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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

At Home In Eden Bringing Plants And Animals Into North Side Nursing Home Has Made A Dramatic Improvement In Residents’ Quality Of Life

For two years, her voice was a whisper, as if speaking louder would awaken memories better left sleeping.

She clipped her words to discourage conversation — yes, no, or, more often, vacant silence and glassy eyes.

When she spoke, she dropped seven decades from her life’s story: childhood in Wyoming, then a room in the Riverview nursing home.

Men — even staff — weren’t allowed in her room. They seemed to conjure life between the bookends of her silence.

But today, the woman is talking and laughing. She’s gripping a man’s hand. She answers questions and looks strangers in the eye.

A bird has awakened her.

“Hi Gracie, hi Gracie, say hi Gracie,” she said to the sea-gray cockatiel on her shoulder.

The stunned staff gather around the woman. One staff member starts to cry. “The cockatiel did something in her we couldn’t do in two or three years,” said J.R. Renner, admissions coordinator.

This North Side facility has begun an experiment that turns conventional notions of nursing home management upside down.

Following the example of hundreds of other facilities nationwide, Riverview is adopting the holistic principles of the Eden Alternative.

Instead of a place to die, the theory says, nursing homes should foster life; fill sterile hallways and drab rooms with a jungle of living things — plants, gardens, birds, cats, dogs and kids.

Plant, animal and child therapy have long been staples of nursing home calendars, but under the intensive Eden Alternative, the halls of Riverview feel as if an eccentric grandmother took over.

Licorice, a round-bellied black cat, stalks a parakeet named George, then scurries under a wheelchair and into the cat box room — formerly the recreation director’s office. Ivy plants dangle to the salt shakers in the dining room. A chorus of birds chimes at lunchtime. An aviary is under construction.

This program is the brainchild of of William Thomas, a Harvard-trained, Birkenstock-wearing doctor who pioneered the Eden Alternative at a rural New York nursing home. The reason, he says in his book “Life Worth Living,” is that nursing homes made him uncomfortable — so he set out to make them different.

Thus far, at least 200 facilities, most on the East Coast, have followed his teaching. At least one state government — North Carolina — is encouraging the Eden Alternative.

At least two Washington nursing homes, in Shelton and Centralia, have begun instituting the Eden Alternative.

But success stories from other states are filtering here, and experts expect more nursing homes to join the trend.

Statewide nursing home groups are sponsoring a seminar on the Eden Alternative on Monday at Spokane’s Shilo Inn.

Another is planned two days later in Seattle.

No nursing homes in North Idaho have adopted the program, according to the Idaho Department of Health and Welfare.

The conversion requires a shift in thinking about care, wrote Thomas in “Life Worth Living,” the bible for “Edenizing” a nursing home.

The problem with nursing homes, writes Thomas, is that they’ve been run like hospitals, emphasizing diagnosis and treatment and antiseptic cleanliness over a homey atmosphere.

“It guarantees that the majority of our resources are spent on the war against disease when, in fact, loneliness, helplessness and boredom steadily decay our nursing home residents’ spirits,” he wrote.

He encourages nursing home operators to “think like naturalists,” constructing “human habitats” that cultivate an atmosphere of health.

Doing so pays off richly, he says.

Residents feel better. They laugh more. They forget to complain about ailments. Lifelong caretakers themselves, they again have life to nourish.

A little green bird - appropriately named Pickels - has brightened 85-year-old Merrill Nystuen’s life, said Janet, his wife of 56 years.

Bed-bound with multiple sclerosis, he fights depression. He yearns again to be young and mobile, said Janet. The bird arrived a month ago. Merrill smiles more now and talks to Pickels.

“It makes a difference in people’s lives, especially in here,” said Janet, 84. “It’s something that’s living and breathing.”

Staff also see residents relishing the opportunity to give care and kindness.

“These people were providers all their lives, and then we took it all away out of kindness,” said Renner. “We realize now that you must be needed.”

There seem to be financial rewards. At New York’s Chase Memorial Nursing Home, the facility where Thomas first tested his ideas, prescriptions bills and infection rates dropped by half. Mortality rates fell by 15 percent after his program was in place.

At the Broadway Nursing Center, in San Gabriel, Calif., staff turnover - typically 100 percent per year - has been halved. That cuts training costs and ensures a well-qualified staff, said Shelley Phillips, executive director.

But when Dr. Bruce Dentler, medical director at the 75-bed Riverview, first floated the idea last year, staff members were skeptical.

They worried about patients’ reactions to wandering animals and the cost of plants and veterinary bills. Managed-care companies don’t cover Eden Alternative costs, nor does Medicare.

And nursing homes are doing record business as the elderly population rapidly grows. Riverview, a not-for-profit center loosely affiliated with the Lutheran Church, already had a solid reputation for good care. Why get radical when the norm is lucrative?

But the biggest worry was hygiene. Will residents eat the plants? Will animals track in infections?

“Everyone thought sterility, infection control,” said Christine Krugh, a staff social worker. “But a cat walks across the desk at home and it’s OK. Why not here?”

Krugh, accompanied by recreational director Donna Allen and a nursing supervisor, went for a week of training with Thomas and returned sold on the idea.

Riverview’s board of directors signed off. A round of meetings followed, with state inspectors, hospital discharge planners and residents’ family.

Elsewhere, state officials have been leery to unleash a kennel of cats and dogs into a nursing home.

But Edith Coleman, a state official who licenses and certifies nursing homes in Spokane, applauds the program as long as pets are clean and sanitary.

“This promotes the whole continuum of life,” said Coleman.

But, she adds, “Not everybody wants lots of pets around or wants to be bombarded with lots of plants.”

In preparing for the Eden Alternative, Riverview also created teams of staff to shape the new plan - plant, pet and kid committees. The collaborative approach is crucial, Thomas writes, because it fills the facility with energy.

The first plants were put in the dining room and in Krugh’s office. When they didn’t die under fluorescent light, more came, followed by dozens of cockatiels and parakeets, Licorice and a tabby kitty named Shurmann.

A German shepherd-Lab mix, Sam, is expected to arrive later this month, and more cats are on the way. Staff members are arranging for local elementary schoolchildren to visit weekly.

Residents will get plants in their rooms soon, as will Riverview’s CEO. His basement office has a single silk plant.

It’s a different place now, says Marian Jasper, 79, who visits her 82-year-old husband Karl at Riverview daily.

“The plants bring oxygen. They brighten it up,” she said. “It feels more like home.”

Jean McAlister is downright busy now looking after Twee-Dee and JoJo, her parakeets. They like lots of music, and their cage must be cleaned four of five times a day, she says.

But the worst part is all the activity, said McAlister.

“I’ve got all these men and women with nothing to do but ride around in their wheelchairs and come in and look,” grumbles McAlister. “This is not a public viewing.”

McAlister never needed to be pulled out of her shell.

But the reclusive, whispering woman’s emergence leaves staff grinning - and convinced the Eden Alternative is a godsend.

“This is why someone like me stays in nursing home care for 25 years,” said Allen.

, DataTimes ILLUSTRATION: 3 Color Photos