Dr. Thomas’ ultimate goal. (8) Thomas boils down our current approach to seniors and elder care in one word: “ageism”.
Bill Thomas took his crusade to the screen and on the road.
Appearing in “Alive Inside”, a Sundance Film Festival award-winning documentary, Thomas talks about exploring music as rudimentary to a life worth living:
“We’re not going to see music in the lives of every old person until we change who we are. We’re going to have to confront our own fear of aging and our own fear of death. If we do that, we can build a society where nursing home means ‘nurturing’ home. Where people go there to grow and live and love and laugh and listen to good music.” (9)
To further the reach of his message, Thomas embarked on what he calls his “Age of Disruption Tour” in which he gives live performances that include music and discussion of the contemporary perception of aging and how we care for the elderly. The premise of his argument is that caregivers should treat elders as people who need care, not just treatment. The tour has taken him to over eighty cities in the U.S. and has enriched almost thirty thousand people. He also gave an insightful and inspirational TED Talk in San Francisco; you can find a link here.
His efforts have been so successful that hundreds of institutions have adopted Thomas’ approach to elder care in Australia, Canada, Europe, and Japan-all with positive results.
Radical Reconsideration of Youth and the Ambassador from Elderhood
In Dr. Thomas’ words:
“As a doctor, I was trained and taught that I had to help older people compensate for their losses-well, that’s a horrible frame around which to construct your life. Aging is not the problem. It’s our obsession with youth, our excessive devotion to the virtues of youthful adulthood. It is youth that is throwing our lives out of balance.” (10, 11)
He gives us pause to consider ourselves and our lives’ trajectories: where and how do you want to live when you’re 85? It’s within your power to decide.
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