By Steve McAlilly / Posted on April 16th, 2019
When Mississippi Methodist Senior Services opened the first Green House homes in Tupelo, Miss., back in 2003, we really believed that they would be game changers in the field of aging services. But we had no idea at the time that some 15 years later, the movement to deinstitutionalize nursing homes and humanize care for elders would sweep the globe.
With some 284 homes built in 32 states, and many more on the way, The Green House Project (GHP) can rightfully claim its position as the leader in small-house design and person-directed, relationship-rich living.
As one of the original pioneers of those first Green House homes, I am proud to announce that I have recently taken the helm as chair of the Center for Innovation (CFI), the umbrella organization of GHP. My election to chair of CFI is joined by the addition of nine new board members, comprising a “dream team” of experienced and talented senior living leaders who are poised and eager to take this movement to the next level.
The collective passion and dedication of the new board is palpable as we look forward to the next 15 years and beyond. Together with a stellar GHP team of staff members, we will continue to build bridges, foment revolution, and spread innovation in new and better ways. At our initial board meeting last month, you could feel that this group of people were ready to help write the next chapter of this story!
The expansion of our board of directors is part of a recently launched initiative known as Green House 2.0, which encompasses a host of innovative partnerships and efforts designed to improve the lives of people at many ages, abilities, and levels of care.
Among these endeavors is Best Life, GHP’s approach to help organizations support people living with dementia (PLWD) to live rich and rewarding lives. The tools of Best Life are available to memory care, assisted living, and nursing home communities as standalone education and training.
On GHP’s reenergized website you will find more details about Green House 2.0. I’m sure you will find that we have a lot going on—all with the intention of making long-term and post-acute care better for all people. I invite you to take a spin around the site and let us know what you think.
As this effort launches over the coming days, weeks, and months, I hope you will consider joining us in our movement to eradicate institutional models, destigmatize aging, and humanize care for all people.
Steve McAlilly is the president and CEO of Mississippi Methodist Senior Services in Tupelo. He led the development and opening of the first Green House Home in 2003.
By Anne Ellett / Posted on March 3rd, 2019
A neighbor of mine, recently diagnosed with dementia of the Alzheimer’s type, has shared with me that he hardly ever leaves his house anymore, because he doesn’t want anyone to know his situation. How heartbreaking this is for him and illustrates the powerful stigma that is associated with dementia. This is a man who developed and managed several successful companies and has the reputation in the business world as a “take charge” kind of person. Now he’s hiding in his house…
What’s his fear? He held my hand and said, “ I don’t want to be treated as a child.”
The stigma attached to dementia is real and has emotional and social implications. Within just a short time, my successful, confident neighbor has lost his self-esteem and is fearful of the judgement of others. The stigma and devaluation that is associated with dementia can be paralyzing, as witnessed by my neighbor’s fears and abrupt change in his social interactions.
Facing stigma is often a primary concern of people living with Alzheimer’s and their care partners. Those with the disease report being misunderstood because of the myths and misconceptions others have about the disease. https://www.alz.org/help-support/i-have-alz/overcoming-stigma
One of the most common myths and misconceptions about the diagnosis is that people become “child-like” or retrogenesis (aging in reverse). Of course, this isn’t possible and an adult with the diagnosis of dementia is and always will be an adult, with their full history of accomplishments and talents as part of their identity.
What can we do to help counteract this stigma which marginalizes PLWD and assumes they’re “unable”?
At the Green House Homes, we strive to decrease the stigma and devaluation of PLWD and treat them as adults – not children. We can approach them as adults and involve them in adult activities. Relate to them as adults, not children, and don’t assume they “don’t know”. How often I hear from nurses and physicians that “They won’t know the difference.”
On a recent tour of a nursing home, I witnessed a group of female residents, all PLWD, being handed baby dolls out of a basket that was being passed around. Some of the women tried to cradle and rock the dolls while others appears uninterested and left them lying in their laps.
The distribution of the baby dolls I’m sure came from the staff’s good intentions to engage the women and also comfort them. But the vision of the women being handed out baby dolls seemed like a real example of reducing their abilities to child-like levels, while assuming “they won’t know the difference”.
