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August 30, 2007

Who is Dr. Bill Thomas?

Dr. Bill Thomas is an international authority on geriatric medicine and eldercare. He is a professor at the Erickson School at the University of Maryland, Baltimore County and has been heavily involved in the culture change movement to promote elderhood as an honorable and valuable position in our society. Click here to read more.
Eldertopia and the New Old Age

Dr. Bill Thomas: Eldercare, aging and us

Dr. Bill Thomas speaking at the 2007 Pioneer Conference, Part 1:

Dr. Bill Thomas at the 2007 Pioneer Conference Part 2:

What Is Old Age For?
by William Thomas

Old age is humanity's greatest invention, and on an even deeper level, it invented us. Old age transformed the way our most distant ancestors gave birth, reared their young, lived together, and fed themselves. Later it propelled the development of culture, language, and society.

Humans are primates, and among all primates we are most closely related to chimpanzees. We hold 98 percent of our genetic code in common with them. Yet a comparison of human and chimp life cycles reveals some unexpected differences.

Human beings can live twice as long as our nearest relatives—surprising in itself. Astonishing, however, is that all of this additional longevity follows the loss of fertility. Chimp and human females become fertile at nearly the same age and remain fertile for about four decades. For the aging chimpanzee, death follows hard on the heels of the loss of fertility. The human female possesses a nearly 50-year longevity bonus that follows the end of fertility. Our post-reproductive longevity exists because it affords our species a unique and powerful competitive advantage. Hidden within this extraordinary elongation of life is the story of who we are and how we came to be.

The first grandmother
One million years ago on the plains of Africa, a hominid child cries out from hunger. Her mother has recently given birth and is distracted by the needs of her helpless infant. The delivery was long and difficult and much blood was lost. The mother barely has the strength to nurse her infant. She can neither feed nor care for her older child. The mother of the new mother, the grandmother of the crying child, is moved to act. Thus was the first tentative step taken down the long road that led to the development of the modern human being. The deliberate enlistment of grandparents into the work of rearing the young stands as a defining characteristic of Homo sapiens.

Substantial advantages accrue to offspring who can be cared for by two generations of adults. The extra food and attention significantly improve survival rates. University College researchers in London found that in Gambia, infant mortality rates dropped by 50 percent if the maternal grandmother was present in the household (interestingly, no benefit was found when the paternal grandmother was in residence). Ruth Mace, one of the researchers, noted that the presence or absence of the father had no bearing on infant survival: “If the grandmother dies, you notice it; if the father does, you don't.”

Research in India has found similar results. Surely the grandmothers' contributions of time, energy, and material resources across generational lines are important, but that is not all there is to it. Humans, in particular humans living in active multigenerational families and communities, benefit from intergenerational affection.

The genius of human longevity
The development of menopause and the refinement of grandparenting played a critical role in the physical evolution of the modern human, but the story does not stop there. About 40,000 years ago, another remarkable round of adaptations changed how people lived. Homo sapiens generalized the benefits of grandparenthood by linking old age to the work of social evolution. The development of human culture—its refinement, storage, and transmission—was woven into the fabric of old age.

An African proverb says, “The death of an old person is like the loss of a library.” In these words are embedded the important role given to older adults in many African cultures. After a person has productively lived his or her life as an adult in the community, he or she is honored by initiation into the elder circle. This usually happens around the age of 65.

These elders, now masters of the school of life, have the responsibility for facilitating the transition from childhood to adulthood of new generations. They are responsible for and oversee the process of initiation. The idea of elders as “library” also reveals the fact that only the elders have full access to the tribe's knowledge base. The elders safeguard the highest secrets of the tribe and protect its medicine and inner technologies. They incarnate the wisdom of the society, which they happily share, often in the form of storytelling.

Anyone in the last half of life can attest to the difficulties, the aching joints, the fading eyesight. What is open to interpretation is the meaning of these changes. What if they are understood as a form of preparation (not unlike adolescence) for a new life as an elder of the community?

