Bill Thomas’s Small House Approach to Dementia

Bill thomas’s village of hope; courtesy myminka.com

William Thomas, MD is no stranger to innovation in senior housing and care. In the early 1990s he encouraged adoption of the Eden Alternative to cold, impersonal nursing homes, using plants and animals to soften the environment and make it more life-friendly. Then came the Green Houses in the early 2000s, dividing large nursing homes into 12-bedroom houses, with central kitchen and common areas and staffs called shahbazim (from a Persian concept of noble helper), trained to provide the most personalized care in a homelike setting.

Now comes Bill Thomas’s most personalized approach of all: high-tech small houses for seniors suffering from that most dreaded of conditions, severe dementia, including Alzheimer’s disease. Continuing with his gift for exotic-sounding names, Thomas calls it his Minka project, derived from the Japanese term for “people’s house.” To the rest of us it is more recognizably small houses grouped in imaginative ways and built using the latest innovations in construction technology.

Most Minka homes are 640 square foot structures offering smart home supportive technologies and clustered in pocket neighborhoods to ensure closeness. The houses are constructed of 3D-designed, computer-fabricated parts designed for modular construction allowing completion of one house in two days.

The social innovation of this comes in the types of people intended to occupy these small homes. This past November, in the small town of Clearwater, Pennsylvania, Thomas and the local Alzheimer’s Association of America (AAA) chapter initiated construction of the Village of Hope, projected to be 12 pocket neighborhoods of five Minka homes each on a 23-acre lot, surrounding an elementary school renovated as a community center.

Says Thomas, “Kathy Gillespie, AAA local director, wanted to create genuine communities for people who otherwise tend to get isolated because of their care needs. We all know of couples who get separated when one of them becomes institutionalized for care. Why do that? Why not make them and their caregivers part of a community that helps and is given help in return?”

This supportive approach has been dubbed MAGIC, the Multi-Ability Multi-Generational Inclusive Community. The Village of Hope homes will be occupied by three groups: people with dementia and a caregiver, adults with progressive developmental disabilities who need close, continuing attention, and grandparents and great-grandparents who have been thrust in the role of once again raising children. “The result is a multi-generational neighborhood of people who can support each other,” says Thomas.

As groundbreaking as this concept is for supportive housing, so are the construction methods used to build it. Working with the Danish firm AJGA Architects, Thomas is continuing to evolve the 3D-designed, computerized pre-fabrication approach, involving design software for building information modeling (BIM) guiding a computer producing precision parts (computer numeric control, or CNC). Working with these new construction techniques has been a learning experience, Thomas says. “We started expensively,” he notes, “with a 320 square foot house costing $125,000. But our second house was 640 square feet for $94,000 and the third 640 square feet for $85,000. It is relatively easy to upgrade the computerized manufacturing of parts by simply adjusting the software.”

Courtesy myminka.com

It is important to recognize Minka not as a construction company, but as a manufacturing company, Thomas says—a company that uses precision manufacturing. “We use robots working very hard to make pieces that are standard within 1,000th of an inch, 150 times the precision of a standard 2x4 piece of lumber. We use no standard lumber and no nails, but rather a complex Japanese wood joinery technique assembling parts cut from wood and foam very quickly and precisely. Our basic building block is a roof box, 50 of them for one house, with the pieces transportable flat on a tractor trailer. These are then assembled on-site by a custom crane we’ve devised over the course of two days.”

Yet another Minka project is underway in Victoria, Texas, spearheaded by the Green Gate Fund, a team of geriatrics-related care professionals and business, construction and financial leaders under the guidance of Thomas. Called Kallimos, after a futuristic senior lifestyle Thomas described in a pair of 1990s sci-fi novels, it is a comprehensive attempt at senior co-living, providing seniors all the technological and community supports needed to age successfully at home.

“This will involve 100 small houses again grouped in pocket neighborhoods, with all the Eden Alternative amenities and using Green House operational principles. It is designed to be appealing to insurance payers such as Medicare Advantage, who are agnostic about architectural approach, as long as it works and saves money,” Thomas says.

For Thomas himself, Kallimos is the culmination of all the senior care innovations he has promoted for the past 30 years. “I have waited a long time for this moment to arrive!”