Nursing homes can be dreadful places.
Dr. Bill Thomas describes what he calls the Three Plagues of nursing home existence: boredom, loneliness, and helplessness. And that was before the extraordinary levels of isolation imposed by the pandemic.
When Thomas arrived in 1991 at the Chase Memorial Nursing Home in the hamlet of New Berlin, New York, Thomas decided he would try to bring life to an environment associated by almost everyone with death. He was 31 years old and admitted that he didn’t really know what he was doing.
Chase Memorial was home to 80 severely disabled residents. Four out of five had Alzheimer’s disease or some other form of cognitive disability.
Thomas decided that the antidote to death was life. He approached Chase’s management and recommended that live plants be brought into every room. The lawn would be transformed into a garden for flowers and vegetables. The children of staff members would be invited to hang out after school.
But Thomas’ most eyebrow-raising recommendation was to transform Chase into a veritable zoo. New York state codes allowed for the presence of one dog. Thomas applied for two. And four cats to boot. But what he really wanted were 100 live birds – at least one for every resident’s room.
The director of nursing, Lois Greising, was appalled. “One hundred birds in this place? You’ve got to be out of your mind! Have you ever lived in a house that has two dogs and four cats and one hundred birds?”
Thomas answered, memorably: “No, but wouldn’t it be worth trying?”
As fellow physician Atul Gawande recounts in his book Being Mortal, the state of New York signed off on all the creatures. Thomas decided to go for the Big Bang – to bring in all the changes at once. Unfortunately the delivery truck bringing the 100 cockatiels, parakeets, and parrots arrived before the cages did. The birds were placed inside the nursing home beauty salon. The delivery men closed the door and walked away.
This was going to be interesting.
The cages arrived that afternoon, in flat boxes, unassembled. “It was total pandemonium,” Thomas remembers. He still smiles when he thinks about that day.
“We didn’t know what the heck we were doing. Did, Not, Know what we were doing.”
Gawande writes: “Which was the beauty of it. They were so patently incompetent that most everyone dropped their guard and simply pitched in – the residents included. Whoever could do it helped line the cages with newspapers, got the dogs and the cats settled, got the kids to help out. It was a kind of glorious chaos – or, in the diplomatic words of nursing director Greising, ‘a heightened environment.’”
What in the world was Thomas trying to do?
He was voting for life. Life in the presence of death. Along with life there will be noise, motion, chaos, and messiness (have you ever tried to clean up after 100 birds?). But there will also be generous doses of hope and meaning.
Researchers studied Chase Memorial Nursing Home carefully. After two years it was evident that something significant had happened. The number of prescriptions per resident fell to half of what was expected. Drug costs declined by 62%. Deaths fell by 15%.
Thomas concludes: “I believe that the difference in death rates can be traced to the fundamental human need for a reason to live.”
And the power of those animal companions?
Gawande writes: “In the place of boredom, spontaneity. In place of loneliness, they offer companionship. In place of helplessness, they offer a chance to take care of another being.”
All of which reminds us that God knew what he was doing when he placed the first humans in a garden. With plants, and animals, and endless beauty.
Because enjoying life, and life’s Author, is the ultimate reason to be alive.
A Reason to Live
Nursing homes can be dreadful places.