The physical decline that comes with aging actually cements the relationship between old and young. Indeed, an old man still capable of stalking, killing, and butchering a mastodon would have little inclination to spend hours doting on grandchildren, telling them stories, and instructing them in the ways of their people. An old woman still capable of producing young of her own would hardly be inclined to pour time, love, and attention into the lives of her grandchildren. The physiological changes that accompany old age, and upon which contemporary society heaps unlimited scorn, are actually essential preconditions for a socially productive old age.

Human elders have long been known as peacemakers, and for good reason. The physical changes that accompany advancing age make conflict, armed and otherwise, worthless to the old. Like statesmen serving their final terms in office, elders are freed from the tactical maneuvering that defines the struggle for adult rank and prestige. It is this freedom that allows them to put forth unique interpretations of the problems faced by their families and communities. The awareness of one's mortality that normally arises in late life—and so terrifies adults—opens new perspectives for elders on the world in which they live.

Being an elder
The promises of the current anti-aging fad perpetuate an illusion of unlimited longevity. This strengthens the characteristic adult devotion to doing, having, and getting. The result is an underdeveloped, increasingly dysfunctional population of developmentally delayed adults who are prone to catastrophic errors of judgment. The mania for
having and getting diminishes the value of stewardship in our culture. The preservation of resources for the benefit of those yet to be born, or even for the common good of those living now, is airily dismissed as simple-minded idealism. At the root of it all is the adult fantasy of unlimited time, unlimited wealth, unlimited resources, and unlimited information.

Adulthood itself is a right and fine thing. I am an adult. I love adulthood. I find daily pleasure in living as an adult and have no interest in returning to the childhood I have outgrown. Nor am I ready to enter into an elderhood that requires perspective, experience, and judgment that I do not yet possess. Adulthood, rightly understood, provides us with a productive, potentially glorious interlude between youth and old age. The problems begin when we conceive of it as a permanent necessity, an apex of human experience that must be defended and enlarged no matter what the cost.

Adulthood is chained to the rock of doing. When two adults meet, it is rare for more than a minute to pass before one of them pops the question, “What do you do?” Adults inhabit a world of tasks and schedules, payments, obligations, and jobs that need to be done. Yet in all this busy doing, they may ignore deeper questions of whether those tasks are worth doing and whether they foster meaningful relationships. These are questions not of doing but of being.

Doing and being are best thought of as two sides of one coin. As humans age, the action-oriented strategies of DOING-being give way to the indirect and subtle influence of BEING-doing.

Consider how adults and elders bake cookies. The adult tends to approach cookie baking as one more item on a long list of things to do. The children are either banished from the proceedings or—if the adult is feeling particularly guilty about a perceived deficit in the “quality time with the children” account—the children will be included, with some apprehension. The cookies are baked with dispatch, and dire warnings about eating raw cookie dough (possibly salmonella) are issued along with lessons about the virtue of cleaning up as you go.

The elder is much more likely to want to bake cookies than to have to bake cookies. As a result, children are more than welcome. Eating raw cookie dough? “Never mind what your mother says; go right ahead.” Flour, sugar, and eggs are used with abandon. Bizarre and experimental cookie shapes are welcomed. The crucial difference between the adult and the elder is that the former is fixated on the doing while the latter seeks the being. The adult cares about the cookies and is happy to log some quality time if possible. The elder cares about the relationship and is content with the cookies no matter how they turn out.

The central social and cultural challenges of our time revolve around the malignant enlargement of adulthood and the adult obsession with DOING-being. Adulthood, intoxicated by its own might, is intent on remaking youth and old age in its image. It has already defined the best child as the most precocious child. The wunderkind mimics adult behaviors and styles of work and learning. Likewise, adulthood demands that those who would remain worthy defy their age and continue to think, walk, talk, look, and work like adults.

Liberating elders
In 21st century America, only two categories of people still face routine and even permanent institutionalization—criminals and the elderly. In the last half of the 20th century, prisons and nursing homes both experienced a steady rise in the number of inmates. The true nature of the nursing home is especially obvious to those schooled in the ways of institutions. One prisoner wrote to tell me how much the nursing homes where he visited his grandmother reminded him of prison, and I have received many communications like this one from a former nursing home resident:

I have recently returned from “rehabilitation care” in a nursing home. I have pretty severe cerebral palsy and had breast cancer surgery. The nursing home environment did more to slow the healing process than help. I got a terrifying glimpse into a future in such facilities. I would rather die than have to exist in such a place where residents are neglected, ignored, patronized, infantilized, demeaned, where the environment is chaotic, noisy, cold, clinical, even psychotic.

