Green House Blog

New Book written to help caregivers and elders navigate resources

FACT: There are over 44 million family caregivers caring for aging family members.
When the dust settled after two intense years of managing her mother’s care, caregivers, and finances, Faye Levow was determined to create a comprehensive resource so that no one would ever again be lost in a whirlwind of caring for aging family members. Her upcoming book, OMG! My Parents Are Getting OLD! is the result of that determination.
OMG! My Parents Are Getting OLD! is the definitive resource for families on what to do when caught up in the whirlwind of dealing with unprepared, aging parents. It will also give readers tips on how to prepare for their elder years, so life will easier for them and their families.

OMG! My Parents Are Getting OLD! weaves readable chapters from more than 50 professionals who work with seniors every day in a wide variety of capacities and fields, and the lessons from more 70 family caregivers who have “been there,” along with the dramatic, true story of caregivers, theft, finances, and family gone awry during the last years of a loved one’s life.

OMG! My Parents Are Getting OLD! has a comprehensive resource section and will be fully indexed, making it very user friendly.

“My mission is to make it popular to talk about the issues presented in the book and get people out of denial, so they start preparing for elder years well in advance. This will help both elders and their families to deliver better care with less stress when the time comes,” Faye says.

President of Launch Pad Publishing and long time entrepreneur, Faye has been writing and editing for over 30 years and coaching authors for the last seven. She has been a features writer for magazines and newspapers, a contributing author in several books, and has edited magazines, newsletters, and numerous books in a variety of genres, including a Washington Post bestseller.

Faye is co-author of Award-Winning Savory Delights: The Best Restaurants in Greater Fort Lauderdale, author of So You Want to Write a Book? The Best Writing and Publishing Tips, and creator of the upcoming book OMG! My Parents are Getting OLD! scheduled for release Spring of 2013.

Advance purchase the book at a discount and become a supporter of the project at www.OMGMyParentsAreGettingOld.com. Once the book is released, it will be available at major bookstores, both online and off, as well as on the book’s website and www.LaunchPadPublishing.com

Mennonite Home Communities of Ohio Celebrates The Grand Opening of The First Two Green House Homes In Ohio

By: Doug Luginbill, Director of Resource Development and Church Relations

“I want to call your attention to the wind.  I don’t know if you’ve noticed but it’s been blowing!”  With those words, Dr. Bill Thomas stated the obvious but also drew attention to how the “winds of change” have been blowing at Mennonite Home Communities for over fifty years.  The most recent change was why he and others were gathered that day; the blessing of the first two Green House homes in Ohio.

It was a very blustery day as over 250 people gathered under a tent to participate in “A Home Blessing: Celebrating Life.”  The hour-long celebration was marked by Laura Voth, CEO, retelling the eight-year-long journey of persistence and patience that brought Mennonite Home Communities to that day.  Words of thanks were expressed to many people for making that day possible; THE GREEN HOUSE® Project, pH7 Architects, Garlock Brothers Construction, Citizens National Bank, many subcontractors, and staff.  Community supporters were also thanked for the $1.8 million contributed toward the New Vision: Transforming Elder Living campaign that made the project financially feasible.

Phyllis Osborne, an elder who will be moving into one of the homes at Willow Ridge, shared how she had a change of heart about The Green House project.  As an assisted living resident, she was very happy right where she was and couldn’t think of living anywhere else.  When her doctor encouraged her to consider nursing care, she had to “eat crow” and “begged” to see the homes at Willow Ridge.  When she and her family toured the homes, she knew immediately that this was the place for her.  Phyllis, along with her son, a Shahbaz and a member of the clinical support team spoke a litany of mutual support and commitment to one another as a plant was symbolically transplanted and watered.  The litany ended with the following words spoken by those gathered, “Together we nurture one another.  May our Creator bless these homes with purpose and life.”

Lisa Maxwell, Green House Project Guide, shared the importance of being part of the broader Green House network and Ohio Long Term Care Ombudsman expressed appreciation for the person-centered care and culture change focus The Green House homes make possible.