If a PLWD has always been a doll collector and that is part of her/his story, it would be so fitting to surround them with their doll collection. But if a person does not have that history, why offer them a doll, a “fake” baby? Is the assumption being made that they won’t know the difference? Is the assumption being made that they don’t have the ability to respond or have a relationship with a real baby?
Investors are developing more and more almost real baby dolls and robotic pets to comfort and distract PLWD. I am frequently asked to endorse and introduce these life-like dolls and pets to the PLWD that I work with. I can’t do that, because the image of a group of PLWD holding plastic dolls immediately speaks to their inabilities and losses. Anyone can look at a group of grown women being handed out dolls and think, “These aren’t capable adults, why would they be holding dolls instead of real children”?
One ability that PLWD retain is the ability to have real relationships. Yes, a PLWD might respond to a doll or robot, but just watch them with the real thing! The interactions, the feelings, the real relationships are evident and powerful. When someone tells me, “But she loves her doll!”, I say, “She’ll love a real child even more.”
So if we want to comfort and engage PLWD, why would we offer fake babies and pets? More and more care centers are partnering with children’s’ play groups and preschools to have regular interactions. PLWD can provide warmth and real love to the young children. And many places now have dogs and cats who reside with the PLWD, offering opportunities for real interactions and purpose.
As a professional working with PLWD, I remind myself to focus on retained abilities and talents of a PLWD, not on their losses. And to always be mindful that I never want to treat them as children or in any way devalue them.
Let’s bring real children, real pets to PLWD and watch real relationships develop!
By Meg LaPorte / Posted on February 12th, 2019
The Green House Project’s very own Deborah Wiegand recently served as a judge in the 2019 Environments for Aging (EFA) Design Showcase competition. She and 16 other jurors gathered in Dallas in mid-January to review and evaluate 44 submissions from all over the countr
This was the first year that someone from The Green House Project national organization has participated in judging the competition. According to Donna Paglia, EFA’s consultant for special projects, Wiegand (who was appointed by the Society for the Advancement of Gerontological Environments, or SAGE), was chosen “for her specific talents as a consultant to the industry.
The winners were announced Jan. 23, with eight entrants recognized as competition finalists and another 33 to be published in the showcase issue of EFA magazine. “This distinction is given to projects that received overall scores that were at or above our standards to be published,” said Paglia.
Follow are the criteria for the awards:
• Award of Merit: Overall Project Raises the Bar across all criteria: Innovation; Collaboration; Aesthetics; Operations.
• Honorable Mentions: Raised the Bar within one of more criteria: Innovation; Collaboration; Aesthetics; Operations.
• Finalists: Showed significant scoring within criteria: Innovation; Collaboration; Aesthetics; Operations.
You can find all of the award winners HERE.
The judging happens as follows: Jurors are placed into groups to offer a good balance of architects, designers, consultants, and providers on the panel. Teams then review projects virtually over a two-week period before arriving at the “live” event, where t
hey review the projects in teams and as a full group, according to Paglia.
“There were many variations among the designs submitted and it was very clear to me that some had collaborated more extensively with stakeholders than others,” Wiegand said of her experience. “In my opinion, this is a very important aspect to good design.”
The winners will be recognized during the 2019 EFA Conference and Expo, which takes place April 7 to 10 in Salt Lake City, Utah.
By Anne Ellett / Posted on February 9th, 2019
I was deeply distressed to learn that the National Institute on Aging (NIA) is sponsoring a trial for the use of electroconvulsive therapy (ECT) for people living with dementia (PLWD) who exhibit severe aggression and agitation. Not only that, according to a press release on the website of one of the participating organizations, the study is touted as the “first randomized, double-blind, controlled study of ECT for agitation and aggression in Alzheimer’s dementia,” which means that it will compare ECT against other “standard therapies” such as antipsychotic medications and behavioral therapies.
This is inhumane and unacceptable, and I join many other professionals in our field who are also appalled by this study, which is funded by an $11.8 million grant.
I believe there are several factors behind the approval of this “treatment” by NIA. Let’s start with the term “behavioral and psychological symptoms of dementia,” or BPSD. BPSD refers to the actions of PLWD, such as confusion, aggression, anxiety, refusal of care, etc., as “symptoms” due to their diagnosis of dementia. And if actions are considered symptoms, then this provides validation for medically treating these symptoms, because it allows for symptoms to be considered hallmarks of a disease state.