Early advocates for the aged understandably concentrated their efforts on eradicating the mistreatment of the old. They were among the first to speak openly against the agism and overt bigotry practiced toward the aged. The much broader effort to liberate elders and elderhood, however, has yet to be truly begun. Such a crusade is necessary not because it can right wrongs that are visited on older people (although it can) but because it is the essential precondition for a new culture committed to a better quality of life for people of all ages.

The elder-guided society (I call it Eldertopia) is and should be run by the vigorous adults of the time. Elders should intervene at critical points to ensure that the adults take into account perspectives that are too easily ignored by those gripped by the fever of rank and wealth.

Since 1900, the percentage of Americans over age 65 has more than tripled, and those who reached age 65 in 1998 could expect to live on average another 17.8 years. Far from being ravenous locusts determined to consume an ever-increasing share of scarce resources, our growing number of elders represents an unprecedented windfall. I believe that the elders of our time form the only force capable of returning adulthood to healthier bounds. Consider the gifts a liberated elderhood could offer our society.

Elders have always made important contributions to the young of their families and communities. For thousands of years, relationships between young and old have made life better for both groups. In Eldertopia, all school construction and remodeling projects would include housing and community services for elders.

Elder councils could provide a balancing perspective that considers the long-term consequences of any proposed action. The topics addressed might well include matters that the conventional political system would rather sweep under the rug.
Elders have long spoken for Earth, its living creatures, and the children who are yet to be born. Eldertopia would have an Elder Conservation Corps that would tackle projects that strengthen the health and vitality of the natural world.

Any honest accounting of the potential influence of elders and elderhood must address the contributions not only of fit and energetic elders. It must recognize the contributions that people who are weak, ill, infirm, dependent, demented, disabled, and dying can make to this struggle. The old and frail are able to surmount the dizzy bustle that clings to the young—to enter a time and place in which the spiritual and emotional dimensions of human life take precedence over the humdrum workings (and failings) of organs, tissues, and systems. This is among the most admirable of all human endeavors. What the old and frail do is show us the way. They provide us with greater insight into and a clearer perspective on the human condition.

The most elder-rich period of human history is upon us. How we regard and make use of this windfall of elders will define the world in which we live.

Adapted from What Are Old People For? How Elders Will Save the World, by William H. Thomas, M.D., copyright 2004. Used by permission of VanderWyk & Burnham (www.VandB.com), Acton, Massachusetts. All rights reserved. William Thomas is a geriatrician who created the Eden Alternative and the Green House Project .

Posted by Kavan Peterson on August 30, 2007 7:57 PM |Permalink |Comments (1)

September 18, 2007

Eden Up North

I found this nice article on the success of one Eden Alternative long-term care organization, the Burquitlam Lions Care Centre in British Columbia. Read the full article here

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Posted by Dr. Bill Thomas on September 18, 2007 11:00 AM |Permalink |Comments (0)

September 20, 2007

A Gathering of the Tribe

A gathering of the tribe, Eden Educators come together for their semi-annual meeting. These are some of the best teachers in America and I love them and their iron-clad commitment to positive social change.

We had a great evening together.

Posted by Dr. Bill Thomas on September 20, 2007 9:41 AM |Permalink |Comments (0)

September 24, 2007

Kaboom: NYT lowers the boom on for-profit nursing homes

Sunday's NYT pulls back the curtain on the practice of "flipping" nursing homes for profit. There is money to be made and some people are making lots of money. No problem there, this America after all and making a buck is an honored tradition. No, the problem is that there are real problems with safety, quality and dignity. The article can also be read as a cautionary tale regarding health care as a profit making activity. In my opinion, the best starting point is health care as a right not an industry. Click here to read the full article.

Posted by Dr. Bill Thomas on September 24, 2007 2:47 PM |Permalink |Comments (0)

October 4, 2007

Welcome to Friends of Eden

This is just a quick note of welcome to all of my friends in the worldwide Eden Alternative network. Please feel free to send us any news clips, information, rants or insights you think might add to the blog.

