In 1991, Dr. William Thomas took a part-time job as medical director in a nursing home in upstate New York. Thomas, who trained in emergency medicine, had no aspirations to pursue a career in long-term care. But his outlook changed when he found that his strictly medical approach with residents wasn't improving their health outcomes or quality of life.
“I came to the realization that to take good care of older people, it wasn't enough to give them the right pills or the right tests,” said Thomas, now a professor of aging studies at the University of Maryland. “Those things were necessary, but not sufficient.”
What the medical model was not addressing, Thomas learned, was the loneliness, boredom and helplessness many of his elderly patients experienced in the typical nursing-home environment.
So Thomas began to change his approach. He brought in pets as companions for the residents. The more engaged patients became in caring for the animals, the less withdrawn they were with caregivers.
Thomas received a grant from New York state to pilot a model project for a nursing home based on 10 principles he developed from his experience. Those principles included creating a “human habitat,” allowing patients regular contact with animals, plants and children. The project got patients and nursing assistants involved in daily decisionmaking and eliminated set schedules for residents to wake up, eat or bathe.
“We're talking really simple stuff,” said Chris Perna, CEO for Rochester, N.Y.-based Eden Alternative, which grew out of Thomas' pilot project. “If an elder wants to get up late one morning, the nursing assistant can allow them to sleep in.”