A common complaint about institutions for seniors is their lifelessness. Institutions for the elderly are often sterile and so full of routine that the element of life seems to be missing.
Bill Thomas decided to change that when he graduated from Harvard Medical School and returned to the land he loved in upstate New York. In addition to farming, he and his wife were raising five children. He also became the medical director of Chase Memorial Nursing Home.
The place was almost irredeemably lifeless, he found. The residents were so restricted, any independence they could manage was severely compromised by the institutional atmosphere and routine. Thomas began to formulate his idea of the “Three Plagues” that seniors experience: loneliness, helplessness and boredom. These plagues should be replaced, he felt, with companionship, efficacy and lively interests. The way to stimulate that, he thought, was to literally introduce more life into the place.
Atul Gawande, in his best-selling book, Being Mortal, tells how when Thomas got an experimental grant and permission from the administration and the state to introduce elements of life into the institution–plants, animals and children–it looked like, in Thomas’s own words, complete pandemonium. Two dogs, four cats, and one hundred birds later, residents began to liven up. They took responsibility and waxed voluble about the animals and about rediscovering value and purpose in their existences because they could nurture life.
It seemed like a miracle. Life seemed to beget more life. All artificial plants were replaced with real ones; a vegetable garden was started; and soon a thriving on-site day care center for the children of the staff as well as an after school program brought the joy and laughter of children to the institution.
Some of us may ask, “What were the medical results? Were there increases in infections and disease due to the animals running around? Did seniors collapse in despair when a bird died? Did the noise of children bring on dementia agitation?”
To the contrary, an independent study showed that prescription use was cut by half at Chase Memorial Nursing Home compared to a nearby nursing home. Deaths fell by 15%. People were no longer dying of the three plagues. Nor did they need as many psychotropic drugs for their mental issues. Life was doing its re-generative work.
The Eden Alternative(r), which is now an international, non-profit organization, concentrates on creating a good quality of life for seniors whether they are in nursing homes or aging in place. Its vision is to “eliminate loneliness, helplessness, and boredom”, the “Three Plagues,” and the suffering these plagues cause to the elderly. The Eden Alternative(r) maintains that life for seniors improves with plants, animals, and children around. The organizations asserts that seniors should not be left alone and made to feel useless and helpless when they are still capable of nurturing life and giving care as well as receiving it.
The Eden Alternative(r) sees the pandemonium of so much activity as alleviating boredom. One of its Ten Principles is to create communities “with variety and spontaneity by creating an environment in which unexpected and unpredictable interactions and happenings can take place. This is the antidote to boredom.” Instead of “activity rooms” where seniors engage in meaningless and monotonous distractions, The Eden Alternative(r) suggests “art studios” or “artists’ workshops”– terms that themselves suggest creativity and life. “Words make worlds,” says The Eden Alternative(r) on its website.
Using words that carry connotations of creativity and growth can have a strong impact. Residents in Eden-influenced communities are referred to as “Elders”–people who can pass on life skills, knowledge and wisdom to others because of their great experience. Eden communities seek to give “Elders” the “maximum possible decision-making authority” instead of imposing “top-down, bureaucratic authority.”
From The Eden perspective, for human well being, persons must experience being known for who they are, and they must experience growth, autonomy, security, connectedness, and meaning. They must also experience joy. These are the “Domains of Well Being” that The Eden Alternative(r) seeks for Elders in its communities.
It is not enough for seniors to be fed, housed, clothed, medicated, and protected from risk and harm. It is the vibrancy and pulse of life that makes living desirable at any age, even if it means a little pandemonium.
Gawande, A. (2014). Being Mortal. New York: Metropolitan Books. Henry Holt and Company. Pp. 115 – 125.
The Eden Alternative(r) (website). http://www.edenalt.org