Oh yeah, bookmark the site and come back often.

See you later...

Posted by Dr. Bill Thomas on October 4, 2007 2:15 PM |Permalink |Comments (3)

October 26, 2007

Endless Tales of Woe

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Those who know me and my work know I'm an insufferable optimist and am whole-heartedly dedicated to reversing the most intractably pessimistic aspect of our culture -- how we feel about AGING.

But, even my cheerful demeanor blanches every morning when I open my Google-New-Alerts for the two most unfortunate words in the LTC lexicon -- "Nursing Home."

Here is a sample of today's news:

Man Dies Trying To Escape Nursing Home CHICAGO -- A 66-year-old man died after falling from a second-story window at a Northwest Side nursing home Wednesday morning.
Kiril Kirilov, who may have suffered from mental disabilities, attempted to exit Harmony Nursing and Rehabilitation Center from a second floor window via bedsheets he tied together, according to an Albany Park District police officer.

ARE YOU KIDDING ME?

But wait -- it gets worse:

Seniors Fear Losing Independence, Moving Into Nursing Home More Than DEATH
Senior citizens fear moving into a nursing home and losing their independence more than death, according to a new research study, “Aging in Place in America,” commissioned by Clarity and The EAR Foundation.

Tragic, and painfully true. I will write more about this terrible reality soon. Click here to read the full study posted at MyHearingHealth.com.

However, there was one gem out of more than a dozen articles today on abuse, neglect and fraud:

'Home Again' will aid seniors who wish to move out of nursing home
TERRE HAUTE — A new program called “Home Again” will provide rental assistance to seniors on Medicaid who desire to move from a nursing home back into a more independent and affordable community setting.

If you're looking for another ray of hope, go to www.edenalt.org

Posted by Dr. Bill Thomas on October 26, 2007 10:24 AM |Permalink |Comments (6)

December 5, 2007

List of Shame

A guest post from UMBC's Kavan Peterson:

In an unprecedented move, The Centers for Medicare & Medicaid Services is shining the public spotlight on America's Worst Nursing Homes by publicly releasing a list of 54 facilities with the most serious health and safety problems in the nation. Thanks to The Consumerist for alerting us to this development:

CMS has released the first-ever official list of America's Worst Nursing Homes— a move that leads us to suspect that the Department of Health & Human Services must be getting pretty fed up if they are resorting to public shaming. The list includes the 54 most egregious health and safety violators of the 128 SFF, or "Specialty Focus Facilities," in the U.S.
A Special Focus Facility is basically a nursing home that is on double-secret probation— subject to twice as many inspections as a non-SFFs, with the threat of funding cuts for non-compliance.

According to the CMS, the average facility isn't perfect (6-7 violations is the national average.) Those designated as SFFs are guilty of either more violations or more serious violations than usual, as well as a history of fixing problems just long enough to pass inspection, then going right back to business as usual. The CMS dubs this "yo-yo compliance," and the SFF program is designed to deal with it by combining more frequent inspections with more stringent enforcement until the nursing home falls back in line.

If the facility in question doesn't shape up, correct the underlying problems that lead to violations and "graduate" from the SFF program (in about 18-24 months) their funding is cut and they will likely close.

Of course, the first thing I looked for on this list was the names of any nursing homes that cared for loved ones in my family or employed members of my family. To my absolute dismay, I found that the only nursing home in Montana to make this infamous list was none other than Evergreen Missoula Health & Rehab. This facility not only cared for my wife's grandfather during the last months of his life, but it is located on the corner of the street I grew up on and where my parents still live today. I can only hope the public humiliation of making this list will work where government regulations and inspections have not.

Besides sharing this list with as many people as possible, CMS recommends families use its Nursing Home Compare tool to review the ratings of any nursing home they are considering.

For those looking for a ray of hope, go to www.edenalt.org

Posted by Kavan Peterson on December 5, 2007 9:55 AM |Permalink |Comments (0)

Update Shame on CMS

Guest Post by UMBC's Kavan Peterson:

Almost immediately after posting the below story I came across this update from the Des Moines Register:

Names of worst care centers witheld from public, but given to lobbyists

The federal agency that refuses to publicly identify three of the worst-performing nursing homes in Iowa has shared that same information with lobbyists for the nursing home industry.
"This is absolutely outrageous," said John Tapscott, a former member of the Iowa Legislature and an advocate for nursing home reform.

