SENIOR LIVING: Long Term Care Facilities—A New Vision
By FRANK KENNEY Director,
“For decades we have organized the life of the e= lder in a skilled nursing facility around the needs of the institution,” s= aid Jude Rabig, co-director of the Green House Replicati= on Initiative. “But, in a ‘Green House,’ clinical care and activities are organized around the needs of the individuals who live there.” She noted that a Green House is de= signed to be a person’s home for life, and their ability to remain in a Green House is not dependent upon their medical condition.
A Green House is a self-contained dwelling for seven t= o ten people that is designed to look like a private home or apartment in the surrounding community. Each p= erson who lives in a Green House has their own bedroom and full bathroom. Each Green House must have a centr= al hearth with an adjacent open kitchen and dining area, and short halls with access to the hearth. There i= s a common eating area and living room area (both easily accessible form the private bedrooms), and residents can share meals together around a common table. Family members, friends and workers are welcome to join residents at mealtimes and during other activities.
A separate clinical support team includes nurses, soci= al workers, therapists, medical directors, nutritionists and pharmacists. One nurse from the clinical team s= erves the residents in two Green Houses, and other clinical professionals visit t= he houses regularly and as individual residents require.
The people who work and live in a Green House collabor= ate to create a daily routine that meets individual needs, much as they did in the= ir own homes. If they wish, peop= le who live there can cook meals, prepare snacks and help with light housekeeping = and laundry. There is no institut= ional routine in terms of medical care, allowing residents to be more independent= .
The Robert Wood Johnson Foundation has awarded a $10 m= illion grant to help spur the widespread adoption of Green House model. The RWJF states that the Green Hou= se is a total rethinking of the architecture, organization, staffing and philosop= hy of care normally associated with nursing homes.
The five year grant to the NCB Development Corp. will = allow staff to provide technical assistance and pre-development loans to support organizations that want to establish a Green House. NCBDC hopes to establis= h at least one Green House in every state, making it convenient for stakeholders across the country to visit one and consider adopting the model for their o= wn operations.
“Through our partnership, we intend to propel the Green House into the mainstream of long-term care,” said Robert Wood Johnson Foundation President and CEO Risa Lavizzo-Mourey, MD, MBA. “By doing so, we will help p= rovide frail and disabled individuals who otherwise would live in a traditional nursing home with the option of community-based housing where they have autonomy, dignity, and choice, while remaining part of a community and receiving the full range of clinical services.”
“We are committed to making the Green House model available to people at all socioeconomic levels.” States Robert Jenkens, co-director of the Green House Replication Initiative. “Initially, we will selectively recruit Green House spons= ors from the ranks of non-profit institutions, local government agencies and existing long-term care providers. We will insist upon a rigorous commitment to Green House principles = from sponsors and we will provide them with training, technical support and accreditation review.”
The first Green Houses were established in
v&nb= sp; High satisfaction levels from residents, fam= ily and staff
v&nb= sp; Fewer complaints at state level
v&nb= sp; No unexplained weight loss, and almost no nu= tritional supplement use
v&nb= sp; Less decline in Activities of Daily Living (= ADL)
v&nb= sp; Staff turnover of less than 10 percent
v&nb= sp; No transfer-related back injuries in elders = or staff
v&nb= sp; Less prevalence of depression
v&nb= sp; Less incontinence without a toileting plan
v&nb= sp; Less use of anti-psychotics without a releva= nt diagnosis.
The Green House is the vision of Dr. William Thomas, a Harvard-educated geriatrician and an international authority on eldercare.<= span style=3D'mso-spacerun:yes'> He currently serves as president o= f The Center for Growing and Becoming, Inc., a non-profit dedicated to promoting and developing constructive, holistic approaches to aging and the care of our elders. He is also president of the Eden Alternative, a research, consultin= g, and advocacy group committed to improving the care received by people who l= ive in institutions everywhere. D= r. Thomas lives with his wife and five children on a 250 acre working farm that employs draft horses and solar and wind power.
For more information on the Green House model, contact= this writer at 505-388-2523 or rsvpgrant= @zianet.com.