As guests exited the tent they were given a yellow tulip bulb to which was attached the following verse of poetry; “An elder is a person who is still growing, still a learner, still with potential and whose life continues to have within it promise for and connection to the future.”

The celebration ended with a tour of The Green House homes.  Lots of “wows” and “this is beautiful” were heard as guests snacked on cookies made in the homes by Willow Ridge staff.

Leading Age Honors Green House Organizations and Stimulates Thought Leadership

The 2012 LeadingAge Annual Meeting in Denver, CO was an incredible opportunity to connect with thousands of aging services professionals and explore the current and future needs of our field. Through engaging education sessions and a robust exhibit hall, innovative ideas sparked and crackled throughout the convention center. Atul Gawande, a practicing surgeon, a staff writer for The New Yorker and an associate professor at Harvard Medical School, delivered a keynote about the power of communication and person-centered care. He says that, “medicine works best when it works for people’s goals, not the other way around.” It is not surprising then that he has visited Green House projects, Leonard Florence Center for Living, and White Oak Cottages and has returned several times to learn lessons from the elders and the model. This year’s Leading Age Conference highlighted Green House values and adopters throughout the event.

Green House adopters are thought leaders and pioneers in the field of long term care. Audrey Weiner, Leading Age Board Chair, and CEO of Green House adopter Jewish Home Lifecare, addressed the conference and boldly challenged the group to meet and exceed the goals of Health Care Reform through accountability and engagement. Green House adopters are leading the charge of innovation, with a commitment to person centered care, workplace excellence, and clinical outcomes. Steve McAlilly, CEO of Methodist Senior Services of Mississippi, and the first Green House project in the nation, was awarded the highest award that Leading Age gives its members, The Award of Honor. Steve embodies the LeadingAge promise, to “Inspire. Serve. Advocate.” Tabitha Health Care Service, was honored for Excellence in the Workplace, and their commitment to service and leadership in building a better world for the aged.

The Green House Project is proud to be associated with these diverse leaders for their creativity and dedication to quality of person-centered care and join Ms. Weiner’s charge to create homes that meet the triple aim of health care reform: better health, better healthcare and better value. The educational session, The Green House Project: Transforming Skilled Nursing Care, created a space to partner with St. Martin’s in the Pines CEO, Terry Rogers, and share how this model creates real home and meaningful lives. The newest development, The Green House Business Case, presents how this model impacts lives as well as the bottom line of the organization.

The Leading Age meeting was a time to celebrate the hard work and accomplishments of the non-profit sector of long term care. The national Green House Project was gratified by the recognition of Green House organizations for their excellence and thought leadership. The success of the national initiative is bolstered by the success of individual organizations, whose pioneering spirit enables everyone to grow.

The Green House Residences at Stadium Place–A nostalgic spot for long-time Baltimore residents

Via McKnights

As the World Series is getting underway you may not be aware that the new Green House homes in Baltimore have a special connection to both baseball and football! 

Read more about this special project and how the YMCA built new baseball playing fields directly on top of where the old playing field was located AND how Elders at their dining table overlook home plate!

Tabitha Health Systems Honored by Leading Age for Excellence in the Workplace

Tabitha Health Care Services is honored to announce it was recently named the recipient of a national award from LeadingAge, one of the country’s foremost elder issues advocacy groups.

Among an elite list of distinguished winners from across the U.S., Tabitha was recognized for its innovative LIVE to Succeed company culture with LeadingAge’s 2012 Excellence in the Workplace Award.

“We’re humbled and grateful to again be named among the nation’s best Elder care service providers,” said Christie Hinrichs, Tabitha president and CEO. “Outstanding care for Elders begins with outstanding compassion, commitment and training, and we work to enhance those qualities in our Tabitha team each and every day.”

LIVE to Succeed, born in 2006 and spearheaded by then-COO Hinrichs, has transformed the organization with four simple, employee-focused objectives:

  • Love your job
  • Invite optimism
  • Vision success
  • Embrace the mission

Through ongoing employee education, appreciation events and other incentives designed to make Tabitha a great place to work, the organization commits substantial time and financial resources to support its culture, an investment that has paid off in the form of significantly lower employee turnover than the industry average, excellent regulatory rankings and, most importantly, Tabitha’s consistently positive clinical outcomes and family satisfaction feedback.

