High on a seattle hill, there's a building with kids and cats and canaries and grandparents. There are Fig Newtons and volleyball games. There's a beauty parlor and a wellness clinic, a place to garden, and group sings twice a week.
There are connections formed here - between generations, between species, between friends - that add peace, autonomy, and company to the too-often solitary nursing-home existence.
Providence Mount Saint Vincent is a revolutionary model for a small but growing number of nursing homes that emphasize new ways to care for residents' spirits as well as their bodies.
As the generation that fought World War II gets older, and as their baby-boomer children face decisions on how to care for them, more frequently both are rejecting the sterile, old-age institutions with beige tile floors.
"Facilities should be tailored to the individual, and tailored to get to know who the individual is," says Faith Mullen, a senior adviser at the American Association of Retired Persons Public Policy Institute. "So he's not just the guy in Room 411, but he's Mr. Harris who used to be a school teacher and who loves to read."
The Mount, as residents and staff call it, previously operated more like a hospital and less like a home. But since re-creating itself in 1996, the home's been receiving widespread recognition for its forward thinking. It's the kind of nursing home the US government intended to foster when it passed the 1987 Omnibus Budget Reconciliation Act, which overhauled industry standards.
In the decade since its passage, experts say, progress has been slow and charges of abuse have mounted. That has not gone unnoticed. A month ago, President Clinton signed the Nursing Home Resident Protection Act of 1999, which included asking Congress to pledge $309 million to prevent elderly abuse and neglect.
"The fact that, 12 years after nursing home reform, the president should have to have an initiative on neglect and abuse in nursing homes tells you something is still missing," says Sarah Greene Burger, executive director for the National Citizens Coalition for Nursing Home Reform in Washington.
Facilities have tried a variety of ways to create a homelike atmosphere. Many have been remodeled with carpeting on the floor, cheerful paint on the walls, and partitions in dining rooms to make it easier for people with hearing aids to converse.
Another method, the "Eden Alternative" has also become increasingly popular. It advocates opening a nursing home's doors to the community, inviting in children and animals, and providing stimulating activities.
The Mount incorporates all these ideas while charging relatively reasonable rates - $60,000 a year - and accepting Medicaid. Half its residents receive federal medical assistance.
"Having your first concern be the resident is not something that will cut into profits," says Judy Murphy, executive director of the Association for Protection of the Elderly in Lexington, S.C. "Quality care does not cost more."
ONE of the most innovative and popular aspects is the child-care center nestled inside the Mount. The dozens of children at the center often visit the "neighborhoods," the separate wings, of the nursing center and participate in intergenerational classes.
"The kids, they come up and see me occasionally. They shake my hands. It's wonderful," says Kate Squire, who has lived at Providence Mount Saint Vincent for more than five years. "I never had a family of my own, so I really appreciate the little youngsters, I sure do."
With all the changes, the staff has had to adjust to allowing residents to choose their own eating and sleeping schedules. And families have had to become comfortable with the idea that less attention doesn't necessarily mean greater risks.
With all the innovations and renovations, small hurdles need to be cleared every day. But for the most part, the new philosophy pleases the residents.
Octogenarian Margaret Ochs moved to an assisted-living apartment here three years ago, shortly after her husband died.
She struggled at first, she says. "But I've improved a lot. There are so many things to do that just keep me going."
Her schedule one recent day included a baking group, an exercise class, a trip to church, and a trivia session. She went to a concert in downtown Seattle the day prior - something she said she wouldn't likely have done if she lived elsewhere - and she had plans for a shopping trip the following day. In between all that, she enjoys Spanish and poetry classes.
She read from one of her pieces: "Spring and summer have gone, but life goes on. I don't feel at all like fall, it must be the season in between, Indian summer I believe, the best of seasons I recall."
(c) Copyright 1999. The Christian Science Publishing Society