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Public Radio's Environmental News Magazine (follow us on Google News)

The Eden Alternative: Seems So Simple

Air Date: Week of

Following up on an earlier interview on the subject, Living on Earth sent reporter Brenda Tremblay to spend time visiting a nursing home where the principles of the "Eden Alternative" are put to use. The elderly and infirm have an array of companions at the Chase Nursing Home in New Berlin, New York including school children, dogs, pet birds and cats . They also have gardens to tend, and this inclusion of "deep ecology" principles connecting people to life itself appears to be giving some residents more reasons to stay alive healthier and longer.


CURWOOD: It's Living on Earth. I'm Steve Curwood. Going to a nursing home for long-term care can be a traumatic experience for anyone, especially for people used to living active lives. While their bodies are being treated for chronic physical problems, their spirits often wither in a sterile and lonely environment which is nothing like home. But it doesn't have to be that way. A few years ago, the staff and residents of a small rural convalescent facility in upstate New York began to transform their surroundings to make it more like home. They brought in pets. They filled the place with plants and gardens. And they scheduled regular visits by children. They called it the Eden Alternative, and they found that their effort to create a biologically diverse environment changed their lives. We asked producer Brenda Tremblay to explore the goings on at the Chase Nursing Home in Berlin, New York. She prepared this report.

(An old woman's voice crying out)

TREMBLAY: The nursing homes in my imagination are low-slung cinderblock buildings on the outskirts of town. Inside, the halls are lined with listless, bored, elderly people in wheelchairs, parked side by side with demented residents who moan and cry out. Frankly, I hate nursing homes. And I'm not alone. My father says that every time he visits his mother at a nursing home in Michigan, he feels like throwing himself through a plate glass window. So when I went to Chase Nursing Home to check out the Eden Alternative, I was curious but skeptical. I was prepared for the worst.

(Traffic sounds)

TREMBLAY: Chase Memorial Nursing Home is in the town of New Berlin, a small rural community in upstate New York. I arrived in the morning, just as the residents were getting up. So were the birds.

(Bird calls and soft voices)

NEEGER: Of course, the first thing in the morning is my Bible reading, and I finished that just before I came here, so -- that comes first.

TREMBLAY: Beth Neeger is 86 years old. She's lived at Chase Nursing Home for more than 20 years. Her husband was a church minister. He died a few years after they were both in a serious car accident. When Beth's injuries brought her to Chase, she said it was an okay place to live. But when the animals came, things changed.

NEEGER: My -- it's been wonderful. Of course, I specialize with the dogs. (Laughs) But the birds are nice, too. It's great. They just -- seem to liven up the place for everybody.

TREMBLAY: The resident dogs, Target and Ginger, are lounging in the reception area when I arrive, just a few feet away from the aviary: a 5-foot wide, 7-foot tall cage made of wire, glass, and wood. Inside the aviary about 20 zebra and society finches flit from branch to branch. One of them is sitting on an egg in a nest box. Chase Nursing Home is full of birds, plants, and animals. Almost every resident has a pair of birds in her room. As a nurse, Joyce Costeen has witnessed the effects of the birds and animals on residents like Norma Parker, who came here 4 years ago.

COSTEEN : You know, and she did tell me, when I admitted her because I was the unit manager on the second floor at that point in time, that you know, I'm not going to be here long, I came here to die.

TREMBLAY: Joyce says she hears that line a lot when people come into the nursing home. But sometimes things work out differently.

COSTEEN : Norma will be 100 years old in November, and the one cat stays on her bed. As soon as she awakens the first thing she does is reach her hand up to make sure that the cat is there. And it's really made a big, big difference for her. Just something that seems so simple.

(Woman: "All right, who's turn? Fred's turn." A boy shouts. "Come on, Fred! Try again.")

TREMBLAY: Every morning a group of 3- and 4-year-olds from a nearby daycare play in the hallways of the nursing home. The residents sit nearby and watch. Occasionally, a resident will reach out and talk to or hug a child. This morning, 75-year-old Margaret McDonald is watching the kids bowl. Margaret's eyes shine when 4-year-old Brett scores a strike.

McDONALD: If the little people are grumpy, I leave them alone, until they're ready to talk. Which doesn't take very long. (Laughs) But usually they, let alone, they want to tell you their problems. I listen to every one that they have. And they'll say well what would you do? And I offer some suggestions. They seem kind of pleased that you're interested in them.

