The Green House Project

One of my current quests is to get a better handle on the looming senior housing crisis and, in particular, whether there is a better way to address the needs of elders who are currently housed in traditional nursing homes. During the course of my research I came across the Green House Project. Dr. William Thomas founded the movement which espouses a philosophy of providing small homes (no more than 12 residents), providing privacy with single rooms each with their own bath, and offering care that recognizes the individuality, autonomy and dignity of each resident.

I had the opportunity this past week to attend a two day workshop offered by NCB Capital Impact, which manages the Green House Project nationally. The workshop was held at the Lebanon Valley Brethren Home in Palmyra, Pennsylvania, where there are four operating Green Houses.

Green Houses, Palmyra, PA

The strategy is to combine an authentically residential rather than institutional design approach along with a fundamental refocusing of care from one in which the provider is at the center to one in which the elders are center stage. Designs must include a great room incorporating a communal dining table, a working fireplace, and an open kitchen where all meals are prepared.

Green House great room

Individual bedrooms each with their own bath are clustered around this great room.

Floor plan for Sheridan, WY, Green House

Perhaps even more striking is the way in which staffing is organized. Certified nursing assistants are called Shahbazim and are responsible not only for primary care of the residents but also perform all housekeeping and cooking duties. The combination of the small scale and these “jack of all trade” caregivers lead to extremely close relationships being developed between the elders and Shahbazim.

I have to admit that I was skeptical most nursing home patients would benefit from the Green House setting but based on the research done to date and the time I spent in an operating Green House visiting with residents and staff left me convinced that even the most compromised elder does indeed experience a significant improvement in his or her quality of life in this kind of home setting.

From a developer’s or operator’s standpoint, it is heartening to learn that operating costs for a Green House are almost identical to those for a traditional nursing home.

After a serious stroke, my mother spent the last several years of her life in a traditional nursing home. While it was a well run facility, my mother never felt comfortable there often complaining about the lack of privacy. Throughout the two day workshop, I kept wishing that Green Houses had appeared in time for my mother.