Health

REVOLUTIONIZING NURSING HOMES

review by Beatrice Trum Hunter


Life Worth Living
How Someone You Love Can Still Enjoy Life in a Nursing Home
The Eden Alternative in Action
by William H. Thomas, M.D.
Van derWejk & Burnham, P.O. Box 2789, Action, MA 01720 USA
Quality paperback, 208 pages, $17.95

"Loneliness, helplessness and boredom steadily decay our nursing home residents' spirit," contends Dr. William Thomas. Anyone who has had to arrange for placement of loved one, or has visited a loved one in a traditional nursing home can identify with Dr. Thomas' appraisal. Life Worth Living is a frontal attack on conventional nursing home practices and offers an "Eden Alternative," a transformation that can nourish the spirit of the residents as well as the staff.

"Current practices in long-term care is based on a confusion of care, treatment, and kindness," says Thomas, "with the medical model's fixation on diagnosis and treatment." Thomas describes how one institution, the Chase Memorial Nursing Home in upper New York State, beginning in 1991, was converted gradually from a traditional long-term care facility into a healthy, natural habitat with rich multilayers of biological diversity: residents, staff, children in a day-care center and in summer camp, dogs, cats, birds, rabbits, plants, and garden. The approach was radical and non-medical with its 80 residents. Some of the results, that occurred after a gradual transformation should be of interest to public health officials as well as institutional administrators. Compared with a traditional institution (as control) the Chase Memorial Nursing Home had lower monthly average drug cost per resident; lower monthly average cost per prescription; lower average number of prescriptions per resident; and less use of psychotropic drugs. There were other benefits too: a lower yearly number of infections, and extended longevity. Employees were empowered with decision-making, and the result was a lower turnover of staff.

Building human habitats in nursing homes is a commitment for improvement of the residents' quality of life by making it socially stimulating. The loneliness, helplessness, and boredom gives way to human/animal/plant relationships, helpfulness, and stimulation. By making available on-site child-care, after school child-care, children's summer camp, exchange students, young volunteers, and community group activities, normal social connections of all ages were established and mutually beneficial. The presence of resident pets (dogs, cats, birds, and rabbits) as well as living plants not only brought pleasure to residents but involved them in caring for the animals and plants. An outdoor garden of flowers, vegetables and herbs replaced lawns, and became a source of activity and fresh produce for the kitchen.

The experiment with the Chase Memorial Nursing Home was a prototype for Eden Alternatives elsewhere. Life Worth Living gives practical solutions for conversions. The experiment is being duplicated elsewhere. For example, Texas is blazing its own trail with a legislature-authorized Texas Eden Alternatives Pilot Project, and has involved the students and faculty of Southwest Texas University in the project. Elsewhere, notably in Nebraska, Kansas, Oklahoma, Alabama, and Florida, statewide projects are being explored. In New York State, the 1995 legislature permitted nursing homes to pursue the Eden Alternative, and some nursing homes within the state are actively converting to the Eden Alternative. Such conversions are heartening. They make good sense in terms of meeting human needs and also afford the possibility of economic savings.

"The Eden Alternative is a new way of thinking about nursing homes. It employs the principles of ecology and anthropology in the struggle to improve residents' quality of life. It encourages the leaders of nursing homes to think less like administrators and more like naturalists. Finally, it summons all of us to construct vibrant, supple human habitats in which residents can live," states Thomas.

For readers interested in more details, there is a quarterly publication, "Friends of the Eden Alternative Newsletter." Contact Eden Alternative, RD 1, Box 3184, Sherburne, NY 13460 USA, 607-674-5232, Fax 607-674-6723, Email: rumpelst@norwich.net.


Copyright © 1996. The Light Party.

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