TREMBLAY: Margaret is a true extrovert. She was a telephone operator for many years before retiring and eventually coming to Chase Nursing Home. She never married. Aside from a niece and nephew, the people and animals at Chase are all she has. They provide her with more than just companionship. They give Margaret a sense of being needed.

McDONALD: I have a cat that comes in my room, jumps up on my bed, stretches out. We have a nice time together.

TREMBLAY: Do you have birds in your room?

McDONALD: Two. Oh, the cats watch them but they don't do anything. (Laughs) They just watch them. Another thing, they're well-fed, so they're not hungry. (Laughs)

(Footfalls on gravel, up stairs)

TREMBLAY: The hallways at Chase Nursing Home were much quieter 6 years ago, when a young doctor named Bill Thomas moved into the area. Dr. Thomas and his wife Judy live a few miles away, overlooking a valley in central New York State. There are no neighbors in sight from the porch of their house.

THOMAS: I really came to this hilltop where we're sitting now, really very much with the idea that I was going to create my own kind of solution to the world's problems up on my hill. I was going to have my own electricity, my own kind of root cellar, you know, my own milk from my own goats. And that I really didn't need anybody, and I was going to be very independent. I was led to the work at the nursing home really through chance. It was not my intention to get mixed up in it, but when I did, the most important thing I learned was that we all depend on each other far, far more than I was willing to admit.

TREMBLAY: Thomas says that as he began to work with residents, he saw himself reflected in their lonely, listless attitudes. Suddenly, he felt as though his attempt to remain detached from the outside world was somehow misguided. In 1991, he and his colleagues began drawing up a plan to alleviate the residents' boredom and isolation.

THOMAS: I had a big sheet of paper in front of me and I made lists of all kinds of sort of scientific names for it. And I realized it really is not a scientific thing; it's more a -- more a response to the human spirit. And the story of Genesis and the Garden of Eden came to me. I remembered that one of the first things that the Deity had done for humankind was recognize loneliness and then respond by making the animals and ultimately the woman, and I thought here we are in creating nursing homes where that need is just completely neglected. And so it seemed that if we were to aim for Eden, we'd be doing a lot better for ourselves than aiming for some kind of ultimate institutional machine that answers all the body's needs.

(A public address system calls someone to the front desk. Metal squeaks.)

TREMBLAY: Chase Nursing Home is a far cry from the idyllic Garden of Eden. But as I walked around I had to admit to myself it's an interesting place to hang out. It seems more like the combination of a pet store, a shopping mall, and a college dorm, than the nursing homes in my experience. It's full of life. There are hanging baskets of plants everywhere. The sun streams in through frilly curtains in the skylights. Grapevines form an arbor that lead me into one hallway the residents call Sunset Lane, where music is pouring out of the beauty salon.

(Music plays: "Good-bye little boy. Good-bye little joy...")

TREMBLAY: Only the faint smells of medication and urine in the air belie the fact that most of the people here are ill. Down the hall, members of the nursing staff are making their rounds. Scott is a new nurse's aide at Chase. Juanita has worked here as a licensed practical nurse for 18 years. When I asked Juanita if she could imagine living here, she said yes.

JUANITA: That's my room when I get in here. (Laughs) I can see the front door, I can see the road, and I can see everything that's going on. I know just who's coming and who's going.

TREMBLAY: Good. Well, Scott, you've only worked here 4 months?


TREMBLAY: How do you like it so far?

SCOTT: Oh, I love it. It's much, much more relaxed atmosphere than what I came from. Another facility the same size, only we didn't have the birds and the plants and the interaction with the children. As far as activities it revolved around, like a 10 o'clock and a 2 o'clock activity and that's what all the residents would wait for, in between those times it was pretty quiet. Where here, you know, we have the children in and out from the daycare, there's animals strolling around. [Birds chirp; a piano starts up.] You know, the residents enjoy music and go down into the lobby and listen to the player piano.

(The player piano plays: "Get Me To The Church On Time")

SCOTT: I think the residents are -- are less -- less, you know, restless, maybe. Less anxious. It's just -- it's just a much calmer environment. I think that's the big, the big thing that I see. I feel a lot less stressed here.

(Crickets chirp)

TREMBLAY: The calm feeling that Scott feels inside the nursing home extends to the outside, where staff members have planted extensive flower and vegetable gardens with wide paved paths accessible to wheelchairs. There are raised flowerbeds where residents can get their hands dirty planting and weeding flowers. The garden is a good metaphor for the process that's occurred here. It reflects Dr. Thomas's conviction that as human beings we are deeply attached to the natural world. His belief, he says, goes far beyond the kind of social ecology we read about and hear about in the media.

