In his book Being Mortal, Medical Doctor Atul Gawande describes the story of Bill Thomas, a man who in the 1990s started working as the medical director of Chase Memorial Nursing home in the town of New Berlin, NY. He was only thirty-one with little or no experience in eldercare. With his newcomer's eyes, Bill was shocked by "The Three Plagues" of nursing home existence: boredom, loneliness, and helplessness. His plan was simple: start bringing gardens, children, and pets into the nursing home. Lots of pets! Here's a snippet of the conversation that ensued after the nursing home director and his staff agreed to let Thomas bring more plants into the home.
"How about a dog?" Thomas asked.
There were safety code issues. "But maybe so, yeah," the director said.
"Let's try two dogs," Thomas said.
"It's against code," they repeated.
"Let's just put it down on paper," Thomas said.
Dr. Bill was not seeing much enthusiasm in response, but he thought he was on a roll. "How about cats?"
"You want dogs and cats?" they asked. They reluctantly agreed.
"Perfect," Bill said, beaming, ''And we need more sound of life around this place. You know what would be best? The sound of birds singing. Let's put down one hundred."
"One hundred birds? In this place!?" they exclaimed. "You must be out of your mind! Have you ever lived in a house that has two dogs and four cats and one hundred birds?"
"No," Bill said, smiling. "But wouldn't it be worth trying?" Eventually, Dr. Bill wore them down and they ordered the birds. The hundred parakeets all arrived on the same day. But the birdcages hadn't come yet, so the delivery man released the birds into the nursing home's beauty salon. The results were extraordinary. The number of prescriptions halved, with a particular reduction in the use of psychotropic drug, and mortality fell about 15%. This was the starting point for a larger program, named (biblically appropriately) Eden Alternative.
Why was the Eden Alternative so successful? Gawande concludes that we need loyalty, or a dedication to a cause beyond ourselves. It doesn't matter if this cause is small (as small as the care for a pet) or large, what matters is that is such a cause provide meaning to one's life. We all need loyalty, and elderly people need it even more. People also need a sense of belonging. We have an innate desire to be a part of something larger than ourselves. When we are connected to life and to each other, we thrive. When we are disconnected, we die.