I’ve been a nurse for many years, long enough to remember when we responded to actions of PLWD such as confusion or aggression by tying them to their bed or chair. That was acceptable nursing practice! I can be grateful that we’ve moved beyond that…or have we?
The first-line medical treatment for “behaviors” has been the prescribing of strong antipsychotic medications. Unfortunately, even when the FDA came out in 2005 with a “Black Box” warning about the risks of prescribing these medications for PLWD, their usage has increased. In an attempt to decrease the use of these risky medications, the Centers for Medicare & Medicaid Services (CMS) now requires documentation of non-pharmaceutical interventions prior to prescribing antipsychotics, in addition to informed consent.
Even though CMS has established a goal of continued reduction of the usage of these prescription medications in nursing homes it is still common for PLWD to receive these medications.
PLWD are often devalued and stigmatized by both the public and professionals. Once diagnosed, they are perceived as unable to participate in decision making, expressing their needs, and often are considered child-like.
Therefore, when PLWD express their preferences by trying to leave where they have been assigned (known as eloping), or resist care by someone they don’t know, or cry because of loss of meaningful and significant relationships, their actions are seen as symptoms of a disease, rather than communications.
What if we considered their actions as personal expressions, or as unmet needs instead of symptoms to be diminished by medications or other treatments? What if we looked at what is going on in their environment and also at their personal histories and put together a plan for interactions that could be meaningful for them?
Strong antipsychotic medications that were never meant for use among older adults, and now ECT therapy? Let’s stop the use of the term BPSD and instead start discussing what are the unmet needs and challenges of the PLWD.
Kate Swaffer, a well-known dementia advocate, and a PLWD, expressed her fears about this study and said, “ECT is surely just another form of RESTRAINT?????” (emphasis is hers.)
As professionals and family members, if we continue to dismiss normal human actions (Wouldn’t most of us resist intimate care if we didn’t know the person? Wouldn’t most of us be looking for a door to exit if we didn’t know where we were?) as symptoms to be medically treated, we are denying PLWD their ability to communicate and express their needs.
If actions are labeled as “out of control” or aggressive, without determining what someone with PLWD is attempting to communicate, we have pathologized normal human actions.
Anne Ellett is a dementia specialist for The Green House Project (GHP), an organization that seeks to radically transform nursing homes by partnering with aging services providers to reinvent care and empower the lives of people who live and work there. Anne created GHP’s Best Life dementia care initiative, which builds on the organization’s core values of meaningful life, empowered staff, and real home.
By Claire Lucas / Posted on August 31st, 2018
The Green House Project showed up in a big way this year at the Pioneer Network annual conference in Denver, Colo., where senior leaders presented three breakout sessions and a tour of the local Green House homes was sold out.
Green House Senior Director Susan Ryan teamed up with Lisa Czolowski, CEO at Hover Community (which recently broke ground in Longmont, Colo.), and Jennifer Vecchi, principal at Vecchi & Associates, to present on transforming the looming workforce crisis into an opportunity for career enhancement. This subject was especially relevant in light of the shrinking number of qualified workers to fill healthcare positions.
Green House Project Guide, Claire Lucas shared her knowledge on The Green House Project’s success in utilizing Sages—volunteers who act as coaches and advisors for Shahbazim. As leaders across the country grapple with staff retention, Lucas suggested that this model of using volunteers to support staff transcends the Green House model and can be utilized successfully in any healthcare organization.
Debbie Wiegand and Rob Simonetti, design director at SWBR, a design and architecture firm, spoke about the benefits of small-house architecture and design, sharing 15 years of experience.
In addition, Pioneer Network attendees participated in an onsite visit to the Green House Homes at Mirasol in Loveland, Colo. The sold-out tour gave attendees the opportunity to gain firsthand experience in how Green House homes can make a difference in the lives of its elders and staff.
By Admin / Posted on August 30th, 2018
Being seen goes deeper than recognizing the visible attributes of a person. When a person is truly seen their inner complexities shine and all labels associated with them (such as Alzheimer’s disease) are shed. Their preferences in everyday life are understood and their uniqueness is honored.