 

A longtime regional leader in Elder care, Tabitha offers the state’s only complete continuum of services to support aging individuals at every stage of the journey. As just the latest in a growing list of industry recognition, Tabitha’s most recent award supports the measurable success of the organization’s Christian-based mission, innovative approach and definitive status as the answer for Elder care in southeast Nebraska.

As a nonprofit organization serving 28 Nebraska counties, Tabitha’s love embraces a society where everyone is valued and empowered to live life to the fullest, with compassionate at-home support, innovative living communities, exceptional rehabilitation, health care and hospice services.

1st Green House CEO, Steve Mcalilly, wins 2012 LeadingAge Award of Honor

The winners of the 2012 LeadingAge Awards embody the LeadingAge promise, to “Inspire. Serve. Advocate.” As a pioneer of culture change, and innovative care for elders, Steve McAlilly is an extremely deserving recipient. The Green House Project joins Leading Age in honoring this extraordinary leader, who has changed the landscape of skilled nursing care. Click here to read the full article.

Elders Rule: Really

It is not a story until it is told.

Each elder is rich in life stories just waiting to be heard.  Three elders from Porter Hills Green House homes came and shared their stories at the 5th Annual Green House Meeting and Celebration in early September at the Amway Grand in Grand Rapids, MI.  Elders, Ota Champaign, Betty Hechman, and Shirley Farley agreed to talk about their current lives in the homes.  And I hoped to hear the rich nuances of Green House life.  Indeed they shared the joys of reading books in real privacy in their own bedroom.  And knowing staff and other elders deeply and with real affection is a meaningful part of each day.  Ota spends almost unlimited time in the garden,  right now getting the garden ready for winter…

But almost immediately the conversation moved to the stories of their lives, to the experiences  and adventures of lives well lived.  Educators all, memories of teaching Macbeth to high school students in Detroit,  traveling across the country and finding teaching positions to support deep wanderlust,  or working in post-war Tokyo for General MacArthur were the adventures of these women’s lives.   I am honored they agreed to share their journeys with all of us.

Thank you Ota Champaign, Betty Hechman and Shirley Farley!


Video streaming by Ustream

Highlighting THE GREEN HOUSE® Project Team: Emily Duda, Project Associate

Emily is one of 24 grandchildren, yet she has a special bond with her grandparents…especially her grandfather, who at 90 was still downhill skiing. At a young age, Emily’s grandfather demonstrated the potential for growth and meaning in late life. She fondly remembers when she and her cousins were all on the escalator going up a floor and she looked over only to see her grandfather taking the steps!  They quickly reversed course down the escalator, and learned by Grandpa’s example!

Emily believes her positive experience with influential Elders is one of the reasons she pursued her undergraduate degree in Human Development and graduate certificate in Gerontology at Virginia Tech.  Although the aging studies track wasn’t too popular among her peers, Emily felt she “discovered the most rewarding path” when she began working with Elders at the university’s unique, on-campus Adult Day Services program.

Supportive leaders and encouraging mentors played another critical role in supporting her exploration of gerontology.  Dr. Shannon Jarrott was one mentor who provided Emily with opportunities to develop her innate passion for older adults and to identify ways in which we improve the way we approach aging services. With Dr. Jarrott’s leadership, Emily studied abroad in Sweden in 2008, focusing on the role of elders and seeing firsthand the cultural, political, and economic impact on aging services. Emily also supported meaningful engagement between older adults and children with the Neighbors Growing Together Community Building Project. Over a three year period, she helped to develop an intergenerational observation scale for program evaluation and co-facilitated workshops on person-centered programming.

In addition to sharpened skills in program development and evaluation, Emily also developed strong relationships with Elders and a more holistic perspective of eldercare. These experiences ultimately brought her to explore person-centered care, and more specifically THE GREEN HOUSE® model.  As a Project Associate, Emily works with the Project Management team to teach and assist adopters in the development of their Green House homes.

