Shrinking the Nursing Home until it feels like a Home

A recent article in the New York Times article was written about a shift from large nursing institutions to smaller homier living settings referred to as "Green Houses."

"Just 10 residents live in each so-called Green House, which looks nothing like a traditional nursing home. The front door opens onto a large living and dining area; on one side is a hearth surrounded by upholstered chairs, and on the other is a long communal dining table where meals are served. An open kitchen faces the table, so caregivers can chat with elderly residents while preparing meals.

There are 117 Green Houses across the United States now, part of a quiet but intriguing effort to de-institutionalize elder care. The movement has its roots in the 1987 Nursing Home Reform Act, which declared that residents of long-term care have the right to be free from abuse or neglect. Nursing homes across the country have tried a variety of strategies to become more 'resident-centered.'"

Met Council provides independent-living housing for seniors all over New York City. Now, in a city, it is very difficult to provide housing that is not in a large apartment building and so even an independent living building can have an institutional feel to it.

"The notion that elder care should be de-institutionalized is a popular one. According to a poll released in September by NPR, the Robert Wood Johnson Foundation and the Harvard School of Public Health, 82 percent of pre-retirees (adults over age 50 who have not retired but plan to) and 78 percent of retirees are somewhat or very concerned about being in an institutional environment that is not as comfortable as a home.

'Loneliness, helplessness and boredom are the three plagues of nursing homes,' Mr. Jenkens said. 'Arguably, much of the institutionalized practice induced this.'"

Considering these problems, smaller housing units seem like a good solution. The article goes on to list the results of a poll conducted which interviewed seniors who previously had been in a large nursing home and then moved to a "green house."

"...each day they get 24 minutes more of direct and personalized care and 1.5 hours more of nursing staff time than those living in traditional nursing homes. Residents say they feel like they have deeper relationships with the staff, and family members report higher satisfaction with the physical environment, privacy, their own autonomy, health care and meals. Employees, too, report less stress. The turnover rate is significantly lower than in a traditional nursing home. Green House certified nursing assistants are paid on average about 5 percent more than those in institutional settings.

Even if this model of elder care turns out to be impractical on a large scale, Ms. Wells said, 'we can learn a lot from what the Green House is doing and can translate these methods into things that existing nursing homes can use.'"

As an organization that provides housing for the elderly we can learn a lot from this article too. And as a volunteer coordinator reading this, it is clear to see that when something like an extra 24 minutes of direct and personalized care makes a huge difference in someone's life--the kind of direct and personal attention can also be provided by wonderful, caring volunteers who join our seniors in recreational activities!

You can check out the full article here.