This was the message that Susan Ryan, The Green House Project senior director, brought to the stage at the 33rd International Conference of Alzheimer’s Disease International (ADI), held July 26-29th in Chicago, Ill. Ryan delivered a keynote presentation and participated in a panel discussion with the goal of ‘power washing’ conventional thinking in today’s dementia care.
The Alzheimer’s Disease International Conference is the the longest running and one of the largest international conferences on dementia, attracting delegates from around the world. Ryan was among a range of international expert speakers, making up a unique program that enables participants to learn about the latest advances in the prevention, diagnosis, treatment, care and management of dementia.
The concept of being seen (#SeeMe) applies especially to a large percentage of people living in long-term care settings, who are defined by their diagnosis of dementia. Their diagnosis assigns them a label that emphasizes what they can’t do and what’s been lost. Ryan’s message was a call to destigmatize and humanize those living with dementia, in order to see the whole person first.
To see this in action, Ryan encouraged the audience to take a deeper look at how the symptoms of dementia are presented to the outside world. She noted that the Behavioral and Psychological Symptoms of Dementia (BPSD) is a term used to describe the following “symptoms” that occur in people with dementia: agitation, aberrant motor behavior, anxiety, elation, irritability, depression, apathy, disinhibition, delusions, hallucinations, and sleep or appetite changes. According to a 2012 study in the Frontiers of Neurology, about 90 percent of people with dementia have BPSD. Ryan noted that while this finding is not surprising, it is presented in a way that categorizes people with dementia even further.
Instead of following common thinking, Ryan said, what if instead the finding was that 90 percent of people living with dementia will find themselves in a situation where their well-being is not adequately supported? Attendees were encouraged to take it a step further and think through how this revolutionary way of thinking would change the way that providers and other stakeholders “#SeeMe.”
The good news is that this is already happening, Ryan noted. The Green House Project has developed Best Life, a memory care program that is built on the initiative’s core values of Meaningful Life, Empowered staff, and Real Home. Best Life is a process to transform the paradigm and defy the stigmas associated with dementia, she explained.
Ryan concluded by imploring her international audience to “lead the way, address the stigma surrounding dementia, and support caregivers with the skills to see each elder as a unique individual, and to connect them to a meaningful life.”
By Admin / Posted on August 23rd, 2018
The Green House Project Team congratulates Nate Sweeney on his new position with St. John’s!
Rochester, NY via The Post Aug 22, 2018
St. John’s recently announced that Nate Sweeney joined its team as vice president of skilled services.
Sweeney is bringing 17 years of experience in the health care industry, with nearly a decade spent in long-term care.
Sweeney will lead St. John’s skilled nursing operations and focus on developing a nonmedical model of long-term care through advancement of organization directors, processes and culture. He will be responsible for supervising and developing the clinical and administrative businesses of skilled services including Penfield’s Green House Homes, St. John’s main campus of 400 residents and its medical-day program.
“We’re confident Nate’s track record for strong leadership, experience, innovation and passion is a great match for our organization and team,” St. John’s President and CEO Charlie Runyon said. “Under Nate’s leadership, St. John’s will continue to advance its mission and evolve our services to provide the highest quality of care for our residents.“
Sweeney has extensive experience in the health care industry, specifically with exploring and operationalizing new models of care. Most recently, he served as executive director of the LGBT Health Resource Center of Chase Brexton Health Care in Baltimore. There he spearheaded the development of a new division in the organization that focused on resource development for the community, training and education for medical and social service providers and direct community programming.
Prior, Sweeney spent five years with the Catholic Charities of Baltimore where he drove two major changes for the organization. First, he worked with its nursing home, The Neighborhoods at St. Elizabeth, to change the culture of long-term care from pure medical to one focused on its residents. Next, he led the effort for the licensing and opening of The Harry and Jeanette Weinberg Green House Residence at Stadium Place, a program of Catholic Charities and a Green House Home.
Sweeney earned his master’s degree in management of aging services from the University of Maryland Baltimore Country and his Bachelor of Arts in education from University of Illinois. Outside of the office, he serves on the LGBT Aging Issues Network Council for the American Society on Aging. Sweeney resides in Rochester.
