This is the 40th and final column in a series of articles intended to demystify retirement living options. Due to reader interest, I will publish these 40 columns as a collection in a paperback book, and will announce its availability as soon as it is ready.
What do you think of when you hear the term "green house?" A glass building intended to house tender plants? A home that is a model of energy efficiency, perhaps producing as much power as it uses?
Get ready for a third meaning.
The Green House Project (www.greenhouseproject.org) is an approach to designing, staffing, and running an assisted living or nursing/skilled nursing facility to make the residents the true focus and center of attention. It is designed specifically to encourage and support ongoing growth and development in even its oldest residents.
What distinguishes a Green House from a typical assisted-living or long-term care facility? A Green House video explains, "The goal is a complete transformation ... from an institutional setting ... that when you or I walk into it, we think, 'Please don't ever let me have to live here,' -- into something warm ... that you or I would walk into and think, 'I'd be happy living here, or I would be happy to have somebody I really cared about living here.'"
The buildings are deliberately designed to be homelike for 10-12 residents, offering each resident a private room with its own complete bathroom. In contrast, nursing/skilled nursing facilities typically offer only a half-bath in the room, with showers typically taken in a large, impersonal shower room.
The private rooms open off a common area that includes a living room, an open kitchen, and a dining area with one large table - a sort of outsized version of a standard home with an open floor plan.
The vast majority of the care that residents receive is provided by caregivers called shabazim, who as a team, manage the home. They cook, clean, and do laundry in addition to providing hands-on care for the residents.
Because meals are prepared in a large kitchen that is right out in the open, residents can see and hear and smell the meals as they are made. They are welcome to talk with whoever is cooking and may even help out in the kitchen if they want. In contrast, meals in traditional care facilities arrive from behind closed doors, prepared by professionals who the residents rarely see or interact with.
In a Green House, staff members sit and eat at the large dining table interspersed with the residents. They all share the same food, and they all engage in the conversation around the table. Of course, the staff will help residents who need assistance eating; the general impression, though, is that the residents and staff are all part of one large family.
The residents spend their time on a variety of activities that have meaning for them individually. A staff member and a resident may spend hours talking, and it is common for them to develop very close bonds.
Bill Thomas, the founder of the movement, noted in a video interview, "Here's the problem ... conventional long-term care makes the doctors and nurses the star of the show. And so they are out in front, they're in the spotlight 100 percent of the time. The Green House makes the elders stars of the show. They're the ones in the spotlight. And the nurses and doctors are still there, but they're backstage, where they ought to be."
The Green House model is supported by a well-run national program that offers extensive practical support in the areas of building architecture and design, financial analysis related to creating and running a Green House, regulatory compliance, leadership training and employee development.
In Arizona, Green House homes can be found in the Phoenix area. A touching video about Green House projects can be found at http://thegreenhouseproject.org/green-house-model.
In summary, the Green House model presents hope for the future of elder care, because it finds ways to honor and respect elderly residents for who they are, rather than acting as if the most important thing about them is that they have some malfunctioning body parts.
Elizabeth L. Bewley is president and CEO of Pario Health Institute and the author of "Killer Cure: Why Health Care Is the Second-Leading Cause of Death in America and How to Ensure that It's Not Yours." To tell Elizabeth your story or to ask her a question, write to firstname.lastname@example.org.