Jane Isaacs Lowe, PhD
Jane Isaacs Lowe, PhD, senior program officer, Vulnerable Populations, Robert Wood Johnson Foundation, Princeton, New Jersey.
If you are seeking an alternative to institutional-style nursing care for elders, a solution may be right around the corner. The Robert Wood Johnson Foundation (RWJF) has awarded $15 million dollars to NCB Capital Impact to expand the development of what they call “Green House homes” staffed for skilled geriatric care in a way that is unobtrusive, giving residents full autonomy to dictate their day. “The Green House philosophy is a patient-centered approach to elder care,” said Jane Isaacs Lowe, PhD, senior program officer of Vulnerable Populations at the Robert Wood Johnson Foundation. “It’s all about creating a warm, nurturing environment where elders can flourish and live a rich life.”
These Green Houses have little to do with the green environmental movement. The concept is a brainchild of William H. Thomas, MD, a Harvard-trained geriatrician who strongly believes institutionalized, large-scale nursing homes fail to meet elders’ emotional, social and spiritual needs. Dr. Thomas seeks to transform the traditional nursing home to one where elders can thrive, not merely survive.
A Green House is intended to be much like a regular home, each accommodating between six and 10 residents who have their own bedrooms and bathrooms. “From the moment you walk in the door a Green House feels different,” said Dr. Lowe. “The living room has comfortable furniture with people talking, playing games, reading or listening to music. There’s a beautiful kitchen with something always cooking or baking in the oven and a dining room. There’s even a patio where residents can enjoy the outdoors. We want the elders and their visitors to feel completely at home here, like they are in their own house.”
Perhaps someday Green Houses will become an option for anyone considering or needing a nursing home as there are no restrictions regarding physical or mental health. Green Houses operate as licensed nursing homes that provide clinical support from a team comprised of nurses, social workers, therapists, medical directors, nutritionists and pharmacists. Clinical staff are always on site. According to Dr. Lowe, elder residents collaborate with staff to create their own daily routine, including when they want to get up, when they want to take a shower, and anything else they may like to do.
According to a University of Minnesota study on the Green House program, Green Houses provide residents with a higher quality of life and better emotional health. The reported satisfaction levels are higher, there is less functional decline and less depression than traditional nursing homes. Green house homes vary in cost but are typically no more expensive than traditional nursing home services. Green houses accept payment from private sources, including a resident’s own income and insurance, and also accept Medicaid payments for individuals who are low-income or who have exhausted their private resources. The model has been so successful that the concept is gaining widespread interest among elder care providers, many of whom are exploring new alternatives to replace nursing homes, as we know them. The foundation is committed to expanding the program to 50 or more sites by the end of 2010 (there are currently 15 communities with 42 Green Houses in 10 states today).
To learn more about Green Houses, including state-by-state information, visit the Green House Web site:
http://www.thegreenhouseproject.org.