Loveland Housing Authority Fundraising Gala Kick-off Event Has A Surprise Ending from Mother Nature!
By Claire Lucas / Posted on July 15th, 2018
I had the pleasure of attending Mirasol’s Gala fund raising kick-off event in late June. The Loveland Housing Authority has decided to build two additional Green House homes by raising money through an aggressive capital campaign. Invitees included influential members of the Loveland community. They had already received a generous contribution of $100K from one person!
The event was beautiful. They had set up the courtyard in front of their event center with brunch stations – one served omelets to order another a waffle bar. They even had a bartender to provide you with a Mimosa or a Bloody Mary. Dr. Bill Thomas and Nancy Fox were on the program as guest speakers.
What could go wrong?
It quickly became evident that the party as planned would not be possible. However, that didn’t stop this incredible team. They quickly pulled out umbrellas’ and helped all the guests get inside. Food was moved into the event center and the program continued. Despite the rain, the event went off beautifully. Guests learned about the Green House Project, toured the Green House homes and learned about the Loveland’s Housing Authority’s vision for Loveland. Dr. Bill Thomas encouraged people to dig deep when giving donations, so they might provide “shelter from the storm.”
When the party broke up and everyone went out to retrieve their cars, many people, including me, discovered that the dirt lot where we had parked our cars had become a soggy, muddy field. They had to call three tow trucks to pull about 20 cars out of the field! It was quite a show watching the cars being pulled out of the mud.
Between the beautiful setting, the rain, the memorable speakers and the muddy field this is an event that no one will forget soon!
By Admin / Posted on July 2nd, 2018
LITTLE ROCK, ARK. (PRWEB) JUNE 28, 2018
The Green House® Cottages of Poplar Grove (https://poplargrove.care/) announced today the planned Fall 2018 opening of the their long term and rehabilitative care facility in Little Rock, Arkansas. Poplar Grove is the first facility in Central Arkansas based on the Green House® model of care. (thegreenhouseproject.org)
“Poplar Grove is what the future of care can and should be for our elders,” said John Montgomery, Executive Director of Poplar Grove. “We’ve adopted this new model of care so that we can serve our community better than ever before, providing a higher quality of life for residents, as well as peace of mind for their families.”
The Green House® Cottages of Poplar Grove is creating over one hundred and forty new jobs in Central Arkansas. Commenting on the healthcare jobs being created Montgomery said: “We are looking for people who are passionate about the care and service they provide to others. You don’t necessarily need a background in healthcare to join our team. Do you love to cook for others? Do you love to plan and coordinate activities? Are you a registered nurse who has been anxiously waiting to transition into the new model of healthcare? We are looking for people who recognize the autonomy and dignity of care recipients and are passionate about creating a fantastic long term and rehabilitative care environment.”
Poplar Grove is built on the Green House® model of care, a revolutionary movement transforming skilled rehabilitation and nursing home care nationwide. The Green House® model has been highly acclaimed by many national experts and leading publications because it has been shown to deliver better health and satisfaction outcomes than traditional nursing homes (for more, see: (Green House Model Articles).
Here are five ways the Green House® Cottages of Poplar Grove is different from a traditional nursing home:
- A 1:4 direct care staff ratio, substantially more than the State/Federal average
- A small cottage environment with a maximum of 12 residents, living life to its fullest in their own home with private rooms, private bathroom and showers, made to order, “family-style” meals based on elder’s choice… and so much more
- A philosophy of care rooted in meaningful relationships, holistic care and a deep knowledge of each elder and their specific needs, produces a better quality of life and care
- Superior equipment and technology
- Each staff member undergoes a minimum of 120 hours of additional education and training in areas such as nutritional services; senior care techniques and dementia to become geriatric care specialists.
The Green House® Cottages of Poplar Grove in Little Rock will join the Green House® Cottages of Belle Meade in Paragould, AR, The Green House® of Southern Hills in Rison, AR and the Green House Cottages of Wentworth Place in Magnolia, AR as the fourth Green House® model facility developed by Southern Administrative Services, LLC in Arkansas.
