Elsa Lundgren beams as she stands in the archway between her bedroom and living room.
She used to live in a single, hospital-like room on the assisted-living floor at Broadmead retirement community in Hunt Valley. But after a renovation, she now has a sitting room with a flat-screen TV, a small kitchen, a bathroom with a walk-in shower and, most important to her, several large windows that give her plenty of light.
"My eyesight was getting poorer and poorer," says the 96-year-old, who has lived at Broadmead for 18 years. "It was the light that persuaded me to go forward with the move."
The update is exactly the sort of reform that the professors at UMBC's Erickson School of Aging are hoping to inspire. A year after budget and staff cuts had some concerned about the school's future, Erickson is educating 31 graduate students, its largest group ever, and alumni are beginning to use what they've learned to reshape the world of aging.
The changes at Broadmead, for example, might never have happened if CEO Rich Compton and six of his employees had not attended the Erickson school's master's program.
Compton had run Broadmead for almost 20 years when he enrolled. In class one day, he bristled when Professor Bill Thomas said the home was managing the "decline" of residents rather than offering comfortable places to expand and use their skills.
"You get stuck in this way of thinking that you're always doing God's work," he says. "Then, somebody is suddenly telling you, you're not. You can blow them off or you can say well, maybe there's a way we can integrate what he's saying."
The minds behind the Erickson school, founded in 2004 with a $5 million gift from Catonsville-based Erickson Retirement Services, want to change the way we think about aging in this country. In their vision, older people would be encouraged to work longer, and their wisdom would be regarded as a precious societal resource. They would live in private rooms, eat fresh, interesting food and come and go at their discretion.
In fact, these experts believe baby boomers, who began hitting age 62 in 2008, will demand such changes. Unlike their parents, boomers are used to space, independence and, perhaps most importantly, the power to buy whatever they want. They have transformed every institution with which they have had contact, and elder care will be no different, the experts say.
"Aging is the biggest domestic story of the next 50 years," says Thomas, a geriatrician from upstate New York and one of the stars of Erickson's faculty. "We're going to be living in an America that gets older every year for the rest of our lives."
Thomas criticizes the institutional feel of most American nursing homes. The "Greenhouse" approach he developed, in place at Baltimore's Stadium Place and other locations, groups older people in communities of no more than 10. They live in private rooms but gather to make home-cooked meals and tend the garden.
'I'm so lonely'
After graduating from Harvard Medical School, Thomas began his career as an emergency room doctor. He helped at a nursing home on the side and one day, a woman pulled him close and whispered, "I'm so lonely."
Her words made Thomas rethink his mission as a doctor. Did it matter if he prescribed the right medicine to patients when the underlying environment left them uncomfortable and even terrified? He came away convinced that "the answer is never going to be in a pill bottle; it's going to be in transforming the way we deal with aging in society."
Thomas doesn't hesitate to ask for similar self-examination from his students, most of whom have worked in the aging industry for years but enrolled in the three-semester master's program to broaden their knowledge and stay at the forefront of a growing and changing industry.
"With graduate students, very early on you see the light bulb go on and they say, 'Oh, my God, I'm doing it this way!' " Thomas says. "They're unsettled, and that's what a university should do."
Thomas looks like a man bent on defying conventional notions about age. He's 50 but dresses in worn shorts and sandals. He crumples your hand with the force of his shake and fires ideas from behind his bushy beard with the enthusiasm of a toddler.
"The school is about moving the issue to the front burner," he says. "We don't have a snap-in Lego answer. Nobody knows. That's why we need a school that takes a broad look at aging in 21st-century America."
The school, unique in Maryland, takes an approach different from most centers of aging research by blending the studies of physical aging, business management and public policy. "The intersection of all three is really the brilliant insight on their part," says Jim Firman, president of the National Council on Aging. "It's exactly the kind of training our industry needs. To develop the kinds of services that people need, you have to understand them all."
A new view
Students describe their experience at Erickson as transformative, saying the faculty forces them to contemplate aging from perspectives they have never considered.
"The program opened my eyes to a new way of thinking," says Cass Naugle, who had worked in the aging business since the 1970s and led the Maryland chapter of the Alzheimer's Association when she joined Erickson's first master's group. "It's very humbling, because you think you know all this stuff."
For her culminating project at UMBC, Naugle reimagined her organization's approach to this growing population. She organized new support and informational groups and secured a grant to hire a full-time coordinator for early-onset patients. She is working to eliminate arbitrary minimum ages for government programs designed to help dementia patients.
"A lot of our policies and services were developed around what we thought of dementia 30 years ago," she says. "That's the system our parents are in, but the boomers won't tolerate what we have now."
Holly Osters, whose family runs 11 assisted-living communities in the Midwest, flies from Minnesota every two weeks to take master's classes at Erickson. She lived through the frustration of seeking a decent home for her grandmother, who had Alzheimer's. "I really want to have a place that's worth the cost and gives people a chance to live with dignity," she says. "I want to care for them the way their families would."
She says her family will "start over" based on what she has learned at UMBC. "This place just opens your eyes to 'What if I tried this?' " she says.
The reality of death
It's a Friday afternoon in late April and Thomas is asking the master's students to do something unusual. "Write 'I am going to die,' and keep it in front of you as we talk," he says.
Thomas expects the phrase to send chills up the students' spines, to stop them short. His point is that until they grapple with the basic truth about their own mortality, they won't get past hang-ups that prevent them from helping older people to prepare for death.
Thomas believes that many physicians fight an unhealthy war with death to the point of sacrificing patients' comfort and dignity. Some even withdraw from dying patients because they don't want to confront the unbeatable enemy. Nursing homes routinely wheel dead residents out the back door, refill their rooms as quickly as possible and wipe away their seats in the dining room as if they were never there.
"What you're seeing is anxiety about death among younger people contaminating the experience of grieving the loss of a friend and peer," he says.
But older people don't regard death the same way, Thomas says. He tells students of the relief that floods his patients' faces when he asks how they want to die. He describes communities where elders create shrouds and escort their dead friends out the front door, where they invite loved ones in to share laughs and stories about the deceased.
"We have to escape, transcend, move beyond our war with death," Thomas tells the students. But he could just as easily be talking about Americans' entire approach to growing old.
"Aging," he says outside of class, "is a good thing."