"I don't know when I've been so livid in all my life," he added. "This just speaks to a larger problem, which is that the lobbyists are now running the government."

The U.S. Centers for Medicare and Medicaid Services has compiled a list of 128 "special-focus facilities" that are among the worst-performing nursing homes in each state. Those care centers are alleged to have consistently provided poor quality care while repeatedly falling in and out of compliance with government health and safety regulations.

But the federal agency has publicly identified only 54 of those 128 nursing homes. Among the 54 is Blair House, a care center in Burlington.

Shame on me for giving CMS the benefit of the doubt below. Des Moines Register reporter Clark Kauffman sums up my amazement at this egregious action:

It's unusual for a government agency charged with protecting the public to give information to an industry it regulates while withholding that same information from the public.

I'll also give Hillary Clinton credit for being the first presidential candidate in Iowa to lash out at CMS over this.

Stay tuned.

Posted by Kavan Peterson on December 5, 2007 10:56 AM |Permalink |Comments (0)

January 22, 2008

The Healing Power of Dogs

The Eden Alternative has known this (and so have many other people) for a long, long time. Still, it is nice to see scientific proof!

From the NYT...

Dogs have long had special standing in the medical world. Trained to see for the blind, hear for the deaf and move for the immobilized, dogs have become indispensable companions for people with disabilities.

But dogs appear to be far more than four-legged health care workers. Over the years, data on the larger role dogs play in health has trickled out from various corners of the world. One Japanese study found pet owners made 30 percent fewer visits to doctors. A Melbourne study of 6,000 people showed that owners of dogs and other pets had lower cholesterol, blood pressure and heart attack risk compared with people who didn’t have pets. Obviously, the better health of pet owners could be explained by a variety of factors, but many experts believe companion animals improve health at least in part by lowering stress.

Dogs, in particular, also have been shown to do remarkable things to improve the health of their owners. There are stories of dogs warning their owners of imminent health threats. In 2003, University of Florida researchers published a report in the journal Seizure noting that some dogs seem to have an innate ability to detect impending seizures. A 2000 report in the British Medical Journal examined case studies of dogs alerting people with diabetes of a coming hypoglycemic episode.

More recently, some studies have suggested dogs can be cancer detectors. In 2006, the medical journal Integrative Cancer Therapies reported how ordinary house dogs could identify breast and lung cancer patients by smelling their breath. A University of Maine study is testing whether dogs can sniff out ovarian cancer.

The role dogs play in medicine is celebrated in a new book, “Paws & Effect: The Healing Power of Dogs’’ (Alyson Books, 2007), which chronicles the numerous ways dogs contribute to our health. Author Sharon Sakson is a journalist and television producer, dog breeder and American Kennel Club dog-show judge. She admits to being biased about her subject matter, and she tends to write about the mundane details of dogs and their owners. Much of the evidence surrounding dogs and health is anecdotal, although Ms. Sakson includes many references to published research. The stories of service dogs are particularly impressive, as is the nascent research into dogs’ ability to detect cancer.

Dog%20Eden.jpeg

Posted by Dr. Bill Thomas on January 22, 2008 5:41 AM |Permalink |Comments (2)

April 2, 2008

Eden Takes Root in UK

[Editor's Note: Dr. Bill Thomas is traveling in the UK this week and below are photos of his trip. Thanks to June Burgess for emailing these for Bill.]

The Eden Alternative takes root in Bradford on Avon -- Take a look:
Bradford%20on%20Avon%20Town%20Bridge%202.jpg

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Eden%20Associate%20Training%20Bradford%20on%20Avon%20April%202008%202.jpg

Georgian%20Tea%20Rooms%20Bradford%20on%20Avon.jpg
Thanks Bill it was great to have you with us!
-- June Burgess, Eden Alternative Regional Coordinator for the UK and Ireland

[Correction -- June Burgess was initially misidentified as the proprietor of The Georgian Tea House. Sorry about that June!]

