This is part 21 of a series. To go back to the very beginning, start with part one. To go back to the start of this section, start with part fifteen.
When I was in Sicily, the decorative ceramics in Taormina immediately caught my attention, as they’re meant to. Taormina is a tourist trap, so the colorful ceramic pine cones and planters shaped like human heads were there to lure me into the many souvenir shops selling them.
Shopkeepers and tour guides are eager to explain that the pinecone is a symbol of welcome. This is what we say about the pineapple in parts of the US and the pinecone certainly bears a certain resemblance to the pineapple, so sure, it sounds reasonable. The ceramic planters shaped like human heads are to commemorate a doomed love affair. A woman decapitated her unfaithful lover and used his head to grow basil, which thrives on the fertilizer of human brains. Grisly and weird, like most fairy tales.
Two things stuck out to me about this story and made me curious to know more. Different incarnations of the story all mention basil specifically. Only none of the pots I saw had basil, despite it being something that was commonly grown. And the pots are called Moor’s Heads.

I knew from my time in Porto that basil symbolizes fidelity in Portugal and a quick search suggested that was true in Italy as well. So, the plant is mentioned to bolster the idea that the tradition of the planters is about an unfaithful lover. Only, this is a detail that exists only in the story and not in any of the many Moor’s Heads I saw on my road trip from Taormina to Syracusa.
It was not a shock when a quick search of the term Moor’s Head brought up controversies about the racist and xenophobic symbol. It was a warning to North Africans considering invading European destinations on the Mediterranean and Atlantic to reconsider their plans. Is it a coincidence that the Moors Heads are displayed in entryways while other Europeans would display decapitated heads at the city gates as a threat and a warning?
The pinecone may be a symbol of welcome. They're also a symbol of resilience, as the devastation of fire does not destroy the pine forest but instead clears space and spurs germination for a new generation of growth.
This may seem ridiculous to you, to have a whole tourist industry built around what’s obviously an offensive tradition and a preposterous story that lazily tries to cover up how offensive it is. Of course what seems problematic as a foreigner visiting Sicily seems totally reasonable in Plymouth, Massachusetts. We grew up with the story, so why think about it enough to question Plymouth Rock?
Framing the story
In 1958, Thomas Szasz began his battle against the way mental illness is framed by western scientific medicine. He argued that the subjective method of diagnosis and the coercive and involuntary nature of "treatment" made the treatment of mental illness no different from the determination that someone was possessed by evil spirits and the doctor no different from a prison warden. Szasz believed that the power of religious institutions had simply been transferred, rebranded, into the authority of medicine.
Geel could have been the perfect example for Szarsz. Instead, his contemporaries rewrote the story of Geel. Instead of the Colony of Geel being a creation of the Catholic church, it was now something that came out of the hearts of the peasants, inspired by a saint. Just as the story of the Moors Head falls apart upon even a cursory consideration, the story of Geel's history is obviously nonsense. The thing is, no one cares. The story doesn't need to be accurate or even believable.
Still, I can't reduce the Colony of Geel to a bad thing. The people confined to Geel before 1990 were accepted and embraced like the patients in dementia villages are today. Do I think people with dementia should be removed from their communities? Obviously not. Do I understand that at a certain point it’s unsafe for people with dementia to stay at home? Undoubtedly. Do I understand why some people prefer to live in communities of others like them? Absolutely.
Plenty of people prefer to create a safe space apart from the larger culture to focus on shared interests – we have artist colonies, religious communities, retirement communities and universities. There’s even the infamous Gibtown in Florida, for people who’ve retired from the circus. The main differentiator is whether people are being forcibly removed from their community and banished to a place they are forbidden from leaving or whether people are drawn to a place where they feel a sense of belonging.
We know from accounts of people living in communities that this difference becomes less stark with time. People sent to Geel developed a sense of belonging and chose to stay after the laws changed and they were free to go. Plenty of people eagerly join interest based communities and leave with a sense of bitter disappointment and disillusionment.
