Fighting the Three Plagues of Elders: A Book Review

A review of In the Arms of Elders: A Parable of Wise Leadership and Community Building, by William H. Thomas, M.D. (VanderWyk & Burnham 2006).

As a lover of fiction, including some science fiction and fantasy, I was pleased to discover this book. In our world where, to quote Dr. Thomas, "The truth is all wrapped up in rules, regulations, dollar signs, and self-pity," where "the modern obsession with finding and proclaiming the difference between what is real and what is imagined conceals as much as it reveals," fables and parables may not be generally appreciated, but they have a lot to teach us.

This is a fable about thinly disguised versions of the author and his wife, a Geriatrician (physician), Bill, and a Gerontologist (social scientist), Jude, who collaborate to create "the comprehensive book that would successfully integrate medical and social research on aging." This young couple think they have discovered everything about the care and treatment of elders through their research. Feeling good about their book, but fatigued from their efforts, they decide to rent a boat and spend a month in the Caribbean.

A stormy shipwreck takes them to a strange, unknown land called Kallimos. In this primitive, idyllic society, the elders are the leaders; all the scientific knowledge that the shipwrecked couple bring from the "Other World" is useless there. All their ideas about society and community roles are overturned as they learn how the Kallimos community comes together to protect the elders from the three plagues: loneliness, helplessness, and boredom. The elders are thus freed to pass on their experience, wisdom, and knowledge of life to the community.

With the help of two elderly women, Hannah and Haleigh, they come to understand and appreciate their new community, losing their desire to return to the "Other World." They take on their assigned roles, he as a goat herder, she as a gardener, reluctantly at first, since these tasks seem so foreign to their natures. Eventually, they vow never to leave this simple paradise.

Fate, or some supernatural power, brings another storm a year after their arrival in Kallimos, and they are transported back to their old lives, which they no longer want. Eventually, they accept Hannah's challenge to use their new knowledge to transform elder care in their own world. They discover the sad state of elder care in a nursing home where Bill accepts a job and resolve to improve it.

Thus was born the Eden Alternative, part of "an emerging national struggle to remake the daily realities of long-term care for staff and residents alike." One project involves "Green Houses," small residences for no more than ten elders each, with collaborative decision-making and a more human approach than is usually found in nursing homes. The last chapters of the book are devoted to the realities of using the Kallimos lessons to change and improve society.

I have little knowledge of nursing homes, and I'm not a geriatrician or a gerontologist. Still, I was fascinated by the fable that fills most of this book, and I recommend it to anyone thinking about the problems of aging and caring for the aged. To me, as to Bill and Jude, the revelation of the three plagues in itself was enlightening. As an elder, I'm beginning to recognize loneliness, helplessness, and boredom as things to fight against. And of course I like the idea of treating elders with respect and listening to what we have to say.

See Dr. Thomas' blog, Changing Aging, at http://www.umbc.edu/blogs/changingaging/

Here is some intormation from the Eden Alternative website at http://www.edenalt.org/:

"The core concept of The Eden Alternative is strikingly simple. We must teach ourselves to see places where Elders live as habitats for human beings rather than facilities for the frail and elderly. We must learn what Mother Nature has to teach us about vibrant, vigorous living.

"The Eden Alternative shows us how companion animals, the opportunity to give meaningful care to other living things, and the variety and spontaneity that mark an enlivened community can succeed where pills and therapies fail. It also shows us how real leaders can create a warm culture that is characterized by optimism, trust, generosity and people working together to make a better world for our Elders."

Copyright 2008 by Marlys Marshall Styne