Posted by Kavan Peterson on April 2, 2008 10:54 AM |Permalink |Comments (0)

April 4, 2008

Power Up Friday: Attitude Matters, Dude

There is no doubt that the Eden Alternative has been a major force in the movement to transform long-term care in our society. (That's a fact - I'm not just "kissing up" to the Blogmeister here.)

But even Bill Thomas will tell you that the Eden movement has caused a lot of people to pay too much attention to the superficial aspects of the new habitat - the dogs, cats, birds - what we call the "fur and feathers" of Eden. These are tools to help create a human habitat; but simply bringing a cat or a bird into a nursing home without embarking on deeper aspects of interpersonal and organizational transformation will yield poor results, (as many people have found when they have tried to "short-cut' the process).

Now the Green House Project (TM) has spawned a new movement to complete the physical transformation of long-term care through the construction of small homes that house only 8-10 elders. The media and society at large are paying attention. In addition to Green Houses, many other small house models are in development, and a new movement is born.

But every new trend has potential pitfalls for those who rush to adopt the concept without a deep understanding of its origins. So what do we need to watch out for next? What are the "fur and feathers" of these small house models?

Quite simply, it's the house itself. These homes are such a radical departure from any nursing home we've seen, that they cannot help but astound people who view them for the first time. What a great idea! Why haven't we thought of building these before?

There's an excellent reason why. If the building was all there was to it, we'd have built them a long time ago. However, our ATTITUDES about aged care have created the physical features of traditional nursing homes. Our society's view of aging as decline and our paternalistic approach to elder care have informed the institutions we have built over the past half century. You don't erase those biases simply by putting people in a small house.

I believe that small homes like the Green House are the future of aged care. The best ones, however, realize that the physical structure will not solve the plagues of institutionalization unless it embodies more than walls and windows. It must also reflect a new attitude toward aging and the aged, toward well-being and illness, toward risk and reward, toward autonomy, and toward collaborative approaches to care.

In short, we must build Green Houses in our minds, in our interpersonal relationships and in our operational design, before we lay that first cornerstone. Otherwise, it'll just be a 10-bed institution.

-- Al Power

Posted by Dr. Bill Thomas on April 4, 2008 10:19 AM |Permalink |Comments (0)

April 7, 2008

Change We Can Live In

If you take a look at the left-hand column on my blog you'll notice a list of books that are Changing Aging. The Erickson School this Friday is providing a rare opportunity to hear from the author of the newest and one of the most influential additions to this list -- "Old Age in a new Age: The Promise of Transformative Nursing Homes," by prominent free-lance journalist Beth Baker.

I've had the privilege of talking to Beth numerous times in the course of her compassionate and insightful reporting on the transformation of long term care in America. Do you think nursing homes have to be a place of last resort? I highly encourage you to come and meet Beth Baker and learn how nursing homes are turning into transformative homes, and how this change will benefit us all.

WHEN: 1:30 p.m., Friday, April 11, 2008
WHERE: UMBC, ITE Building, Room 102

To RSVP, or for more information, contact Kathryn Gallagher at 443-543-5645 or kathryng@umbc.edu

Posted by Dr. Bill Thomas on April 7, 2008 9:28 AM |Permalink |Comments (0)

April 28, 2008

Monkhouse Monday

[Editor's Note: Dr. Thomas has invited Eden Alternative's Europe Coordinator Christa Monkhouse to guest-post on a weekly basis from across the Big Pond. Christa is personally responsible for introducing the Eden Alternative to Europe, first in the UK, then Denmark and soon in Sweden, Finland and other European nations. Stay-tuned for regular updates on 'Monkhouse Mondays'.]

Eden Europe has now about 1000 associates. We just started a networking platform on www.edenalt.ning.com (if you are an Eden associate you are welcome to join, posts are in English and German) and I have been busy translating posts and video messages by Dr. Thomas into German, as some of his messages and ideas are just breathtakingly new. This inspires fresh thinking on our side and I would like to share with you some of the learning which has taken place:

Bill’s term "mitigated aging“ has brought a high sensitivity to language use, after all, we act what we think. Therefore use of language is an indicator of culture change. I would like to give an example:

Paraprofessional: we all know that this term describes "untrained“ or little trained care workers (para means "beside, alongside, assistant, subsidiary, but also 'abnormal or incorrect'“ (source: http://www.thefreedictionary.com)

This is how we call the most important carers, even scholarly papers do so. In an Eden pilot home we have trained "Life Assistants“, similar to the Shabaz in the Green-House. These are multitaskers and truly complementary to nurses, therapists and physicians. They are the "worldmakers“ (B. Thomas), there to "protect, sustain and nurture“. Why not make this a new, much needed profession with deserved importance, prestige and ongoing education? The European Care License (http://www.scie.org.uk/networks/ecl.asp) is a small beginning. Our Life assistant training was based on it and trains them in all aspects of quality of life.

