Harvard Doctor Reimagines Aging and Reinvents Nursing Homes

“We’re taught that aging is all about decline. In truth, it’s all about change. We taste the sweetness of aging when we choose its meaning.” – Dr. Bill Thomas

Bill Thomas, a doctor who calls himself the “Nursing Home Abolitionist” is seeking to change how we think about aging and nursing home care. Back in 1991, Thomas sought respite from his 24-hour shifts as an emergency room doctor in upstate New York. He took a part-time job as a doctor at the nonprofit Chase Memorial Nursing Home. Thomas felt a calling to make a positive impact on the residents, the staff, how things are done, and how aging is viewed, and what he did was nothing short of spectacular.

Thomas, who is originally from the Binghamton, NY area, thought long and hard, and recognized opportunities to effect deep change. His goal was to bring joy to the residents, and he ended up doing that, and a lot more. He introduced new approaches to dementia, frailty, and the human need for companionship.

Thomas knows personally about living with debilitating frailty. He and his wife, Jude, have five children; their two daughters, Haleigh and Hannah, have been diagnosed with Ohtahara syndrome, a progressive neurological disorder, and have always required home-based nursing care. He wanted to make care better for those who, similar to his daughters, need round-the-clock care.

Animals and Plants in the Nursing Home Did Wonderous Things

Within two years at the Chase Memorial Nursing Home, Thomas brought the residents 80 parakeets, 10 finches, two lovebirds, six cockatiels, two canaries, and dogs, cats, rabbits, and chickens, along with hundreds of plants, a vegetable and flower garden, and a day-care site for staffers’ kids (this and better treatment of staff helped lessen staff turnover, which is a major problem in geriatric care). Fresh-cut flowers and home-grown food—from gardens dug at Chase—graced the hallways and dining room.

All those animals in a nursing home broke state law, but for Thomas and his staff, it was a revelation. Caring for the plants and animals restored residents’ spirits and autonomy; many started dressing themselves, leaving their rooms, and eating again. The New York State Health Department studied the impact of this unprecedented approach and found a 50% reduction in infections, a 71% drop in daily prescription-drug costs, and a 26% lower turnover rate among nurses’ aides. The number of prescriptions fell to half of that of a control nursing home, particularly for drugs that treat agitation. Medication costs plummeted, and so did the death rate.

Thomas named his approach, the “Eden Alternative,” based on the idea that a nursing home should be less like a hospital and more like a garden, a place where people are treated with dignity, respect, and affection. With the success in New York, the approach was replicated in hundreds of institutions in Canada, Europe, Japan and Australia as well as in all 50 U.S. states. The animal restriction in New York was even voted down, so he was no longer doing anything illegal there. To date, the organization has 300 registered nursing homes around the world and has trained more than 18,000 people in what he considers the 10 basic principles of creating a “human habitat” for elders. To learn more about the Eden Project and participating nursing homes, click here.

Thomas Piloted Another Initiative Called “The Green House Project”

In an effort to ensure more privacy and a much higher quality of life for nursing home residents, Thomas has also pioneered small, intimate residences that he calls Green Houses, where residents have their own bedrooms and bathrooms. The result: “Within six weeks, they had to send a truck around to pick up all the wheelchairs,” Thomas told the Washington Post.

Each greenhouse provides 10 to 12 seniors with 24-hour nursing care, well-trained and supported staff, and private rooms and bathrooms in a layout designed with an open kitchen and dining room and plenty of light and access to the outdoors. The pilot project was funded by the Robert Wood Johnson Foundation and NCB Capital Impact, a Washington, DC-based nonprofit, to complete 41 Green Houses in 10 states, with another 18 projects in development. The goal is to open a Green House in every state. Learn more about the Green House Project here.

Thomas Seeks to Challenge the Status Quo About How We Treat our Elders

Besides his amazing programs and work in nursing homes, Thomas’s vision seeks to shift our underlying cultural philosophy about aging. According to Thomas, “I’m a firm believer in the rights of elders to do whatever . . . they want. If you only have the right to make the ‘good, wise’ decisions that your grown daughter agrees with, then you’re not running your own life anymore.” Old people, he says, can make decisions even if they are bed-ridden and confused. “I’ve taken care of lots of people who didn’t even know their own children,” he notes. “Sure, they probably shouldn’t be making decisions about their 401(k) plans, but they can decide what to wear and what to eat and whether to go outside on a daily basis. People think that if old people cannot make the big decisions, they cannot make any decisions—and that is just wrong.”

Thomas founded the website,, as a platform for innovators to share their ideas. His work was featured in a 2014 documentary, Homes on the Range, on efforts to bring the Green House movement to a small town in Wyoming.

Do You or a Loved One Need Nursing Home Care?

If you have a loved one who needs nursing home care, of course, you want to find the best place for him or her. My Nursing Home Evaluation Tool, from my best-selling book, the Nursing Home Survival Guide, is free and can help you ask all the right questions to all the right people. Better yet, order the entire book here, which is chock full of tons of other valuable information to help you in your search for a good nursing home.

Nursing homes in the Metro DC area cost $12,000-$14,000 a month, which can be catastrophic for most families. To protect your family’s hard-earned assets from these catastrophic costs, there is no time like the present to begin Medicaid Asset Protection Planning. Please call us to make an appointment for an initial consultation to discuss your options:

Elder Law Attorney Fairfax: 703-691-1888
Elder Law Attorney Fredericksburg: 540-479-1435
Elder Law Attorney Rockville: 301-519-8041
Elder Law Attorney DC: 202-587-2797

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.

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