Below is an editorial from Syracuse.com about geriatrician Dr. Bill Thomas, a proponent of Green House Project and The Eden Alternative.
Ready for a new idea? Nobody has to live in a nursing home anymore.
"Every person in a nursing home has an exact clinical double living at home," says Dr. Bill Thomas, of Ithaca.
A geriatrician and evangelist for sensible new kinds of "elder care," Thomas created The Eden Alternative to raise awareness and change the culture around aging; and the Green House Project, which seeks to replace big, institutional nursing homes with scattered-site housing.
Thomas was in town earlier this month as keynote speaker at Loretto’s Legacy Awards luncheon. Loretto has 17 facilities housing elderly residents in a variety of settings, and also runs PACE, a program that provides home-based care. Loretto CEO Michael Sullivan says PACE already keeps as many as 370 elderly clients out of nursing homes.
Although the numbers of the elderly in nursing homes has dropped in the last several years, beds are still filled in large facilities like Cunningham-Fahey, James Square, Rosewood and Van Duyn. Why are so many still living there, if home-like settings are feasible in every case, as Thomas argues?
"Because their daily needs are greater than family and friends can provide," Thomas explains. Back in the 1960s and 1970s, Syracuse made a major investment in what was then state-of-the-art elder care. "It was far-seeing — then," says Thomas. But it created what Thomas calls "legacy overhang." He says cities like Seattle, Wash., and Lincoln, Neb., now are ahead of Syracuse, moving to scattered-site elder housing.
"Use economies of scale for billing, records," says Thomas. "Get to the small scale for care." Smaller can be economical, he adds. "It’s a costly ballet to deliver 500 meals simultaneously," he says. "In Green Houses, food costs are way down. They cook what they want, when they want it."
Years ago, people with mental and developmental disabilities moved from institutions to community housing. Likewise today, there are alternatives to prison for nonviolent inmates.
In the case of the elderly, the transition to scattered sites could be easier, because community resistance — "not in my backyard" — is less of a factor. Thomas says there are 100 Green Houses in 12 states and more on the way.
He found a willing audience among Loretto’s leaders. CEO Sullivan said Loretto has two scattered sites, on Highland Street and Fayette Street, and he wants more. "We would like to do away with nursing homes, floor by floor, house by house," he said.
Getting there won’t be easy — particularly with state government cutting back aid. Thomas hopes to amplify his message of "culture change" via the Oprah Winfrey show. "The media still treat old people like a plague of locusts," he says. "I think aging is a good thing, though bad may come with it. It’s a kind of human development. What’s missing in the media is how age makes you better."