  • 6 years in aging services
  • B.S. Human Development, Graduate Certificate in Gerontology, Virginia Tech
  • Research Assistant, Virginia Tech Adult Day Services/Human Development Department
  • Trained Eden Associate
  • National Honor Society for Human Services-Member

Emily thoroughly enjoys spending time with family, friends, and Chase, her Australian Shepherd.  Part of that time is spent running, cooking or crafting—although over the past two years a significant amount of that time has been spent with 12 weddings!!   Emily was the president and a member of Sensations, an all-female a cappella group at Virginia Tech.  She comes from a strong musical family and enjoys when she, her siblings and parents gather it’s often time to enjoy concerts or make music of their own!

Surplus Safety: A Symposium To Redefine Risk

Drs. Judah Ronch, Dean of the Erickson School of Aging, and Dr. William Thomas, founder of the Eden Alternative and Green House Project, have coined a new term and developed a new concept called surplus safety. Instead of risk meaning the possibility that only something bad might happen, they teach that the real definition of risk is the possibility of an unanticipated outcome. They further explain that there are two kinds of risk, upside and downside. Downside risk is an outcome that is worse than expected and upside risk is an outcome that is better than expected. They point out that our obsession with downside risk unfortunately leads to the taking away of any chance of upside risk for those living in long term care environments and that we prevent outcomes better than expected (upside risk) because we our obsessed with minimizing the risk of a worse outcome. Dr. Thomas as a physician and Dr. Ronch as a psychologist point out that no other part of the human life cycle allows this removal of upside risk. For instance, we do not restrain toddlers as they try to learn to walk because they might fall. Not too many people talk about our development and growth at an older age but thankfully they do. Each advocate that our human development includes a balance of both upside risk and down side risk.
The current landscape of safety where the current conception of risk includes only downside risk – in which harm may come to elders if they attempt certain activities such as getting out of bed – has resulted in very restrictive policies and practices, such as bed and chair alarms. Many safety measures, such as alarms, are designed with only downside risk management in mind i.e. preventing falls. However, the upside risk of preserving one’s ability to continue walking and to keep their balance and strength are not evaluated. Nor is the other downside risk of losing these abilities talked about. Nor is the quality of life considered according to the person of being immobilized by an alarm or agitated or isolated. Therefore, there is a strong need to look at upside risk management in addition to the traditional focus of managing downside risk.

Thus the first-ever Surplus Safety Symposium was held on September 12 – 13, 2012 in Baltimore, MD. Many thanks to the Hulda B. and Maurice L. Rothschild Foundation for funding and to the Erickson School for hosting this event.
Approximately 50 stakeholders from a diverse group of constituencies discussed the current state of the safety landscape. Experts addressed the areas of: Policy as Written and Interpreted; Risk Assessment Methodologies; Case Law; Management and Workforce Conditions; and Resident Perspective presenting key issues and identifying levers of change. Workgroups then recommended ways to implement a strategy to change how risk is perceived, understood, managed and regulated.

The goals for the two-day symposium were to:
1. Identify strategies to promote a full evaluation of risk vs. potential outcomes in long term care.
2. Reframe the current concept of safety to better balance both upside and downside risk potential.
3. Identify codes and standards which should be addressed in order to better balance upside and downside risk.
4. Identify stakeholder groups to enlist in seeking necessary code and standard changes.