Two days ago, the Swiss Health Obersvatory (http://www.obsan.admin.ch) published a report, saying that care costs will increase by over 100% in the next 30 years, simply because the numbers of older persons who need care will increase. What they do not mention is that the supply of carers will decrease (future carers are already born today). High time to attract them into a profession, not a "paraprofession“.

-- Christa Monkhouse

Posted by Kavan Peterson on April 28, 2008 7:15 AM |Permalink |Comments (0)

May 6, 2008

Monkhouse Monday: Dementia, Diversity and Eldercare

[Editor's Note: (Below is this week's edition of 'Monkhouse Mondays', accidentally postponed to Tuesday -- Sorry Christa!)
Dr. Thomas has invited Eden Alternative's Europe Coordinator Christa Monkhouse to guest-post on a weekly basis from across the Big Pond. Christa is personally responsible for introducing the Eden Alternative to Europe, first in the UK, then Denmark, Austria, Germany, Switzerland and soon in Sweden, Finland and other European nations. Stay-tuned for regular updates on 'Monkhouse Mondays'.]

Persons with Dementia (PwD), do they need "Special Care“ or simply to be part of our "Cultural Diversity?“

Presenting the Eden Philosophy to varied audiences of professionals I am often asked: "Which model of care do you use for people with dementia?“, implying that surely they must be treated "specially“, given the proliferation of "special care units“.

My answer, informed by experience is: "Intentional and informed diversity-management.“

What do I mean by this? Some context: We know that people with dementia are overmedicated (see Al Power’s post on Antipsychotic Restraints), at conferences we hear about solutions for "wandering“, "aggression“, "unrest“ and "violence“. We keep PwD in "secure“ or "special care“ units. Research has shown that overmedication causes more deaths, that wandering is a normal and purposeful reaction to "feeling out of place“ in an institution, so are aggression, restlessness and violence. Secure units and chemical restraints keep people with dementia away from mainstream society. In Swiss law and medical ethical guidelines (www.samw.ch, english version/ethics/guidelines = coercive measures in medicine) a person can only be "secured“ for a short time if she is a danger to herself or others. Anecdotal evidence shows that people with dementia are actually very cautious, perceiving different colour flooring as "gaps“ and stopping in front of them. The question arises if "secure units“ are a severe infringement of human rights?

The answer? Why not educate the general public, schoolchildren in how to deal with PwD? How to serve them with attention and compassion at the supermarket checkout, the bus, the train, the cafe? If a person has "eloped“ from a care home, educated police will know what to do, normal, everyday business, calm, professional, warm. As there will be more and more people with dementia, they have the potential to add to the diversity of our society, visible at parties, restaurants, parks, hairdressers, beauty parlours, banks and hotels. They should not be marginalized, segregated and hidden. No, they can remind us how being, not just doing, is valuable in our lives and that tenderness and compassion can be practiced every day. This would be a true recovery approach to dementia care as outlined in Dr. T. Adams’ insightful and practical new book on Dementia care(p. 283). PwD would so re-cover the ground they have lost through the socially constructed segregation from mainstream society.

An empathic, practical and useful approach to dementia recovery on a personal level is the Spark of Life program developed by J. Verity, Eden Mentor for Scandinavia and Dementia-care pioneer from Australia. Watch the Demo-Video on YouTube and be moved (I was) to tears

--
Christa Monkhouse, www.eden-europe.net

Posted by Kavan Peterson on May 6, 2008 11:10 AM |Permalink |Comments (3)

May 9, 2008

Power-Up Friday: International Eden Conference

For anyone who enjoys reading these pages, I hope you will seriously consider joining us at the 4th International Eden Alternative Conference, June 3-6 in Columbus, Ohio. Every two years, leading innovators from around the world gather at a different city to share exciting developments in changing aging in society. Columbus is easy to
get to, and it should be a fabulous time!