THOMAS: Social ecology is sort of what we think of as, you know, environmentalism, you know, pick up your trash, try to not burn as much gas. You know. Good stuff, like that, 50 ways you can save the Earth, da da da da da. But the deep ecology, people say, there is a yearning and a need for wildness and a sense that we are hooked into this planet far more deeply than we can even verbalize.

TREMBLAY: Hooking elderly people into the natural world has yielded Thomas dramatic results. The residents of Chase Nursing Home are significantly healthier now than they were before the Eden Alternative. Between 1992 and 1994, Thomas conducted a study comparing Chase Nursing Home with a statistically similar home. He found that the infection rate dropped by half during the study period. The nursing home saved $75,000 a year in drug costs because residents needed less medications. Perhaps most significantly, the death rate dropped 15% the first year of the Eden Alternative and 25% during the second year. Though the study was conducted on a small scale and couldn't prove the cause of the improvements, it suggests that Thomas's prescription is a powerful one. He remembers the case of one man he calls Mr. L.

THOMAS: This was a fellow who had lost his wife recently, who had had an accident, you know, sort of one of these accidents on dry pavement on a clear day. Somehow he survived. And you know, it was really clear that he wasn't going to be able to make it at home, came to the nursing home, on the off-ramp of life (makes a screeching sound). You know, this was it for him; he was checking out. And he, and this man in particular became, very slowly but steadily more and more involved with the dogs that were living there. And started to place himself into a caretaking role for the dogs and taking them out for walks and -- and really, those animals taught him that there was more life to be lived, and it was not time to go. And he strengthened himself and returned to a level of function where he was able to go back home.

TREMBLAY: Don't you think that's an extreme example, in a sense?

THOMAS: No, it is not an extreme example. That's what happens. Those are the stakes that are being played for in nursing homes all the time. I do believe that a human being with a reason for living is a powerfully adaptive and resilient creature. A human being that feels there's no longer any reason for them to exist is prone to infection, disease, depression, and death.


TREMBLAY: Of course, not everyone living at Chase Nursing Home is reinvigorated by the Eden environment. After lunch I met Joyce Waffle in the garden. Joyce was visiting her dad and nervously puffing on a cigarette. Last Spring, she made the painful decision to bring her invalid father to live at Chase Nursing Home. He's still not happy here, and her visits with him are tense.

J. WAFFLE: If he can be happy anywhere in a nursing home, I suppose, you know, it's one of the best, I'll tell you that.

TREMBLAY: Do you like it here?

R. WAFFLE: I do good. I got a nice little home sitting down there.

TREMBLAY: For residents like Roy, nothing can ever replace the feeling of being home. Not the birds, the plants, or the animals. Even human companionship inevitably brings pain and loss.

(A woman calls, "B-10. B-one-oh." Another woman: "Oh, bingo!" "My goodness, here." "One right there.")

TREMBLAY: It's 2 o'clock and time for afternoon bingo. About 30 people, including Margaret and Beth, are sitting at long tables in front of laminated bingo cards and stacks of wooden chips.

(Women: "Okay, Lillian and [inaudible] gotcha?" "Bingo." "Bingo." "Be right there.")

TREMBLAY: During the game, a nurse discovers that a long-time resident has died. The paramedics pull up in a van and wheel her body out while another nurse peels the name plate from her door and slips it into a desk drawer. Although there's no formal announcement, everyone seems to know what's happened. The residents wheel themselves back to their rooms down the long hallway under the grape arbor, like a slow, silent parade of turtles.

(Children in the hallway. Woman: "Stop it right now." Child: "I'm playing Little League next year and I hope I'm the Braves.")

TREMBLAY: But then another group of kids burst in from the local elementary school. Their shouts and laughter shattered the quiet and brought life back into the hallways.

(Child: "My baseball's in the -- she's nursing her." Woman: "This is a good place.")

TREMBLAY: Creating a good place where everyday life is worth living is what proponents of the Eden Alternative hope to offer elderly people. Today more than 100 nursing homes in the United States are Edenizing, trying to create stimulating, life-giving environments for the people who live there. And as I got in the car and headed home from Chase, I had an optimistic feeling that someday, if I or someone I love needs full-time care, a typical nursing home may actually feel like home.

(The player piano plays)

TREMBLAY: For Living on Earth, I'm Brenda Tremblay in New Berlin, New York.



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