Some ideas collected (not consensus) were the following:

• Consider using probability instead of potential for harm in the CMS scope and severity grid; gather the research to back the use of probability of harm instead of potential which can be anything.
• Consider adding to every regulation “if the resident desires” or “according to the resident;” for example, Tag F363 Menus be followed if the resident desires.
• Discontinue making policies for the 1%, make the policies for the 99%. Broad global policies limit life for the 99%, individualize polices by stating that individual care plans will be adapted for each person in relationship to risk, safety, etc.
• Copy the CMS survey process for homecare where whatever provider has done is recognized and considered into survey findings.
• Incentivize like Colorado P4P bonus reimbursement and Ohio Medicaid Reimbursement where homes must implement a subset of person-directed practices in order to receive full reimbursement.
• Include each person’s goals for themselves and their perspective on risk. This should be individualized based on how much risk they want/can tolerate. Kind of like investing in 401K plans, some of us prefer low risk, others moderate or high risk. Risk needs to be determined by the Elder primarily, and not by surveyors, corporate leaders or other professionals who assign this determination based upon what they think is best for all parties involved.
• Concept of safety is one dimensional regarding the body. Need to add mind/spirit, psychosocial.
• Immediate Jeopardy includes potential for harm which is so very easy to cite, easier to cite IJ than a G. This needs to change because it has the greatest sanction associated with it – possibly move potential for harm somewhere lower down on the grid.
• Equitable attention to all relevant regulations; treat all requirements the same. Preventing accidents is just as important as resident has the right to refuse medical treatment or right to choice.
• Eliminate FOSS/federal surveys as they are over burdensome and do not result in better care for residents; redirect those resources to training of how culture change practices embody intent of OBRA ’87 Nursing Home Reform Law and current regulations.
• Explore legal strategies to promote resident choice and consistent enforcement of all regulations.
• Recognition that accidents happen – differentiate between accident and neglect/systems failure.
• Reconsider the current metrics for success and incentives: do we incentivize surplus safety or highest practicable physical, mental and psychosocial well-being?
• Research the benefits to upside risk.

As you can see, many good ideas on how to eliminate surplus safety were collected. According to Rob Mayer of the Hulda B. and Maurice L. Rothschild Foundation, this is just the start. Be on the alert for more to come. In the meanwhile, do whatever you can to promote the balance in every person’s life of both upside and downside risk. Better yet, do all you can to promote that the person continues to be the boss of their life. Promote this daily with persons you serve. Call for meetings with your survey agency that is to serve the persons living in nursing homes and assisted livings in your state. Lean on your state culture change coalition to bring up these issues in already-established stakeholder meetings. Don’t wait for someone else to do something. See what you can make happen. Go get famous. Eden has a great motto: “It’s Time.” Actually, it’s past time. We all want better.

Carmen Bowman, Regulator turned Educator, owner Edu-Catering: Catering Education for Compliance and Culture Change and Facilitator of the 2012 Surplus Safety Symposium

The Green House Project to present and exhibit at The LeadingAge Annual Meeting in Denver

The Green House Project offers a model for long-term care
designed to look and feel like a real home. Green House
homes are seen as a national leader and proven business
model for long-term care. Today there are hundreds of
Green House homes open or in development in the majority
of states.

Our evidence-based model has been proven — through
independent research — to be effective, feasible and
sustainable. Our technical assistance is a big reason why
The Green House Project has become a preferred partner
in helping organizations meet demands of the changing long-term care market.

Connect with Us at the Leading Age Conference:

  • Pick up a free copy of our Business Case at our booth (2118)
  • Join our Session, “The Green House ® Model” Transforming Skilled Care, on Wednesday, October 24 @ 2:30-4:00p
  • Talk to us about how you can bring The Green House model to your community

Green House project, Leonard Florence Center for Living, honored by McKnight's Long Term News

Leonard Florence Center for Living in Chelsea, Mass., is a prime example of the revolutionary potential of The Green House model. Leonard Florence Center for living includes homes that employ advanced assistive technology to allow individuals immobilized by ALS (Lou Gehrig’s disease) and multiple sclerosis, to live more independently. Their innovations were recently honored by McKnight’s technology award, “Boston’s Chelsea Jewish Foundation won the top prize in the High Tech/High Touch category of McKnight’s Excellence in Technology Awards — Connect Our World.”

Congratulations to Leonard Florence Center for Living for this honor and thank you to McKnight’s Long Term Care News, for recognizing the power of The Green House model to create high touch, high tech environments that result in meaningful lives and excellent outcomes. click here to read the full article