“We are proud to bring this transformative new model of long term care to Central Arkansas,” said John Ponthie, Founding Member and Managing Director of Southern Administrative Services LLC. “By delivering outstanding care and creating a real home environment and providing elders with dignity, autonomy and choice, Poplar Grove will provide our Elders with the best quality of life possible.”
About The Green House® Cottages of Poplar Grove
The Green House® Cottages of Poplar Grove (https://poplargrove.care/) create loving homes where Elders are supported by quality care, choice, and positive relationships. In our homes, the Elder, not a calendar on the wall, decides the schedule of each Elder. Our caregivers are dedicated to the homes, helping to create meaningful relationships with our Elders. While Poplar Grove is licensed and skilled nursing community, the cottages are designed to look like the homes in the surrounding neighborhood. Homes feature high ceilings in the hearth rooms of each cottage, large windows throughout for natural light, and private bedrooms, each with a private en-suite full bathroom.
Executive Director – The Green House® Cottages of Poplar Grove
501- 454 – 5604
CEO- Bespoke Health Media
By Mary Hopfner-Thomas / Posted on June 28th, 2018
“The Green House helps give us tangible ways to live out our mission in the way we give care” – Deedre Vriesman, Resthaven CEO.
On June 25, Resthaven team members celebrated the groundbreaking of their second Green House home, officially kicking off development of the Janssen Cottage. In 2007 the Boersma Cottage opened at Resthaven for 10 elders.
The ceremony included a special thank you to the Resthaven Board of Directors, the Janssen family, all the donors, GMB Architecture & Engineering, CL Construction and the Holland community who are making this home a reality.
Congratulations to all!
By Mary Hopfner-Thomas / Posted on June 22nd, 2018
Hover Senior Living Community will soon be the site of Green House homes for 48 elders. In late May, the weather cooperated in providing a beautiful backdrop for the groundbreaking ceremony.
The planning for these homes began five years ago and Hover President, Lisa Czolowski credited the community‘s volunteer board of directors for their dedication, saying, “This project couldn’t have happened without them — it‘s really a labor of love.”
The homes will officially be called The Katherine and Charles Hover Green House Neighborhood Homes.
The first elders are expected to move in by early Spring 2019 and all four homes should be completed by the end of Summer 2019. With the addition of the Green House homes, Hover will be considered a Continuing Care Retirement Community (CCRC) or Life Planned Community. The Hover campus includes nearly 119 apartments and 51 assisted living suites
Once complete, the new portion of the Hover Senior Living Facility would be the third Colorado Green House partner to adopt the model. The first two locations are in Mirasol Green House Homes in Loveland and Washington County Nursing Homes in Akron.
We wish the Hover team much success in the development of their homes!
By Rachel Scher McLean / Posted on May 14th, 2018
“For thousands of years, elders have been held in high esteem and involved in the community,” says Steve McAlilly, CEO of Mississippi Methodist Senior Services. As the world shifted and the role of elders changed, Steve sought a way to bring them back to a place of reverence and respect. 15 years ago, Steve courageously opened the first Green House home in Tupelo, MS, effectively building a home where elders could live full and meaningful lives, “Within hours of moving in, a peace came over the home,” Steve remarks.
Not only do these homes positively effect the elders who live in them, but also the direct care staff who take on expanded roles to become the managers of the home. The skills that they learn in The Green House homes affect every area of their lives, “I’ve watched team members grow and thrive in the Green House” says Michele Daniel, VP of Philanthropy & Strategic Implementation. Mississippi Methodist Senior Services currently has 19 Green House homes on four separate campuses.
Returning the elders to a place of esteem, honor and respect is an investment in the quality of life of the entire community.
This 15 year milestone began with the vision of Dr. Bill Thomas and was embraced by Steve McAlilly’s leadership. Thanks to the support of The Robert Wood Johnson Foundation, this radically simple innovation has become a proven movement that continues to grow with integrity and sustainability. Now with Green House homes open and operating in 33 states, small house nursing homes are a trend addressing many of the challenges in healthcare. The Green House model is demonstrating that the status quo is not good enough and that there is a better way. Thank you to Mississippi Methodist Senior Services, and all of The Green House partners who have opened their doors in the past 15 years. Together we are fostering environments of empowerment, dignity and respect, and a world where every individual can anticipate a hopeful future