Gathering people into dementia villages and group homes does make sense for many reasons. In many ways it's more practical to provide custodial care and 24/7 supervision at scale than in individual homes. While modern society’s love for efficiency has gone too far, efficiency does have a place in our considerations when looking for solutions we can bring to fruition.
A cursory understanding of the history of care outside of formal residential institutions suggests that there has always been a mix of foster care, group homes, and small local facilities. The problem is that the options aren’t really ours to choose from. It doesn't feel like we're given choices, because there are astronomical costs, paperwork to wade through, eligibility restrictions, and long waiting lists.
Family life
I’m intrigued by the fact that as soon as patients in Belgium were given choices, they stopped choosing to be placed with foster families. People who were already living in Geel when the laws changed opted to stay with their foster families, but few people joined them once they could instead live in a group home anywhere in Belgium.
Being matched with a foster family may not sound like a fantastic first choice for an adult. However, the most common alternative, group homes, also don't sound awesome.
It's also reasonably common for young adults and adults to choose to live with foster families for other reasons. My sister spent a year in Germany through the Congress Bundestag Youth Exchange. A friend of mine had her young kids share a bedroom in order to host foreign college students. Other friends, of various ages, have done home stays of various lengths in order to have “authentic” experiences during their world travels. During the isolation of the pandemic I wanted to stay with a family, so I signed up with WWOOF and spent the winter on a horse farm on Vancouver Island.
Of course, people who choose homestays are in the minority. Most international students, people living abroad on a working holiday visa, and travelers do not want to stay with local families. They stay in hotels, in dorms, and hostels.
The vast majority of boarders in Geel — and the boarders at the Jersey Shore — did not sign up for an exchange program. They were labeled by the state, processed through an institution, placed in the colony, and lacked the authority to leave of their own volition. Like anyone who has been forced out of their home and exiled, plenty of people managed to build a life of joy and meaning. Their success is hardly an endorsement of the system.
When I visited the Fountain House, one of the members pointed out how patronizing the language is — adult foster care, foster family. It all sounded very patronizing. It was so obvious once he said it. He is an eloquent, well dressed man who worked in a legal firm — he did not need new parents. He needed support tailored to his needs without hampering his abilities.
My experience staying with other families hadn’t felt patronizing. My experiences had been wonderful, even though they were also incredibly stressful and disorienting. Making sense of the norms within a new family can take a lot of mental energy. It’s taught me different ways of relating to people and responding to situations. Watching different families navigate disagreements and stressful situations is so much more powerful than reading books on communication. I had no idea how much my understanding of the world was limited to what I’d seen within my own family until I started staying with other families while I traveled – something my parents encouraged.
You don't even need to leave town to experience a cultural exchange. Families — and their norms and expectations — can be very different. Crossing the class line within your town can be just as dramatically different as flying to another country.
Boarding-out
Perhaps one important step in expanding adult foster care is rebranding it. People writing about Geel make such a fuss about how patients are “boarders.” I found this off-putting, like they hadn’t become locals after decades in the community. I have to admit that asking someone if they want to board with a host family does sound nicer than asking if they want to enter adult foster care. It sounds like we’re asking them to agree to be a child.
Putting the options for adults within the social welfare system alongside their equivalents for adults who are living “independently” changes them. There are large institutions — dorms offering single rooms and dining halls, apartments with kitchenettes, and hostels. There are small institutions — boarding homes, collective houses, special interest housing, and group homes. There are homestays with host families. Then there is living in our own apartment or house. It would be nice if all of us had an array of housing types to choose from, based on our needs, interests, and desires.
Thank you for another great piece! If your travels ever take you to the UK, have a look at Shared Lives Plus - a thriving homeshare charity there https://sharedlivesplus.org.uk/. I'm friends with the former CEO, Alex Fox who wrote a great book, Escaping the Invisible Asylum https://www.amazon.ca/New-Health-Care-System-Invisible/dp/1447341678. Donna