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« Pumping Iron the Old Fashioned Way | Main | Change We Can Live In »

April 4, 2008 |Permalink |Comments (0)

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

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