Hand in paw
• A nursing home counters loneliness with a prescription of pets
Wishbone, a small gray terrier who looks like Toto, bolts down a hallway at the Porthaven Nursing Home and leaps into the lap of Julia Giannini, seated in a wheelchair. The docile dog sits pretty for 10 minutes as Giannini pets her.
Wishbone spends her days with the 84 residents and 89 staff members of the Northeast Portland facility, along with Honey, a shepherd mix wearing a red bandana around her neck, and a jittery Italian greyhound named Rallie. There are also 13 caged birds at the home Ñ parakeets, cockatiels and lovebirds. Some chirp from their perches in a sunlit common space, while others live in residents' rooms.
'Nursing homes can be depressing,' notes Melissa Ginsburg, who worked at Porthaven until recently. The home counteracts dreariness by integrating pets, children and plants into residents' lives.
Porthaven has institutional elements, such as white linoleum floors in the bedrooms, but the pitter-patter of dog paws, vibrant green plants and skylights in the hallways make the atmosphere homey and cheerful rather than antiseptic.
The facility opened its doors in 1954; a Washington-based company, Prestige Care Inc., bought it in the early '90s. The model of caregiving it uses today is based on a theory called the Eden Alternative, outlined by Dr. William Thomas of New York in his 1996 book 'Life Worth Living.'
'Like a natural habitat,' he writes, 'a nursing home gains strength from the richness and complexity of its interactions.'
Thomas' desire to make nursing homes more lively stemmed from his frustration with the health care industry.
'The system takes care of the body, not the spirit,' he says in an interview. 'There are three plagues raging through nursing homes: loneliness, helplessness and boredom. These things are responsible for most of the suffering that goes on in nursing homes.'
The Eden Alternative combats loneliness by providing nursing home residents with animal companions. Taking care of a pet, Thomas says, helps alleviate feelings of helplessness. And animals, children and plants decrease boredom because they introduce spontaneity and variety into nursing home life.
'It's important for them to have something to care for when they've lost so much,' says Jodi Burroughs, Porthaven's activities director.
'Many of the residents are diagnosed with depression when they arrive,' Ginsburg adds. 'The animals give them something to care about.'
More than 300 U.S. nursing homes follow the Eden Alternative approach, many of them in the Midwest and the South. Statistics show that the program helps decrease mortality rates, drug use and infection rates at nursing homes.
A tour of Porthaven testifies to the healing power of animals. One resident, Arvilla Gallas, had trouble breathing and suffered from anxiety attacks when she moved in a year ago. Her symptoms lessened, however, when Wishbone began spending time with her.
Burroughs, who owns Wishbone and takes her home at night, says: 'It's surprising how much more the staff and residents respond to Wishbone than me. Wishbone gained 6 pounds when she got here because she knew who to go to for food scraps.'
When she arrived at Porthaven, resident Leatha Martin, 89, holed up in her room. 'Then she started coming out to see the birds,' Burroughs recalls. 'Now she's one of the most social people here.'
Martin likes to sit in her room and talk to her parakeet, Precious.
'I get lonely sometimes,' she says. 'But I don't get lonely with him. And he sings if people come in the room singing. He can follow along.'
Home's where the pets are
Cindy Noordijk, a former activities coordinator at Porthaven, started 'Edenizing' the nursing home in 1996.
'I felt that the facility needed to feel more like a home,' she says. 'I went to a training session and learned about the Eden philosophy. I read 'Life Worth Living' and really agreed with it.
'I started by bringing in my dog,' she says. 'Most of the residents loved the dog. The second dog we brought in was slightly wound up, and we were concerned that he would be a safety hazard. But we never had a fall related to the animals. The dogs know to get out of the way.'
The Oregon Department of Human Services periodically evaluates all nursing homes in the state. Thomas thinks that many facilities don't have dogs, cats and birds for fear of failing health and safety inspections. But Elaine Young of the Seniors and People with Disabilities branch of the state agency says that practicing the Eden Alternative does not put a nursing home in the doghouse come inspection time.
'We're very supportive of the Eden Alternative,' Young says. 'Our surveys are resident-focused, and it's well proven that the introduction of pets and homelike settings fits well with the expectations of what nursing home facilities should be ÑÊas long as the facility institutes these concepts with good common sense.'
Birds to the rescue
Along with dogs, Noordijk introduced lovebirds, finches, parakeets and other birds to Porthaven.
'I thought that birds were friendly and that they responded well to people,' she says. 'Also, for logistical reasons, you can hang bird cages and not take up counter space.
'We had one resident who wasn't a very loving person. We found out that she liked birds. She gave her birds love, but didn't give it to the staff or the other residents,' Noordijk says. 'She talked to the birds and smiled at them. She was concerned that they wouldn't have enough light,'
Another woman, Ginsburg notes, never left her room when she moved to Porthaven. Going on a tip that the woman loved cats, Ginsburg and other staff members hung pictures of cats in her room. Over time, she came out to the common areas to mingle with the birds, dogs and other residents. (No cats or fish currently dwell at Porthaven, but the staff plans to bring both species into the fold soon.)
A little bit of life
Many of the residents are hard of hearing and taciturn. One couple, Elva and Donald Whitmore, sit in silence, watching a weather report on TV. Their faces brighten when Wishbone runs into their room and hops onto the couch beside them.
Connie Spani, on the other hand, talks a blue streak to visitors and the two lovebirds that hang above the foot of her bed. Accustomed to Spani's constant affection Ñ 'Isn't that right, babies?' she regularly asks them ÑÊthe birds squawk when Spani focuses her attention on visitors.
The Eden Alternative gives residents a sense that they're contributing to the nursing home community. The staff encourages residents to take brief walks with the dogs, to clean the bird cages and to water plants throughout the facility.
'We do have several people who chronically overwater the plants,' Burroughs says.
Frequent interactions with students from the nearby Rigler Elementary School also lift the spirits of Porthaven residents. Twice a week, some residents cross the street to the school and help children with their reading. In turn, the children sometimes come to Porthaven to sing or visit.
'Both animals and children respond well to elders,' Noordijk says. 'And having animals is a huge way to get kids in. It's an icebreaker.'
'Edenizing is about keeping the light in people's eyes,' Thomas says. 'It's about life.'