William Thomas

Ashoka Fellow
Sherburne, New York, United States
Fellow Since 2002
Related TopicsHealth & Fitness, Aging


This profile was prepared when William Thomas was elected to the Ashoka Fellowship in 2002.
The New Idea
Bill Thomas was working as the medical director of a nursing home in upstate New York when he realized that the very institutions designed to care for people and improve their health were actually making them sicker. Long-term care of the frail, chronically ill, and elderly is designed and operated as a business whose ultimate goal is to increase profits. The industry is driven necessarily to standardize care, comply with regulations, reduce accidents, and increase revenue, while decreasing the amount of personal space available to elders. The result has been large, sterile, hospitallike environments. Bill's vision moves the nursing home industry away from institutions and replaces them with small, community-based care environments that offer seniors a better quality of life and better clinical care.
Realizing that 1.6 million frail and elderly people are living in the current nursing home system, Bill is also working to create small "households" within large facilities. Bill and a network of regional coordinators teach the Eden Alternative, an approach to care that transforms large institutions into human habitats–giving people a much better opportunity to get to know one another and changing the staffing structure to ensure that each elder receives individualized attention. Several independent studies have shown that care improves as a result of these organizational and environmental changes. Elders living in Eden Alternative facilities take fewer prescription drugs, have fewer infections, and live longer than patients at control facilities. In addition, staff turnover has dropped 26 percent, and staff absenteeism decreased 48 percent.
Using that success to propel his vision, Bill is currently implementing another project to move long-term care out of institutions and into the community. Bill projects that by 2010, most of the nursing homes built in the 1960s and 1970s will not be habitable, they will need to be replaced. Recognizing that the field is ripe for change, Bill is working with state and federal governments, insurance companies, architectural firms, and facility owners to eliminate the practice of institutionalizing elders in favor of small, neighborhood homes. Several nursing homes, including facilities in New York, Mississippi, Nebraska, and Michigan, are already working to build small "Green Houses" that will be open to elders in the coming year.
The Problem
The Strategy
The Person

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