Dr. William H. Thomas and Homes that House the Livingby Kurt Schlabach
Dr. Thomas is a geriatrician, a writer and a rock star. He might shy away from the last label but it's a hook that fits for many of his admirers. Given the way this man plays his instrument and uses his head he certainly deserves all the accolades he has received.
The Eden Alternative
Dr. Thomas graduated from Harvard Medical School in 1986. It was a time when most baby boomers were well into their stride. The top end of the demographic had moved on from the turbulent sixties, establishing families and careers. They were busy being busy. Very few of them were contemplating the afterlife that comes after retirement. Even though it wasn't something boomers were actively thinking about, it became abundantly clear that in his first decade of medicine Dr. Thomas was beginning to seriously rethink and challenge the way we care for the elderly.
Dr. Thomas began his medical career concentrating on emergency medicine but after a short stint working part time in a nursing home, he quickly developed a passion for geriatric medicine. In the early nineties he helped co found, with his wife Jude Thomas, the Eden Alternative. The Eden Alternative is a non–profit group whose focus is the deinstitutionalization of long term care nursing homes. The Eden Alternative proposes that deinstitutionalization can only occur if the culture of nursing homes is challenged and replaced by a more fitting and elder based philosophy.
The Green House Project
In 2003, Dr. Thomas created the Green House Project. The Project was an ambitious undertaking with the direct aim of replacing the institutional nursing home model with much smaller intentional communities. New homes would house only a small population of residents or Elders not exceeding 10–12 members. Elders and staff would interact in a collective fashion with the intent of improving and fashioning a living environment where the quality of life for all, was the main driving force.
The Green House Project has blossomed over the years and as of 2011 there are ninety nine homes operating in America. The design principles have caught on internationally as well with the establishment of likeminded homes in Europe and Canada.
The big idea is small
So what is it about the actual home that makes it different from what you might expect in traditional nursing homes? Well, let's get the first major difference out of the way. Size does matter. Green House Project homes are structurally smaller than their institutional counterpart. They are actually quite similar to the homes you and I would live in only slightly larger to accommodate the ten to twelve residents. The center of the home is the kitchen and the common living space. Each resident or elder has their own bedroom with adjoining bathroom. All rooms and bathrooms are equipped with ceiling lifts to assist less mobile elders if needed. The layout of each room is based on retaining the dignity and quality of care for each of its occupants.
Staff responsible for the care of these elders is divided into four distinct but symbiotic groups.
- The Shabaz provides frontline care including personal assistance with hygiene, cooking and feeding and housekeeping. The Shabaz has replaced the old handle of nursing assistant. Due to the small elder populations in these homes the Shabaz to elder ratio is small and works well in establishing a good functioning work environment. Staff enjoys their work and elders benefit from the Shabaz and their commitment to good quality care.
- The Guide is responsible for the supervision of the Shabaz and the general operation of the home.
- The Sage is an elder living in the home who volunteers their time acting as both a resource person and advisor to the work teams in the Green House Project home.
- The Clinical Support Team consists of nurses, therapists and dietary professionals who provide services in close consultation with the Shabaz individualizing the care for each and every one of the elders living in the home.
A home with a sense of community
The Green House Project home is exactly as the name implies. It's a home. Staff and elders alike share the dining room table for meals. Elders can mosey up to the kitchen counter and discuss the planned meals for the day. If they are so inclined they can give staff a hand at prepping the food. Roles are interchangeable and nothing is sacred. A direct result of these embraced attitudes is the sense of community that evolves.
Lifestyle of elders is important
New homes for our elders like the ones Dr. Thomas has helped to create and make are shining examples for all of us. It's not about housing away aging populations in large institutional settings where they wither and rot with the passing of time. It's not about maintaining too many people with too little staff. It's not about meeting strict regulations with an even harsher engagement. The life of elders is important to both their families and our community. In the Green House project home elders are afforded the rightful opportunity to continue living as adults. There is no talk of the end years here. These are homes that house the living. We can thank Dr. Thomas for that.