Aging expert: Abolish nursing homes, value elders

• Dr. Bill Thomas is a self-proclaimed "nursing home abolitionist."
• He is the author of "Second Wind," which explores a new phase of life "beyond adulthood."
• The Wall Street Journal named Thomas one of the most influential Americans shaping aging.
• He is featured in the documentary "Alive Inside" about the impact of music therapy on Alzheimer's.

Bill Thomas is an author, physician, performer and internationally recognized authority on longevity and long-term elder care who is challenging conventional views on aging.

He is the author of "Second Wind: Navigating the Passage to a Slower, Deeper and More Connected Life" (March 2014), is co-founder of the The Eden Alternative and founder of the Green House Project. He lives with his wife and children in Ithaca.

Thank you for taking the time to talk with us. You wear many hats as an expert on aging, author, gerontologist and performer who is working toward changing the culture of aging, how do you synthesize your work?

The first thing I would emphasize is that I'm a nursing home abolitionist. I believe that American society made a wrong turn about a half century ago when it started institutionalizing older people on a mass scale. This experiment has been conducted and failed. These institutions don't provide people with a life worth living and it's time to think about a future without nursing homes.

I'm a pro aging activist. I write about it, think about it and perform and travel and tour trying to help our culture and society begin to identify how we might rethink or re-imagine aging.

Where did we go wrong as a society?

The problem is that we created a system that encourages people to think of older people by their deficits and weaknesses and not to think of them of their strengths, wisdom and well-being. The nursing homes see themselves doing a good job if they attend to the medicines and the cleanliness and bring the nice volunteers in now and then. The problem isn't them, they're playing the game the way they understand it. The problem is the game is rigged in such a way that the only thing that matters to them is their decline. What we argue for is a different approach where what matters most about older people is their growth.

What does that look like in practice?

The emphasis is on relationships. A nursing home can be full of people and be the loneliest place in the world. If you don't have relationships that matter, then it's hard to find joy.

You co-founded the Eden Alternative approach with your wife, Jude Meyers-Thomas, (in 1992) and now there are over 500 long-term care facilities that have adopted the philosophy around the world. Can you explain what it is?

The Eden Alternative is what I call a heart transplant for a nursing home. We take out the mechanical heart and we put in a real flesh and blood heart. The whole idea of the Eden Alternative is that people in order to thrive need to be connected to the world around them and to live in a place that is more like a garden and less like a hospital.

And the Green House Project?

The Green House grew out of the Eden Alternative. It is a small intentional community of 10 elders (in over 27 states around the country). You want to live in a house you come to know. One of the definitions of a nursing home is a "life among strangers." In a Green House there are no strangers and that's key.

Part of your work is combating agism, can you talk about that and some concrete steps we can take to fight agism?

Agism is like racism and sexism in that people are judged on a single attribute and conclusions are drawn on them. Part of the work I do is campaign against agism. I call out ageist language and policies where I see them. It's amazing how pervasive it is. The word "elderly" for instance. "Elder" carries with it a picture of a person accomplished in life, not their job, but they have an abundance of lived experience. "Elderly" is frail weak, disabled, diminished, suffering. What I find is there is no redeeming parts of the word "elderly." There's no good part. You never find older people using the word "elderly" to refer to themselves. You never meet a person who says, "I'm Tom's elderly mother."

Another word that is used thoughtlessly is "still." You can take any sentence about any older person and use the word "still" to indicate ageist bias. Your mom "still drives." It's exactly the same meaning "my mom drives," "my dad works as a lawyer, he's 86." "Still" says this person is admirable because this person acts like a young person and says young people are admirable and old people aren't. So if you want to be an admirable old person you have to act like a young person. And the word "still" is used as a form of praise but in fact it's coming out of a deficit.

Who is happier, the 20 year-old or the 70-year-old?

The 70-year-olds say they are happier. The human brain continues to change across the life span. Younger people have a much more limited control over their emotional state compared to older people. Older people have a greater degree of emotional control. So the 70-year-old has a greater insight into the problems of living. The 20s are not the happiest decade. What we find is that age brings greater happiness and a sense of well-being than youth. That's a global phenomenon.

And what can we do to help change the culture of aging?

One thing we can do is change the map of your life. In the map of life we have as a society, you grow to maturity, become an adult and then do everything in your power to remain an adult as long as you live, independent, productive, valuable. That's the map. However, for a large part of human history the map of life for women, for instance, was: maiden, mother, crone. Crone meaning a woman wise with time. A crone would be a midwife, a healer, a counselor, a matriarch. A woman who had outgrown motherhood, adulthood and into another phase of life.

When does adulthood end and elderhood begin?

People become an elder when they begin to outgrow adulthood. Our culture doesn't really sanction it so people have to figure it out on their own. It's like the time when the person is offered the big promotion but rather would spend time with their grandchildren.

The problem in America is that there is childhood and adulthood and we've taken adulthood and extended it is so that elderhood doesn't exist. To the adults reading this article, I say to you, you're elders in the making just as children are adults in the making. The question is how are you preparing for your elderhood? How are you preparing to outgrow adulthood and enter into a new phase of life when it's not contingent on performance and endurance and productivity. The answer for most people is: "I'm not. My plan is to stay the same for 50 years!"

What do you envision for the future?

Eldertopia. It's a society where we create an abundance of opportunities for the old to rely upon the young and the young upon the old. We'll know we're there when there's a real increase in inter-generational reciprocity. What we want is to bring the generations together so they can rely on each other. America does a lot of wasteful things but the catastrophic waste of the wisdom and life experience of older people is probably the most shocking and decadent misuse of an abundant natural resource and that's the lived experience of older people.

About Bill Thomas

Occupation: Author, aging and long-term care expert, gerontologist, performer.

Age: 55.

Hometown: Nichols, New York.

Resides: Ithaca with his wife, Jude Meyers-Thomas, and their five children.

Education: B.S. SUNY Cortland; Harvard Medical School.

Websites: changingaging.org; thegreenhouseproject.org and edenalt.org.