Eden Founder Dr. Bill Thomas will be on hand, and will give the opening Keynote address, and Executive Director Nancy Fox and Board member Sara Rowan will convene the conference. There will be dozens of speakers throughout the meeting, including Jane Verity and Hilary Lee (see the "Spark of Life" video on the 5/6 Monkhouse Monday post). There will be a presentation on Green Houses(R), and one about using computer technology to enhance the lives of elders. Bloggers Christa Monkhouse and myself will have presentations as well.

There will be a dinner/dance which will also include a theatrical performance by Howling At The Moon, a company of 8 women over 60 who write and perform sketches about what it means to be older. An International Reception kicks off the event with a convergence of Eden Associates from all corners of the world. The closing Keynote speaker will be Richard Pimentel, a prominent disability rights advocate recently profiled in the documentary film "Music Within".

In between all of this, you can learn about culture change from Europe to Australia, about aromatherapy, intergenerational experiences, changing roles of nurses and others in the elder care workforce, and many, many other topics.

A discounted "early bird" registration deadline has been extended to May 16th. Your fee covers the whole conference, plus breakfasts and lunches, the Tuesday reception, the Wednesday dinner/theater/dance, and a free showing of "Music Within". It's an incredible deal!

To see the whole program and to register, go to www.edenalt.org, and click on the conference link. See you there!
-- Al Power

Posted by Kavan Peterson on May 9, 2008 8:05 AM |Permalink |Comments (0)

May 12, 2008

Monkhouse Mondays: Care Capitals of Europe?

[Editor's Note: Dr. Thomas has invited Eden Alternative's Europe Coordinator Christa Monkhouse to guest-post on a weekly basis from across the Big Pond. Christa is personally responsible for introducing the Eden Alternative to Europe, first in the UK, then Denmark, Austria, Germany, Switzerland and soon in Sweden, Finland and other European nations. Stay-tuned for regular updates on 'Monkhouse Mondays'.]

From the European Culture Capital to the European Care Capital* – What else?

Every year the European Union (EU) selects and celebrates a cultural capital of Europe. They spend considerable amounts of money to polish them up and promote tourism. In fact, several "B-Cities“ have, through this program, become permanently attractive European tourist destinations. One such city is Graz, the capital city of Styria (Arnold Schwarzenegger was raised nearby), and Linz has been chosen for 2009. It's the capital of Upper Austria, on the (blue) Danube close to where I was born and raised. It boasts galleries, musical performances -- such as the impressive "cloud of sounds" -- and the new and well known solar-city, an energy sustainability experiment, with community and neighbourhood-building projects attached to it.

The time is now right to begin selecting the European Care Capital. Cities could apply to show how they have provided an excellent quality of life for their Elders, how they make them welcome, safe and how they promote growth by providing integrated services, imaginative housing, prevention, education for elders and carers, families and integration for people with dementia into society (see my post last Monday). Money would be proudly invested to motivate other communities to strive for the same excellence.

An inspiring example is the "generation-village“ in Burgenland, Austria, near the Hungarian border. The Strem-Village senior center is now being extended into an intergenerational village, bringing back Elders, creating work places mainly for women and thus benefitting the local school, the kindergarden, local businesses and making this rather remote village in wine growing country among rolling hills and open skys an attractive place to raise families. More housing is being built and population is on the increase while neighbouring villages are losing people. Mr. Peter Kalman (peterkalman@aon.at), the CEO of the development, will speak at the Lahsa-Vienna conference in May. He will explain how their approach makes perfect business sense in addition to preserving and enhancing local culture beyond measurement.

So why not copy, copy, copy on a grander scale.

[*Footnote: The European Care Capital is not my idea, but was put forward to me in 2005 by Mr. Rainer Bensch, a politician from Bremen, Germany. He met with me to talk about the Eden Alternative and how it could be the "blanket“ for our society to care for Elders and how European Care Capitals could become it’s gold standard.

--- Christa Monkhouse