Green House Blog

Data Collection for THRIVE Projects is Now Complete

The Green House Project has partnered with the Robert Wood Johnson Foundation’s THRIVE (The Research Initiative Valuing Eldercare) collaborative to learn more about the Green House model as well as other models of care. Supported by the Robert Wood Johnson Foundation, the THRIVE team is conducting a series of interrelated research projects that together will comprise the largest research effort undertaken to date in Green House homes. Each quarter, a member of the THRIVE team will contribute a blog post to the Green House Project website.

Data collection for the THRIVE projects is now complete, and the research team is analyzing the results.  The THRIVE team will share research findings in upcoming articles in a special issue of the journal Health Services Research, and through conference and webinar presentations and blog posts.  In 2014, conference presentations will include those at annual meetings of LeadingAge (October), and the Gerontological Society of America, and the Green House (both in November).  This blog post is part of our series devoted to explaining research terms so that non-researchers can better understand these articles, presentations, and posts.  This post focuses on quantitative research – research based in numbers – and explains the important topic of “significance.”

Quantitative research findings are often discussed in terms of their statistical significance.  What does it mean to say a finding is significant?

Let’s consider an example.   A researcher thinks that there may be more female than male elders living in Green House homes.  This hunch is called a hypothesis.  The researcher visits all the Green House homes in the state, tallies the numbers of females (85) and males (15) and performs a statistical test to compare males and females.  The statistical test will result in a p-value (probability value) expressing whether the difference is large enough to indicate that it isn’t just by chance.

 

To better understand what it means to have a “large enough” difference, think of it this way:  if the number of females was 52, and the number of males was 48, the difference between these numbers is pretty small, and it’s not likely statistically significant.  The question is, is the difference between 85 and 15 large enough to suggest that there are statistically more females than males living in Green House homes?  A difference of 85 to 15 is probably large enough to not be by chance (i.e., it is statistically significant), whereas a difference of 52 to 48 is so small that it quite likely occurred by chance.

It’s also important to realize that findings that are statistically significant may not be clinically significant.  Clinical significance means that the information is important for clinical care.  In terms of care, does it matter that there are more females than males residing in Green House homes?  It does matter, for example, if women tend to be more depressed than men, or to have more family members.  However, if there are no clinical implications related to the difference, than they are statistically, but not clinically, significant.

The bottom line is that it’s important to carefully consider the meaning of all findings, and use your knowledge and judgment to interpret when differences matter and when they don’t.

Stay tuned for the next THRIVE blog post.  In the meantime, if you have questions about this post, or suggestions for future ones, please let us know.

Questions about THRIVE can be directed to Lauren Cohen (lauren_cohen@unc.edu or 919-843-8874).

Alive Inside, MUSIC & MEMORY℠ and the GREEN HOUSE® Project

The film Alive Inside, which documents “music’s capacity to reawaken our souls and uncover the deepest parts of our humanity,” is now available on Netflix. It is a touching documentary that “follows social worker Dan Cohen, founder of the nonprofit organization Music & Memory, as he fights against a broken healthcare system to demonstrate music’s ability to combat memory loss and restore a deep sense of self to those suffering from it.” Alive Inside was featured on Dr. Bill Thomas’ Second Wind Tour, which also included guest presenters, Susan Frazier and David Farrell of THE GREEN HOUSE® Project.

Alive Inside inspired the Music and Memory Program. MUSIC & MEMORY℠ “is a non-profit organization that brings personalized music into the lives of the elderly or infirm through digital music technology, vastly improving quality of life.” Their purpose is to “train nursing home staff and other elder care professionals, as well as family caregivers, how to create and provide personalized playlists using iPods and related digital audio systems that enable those struggling with Alzheimer’s, dementia and other cognitive and physical challenges to reconnect with the world through music-triggered memories.” The results are stunning and  powerful.

The Wisconsin Music and Memory Program is a state-wide program “designed to bring personalized music to individuals diagnosed with Alzheimer’s disease and other related dementias.” So far, 100 nursing homes have been certified as MUSIC & MEMORY℠ facilities, funded through the Wisconsin Department of Health Services. The Green House home, Lutheran Homes of Oshkosh, was accepted to become a certified MUSIC & MEMORY℠ facility. This program requires “nursing home staff to attend a series of three 90-minute webinars, taught by MUSIC & MEMORY℠ founding Executive Director, Dan Cohen, MSW.”

The Music and Memory Program is changing the way people with dementia are cared for, by unlocking words, memories and thoughts that can’t always be accessed in an institutional setting. Here at the GREEN HOUSE® Project, we are excited about the change in care that this program can bring, and we look forward to seeing MUSIC & MEMORY℠ in every state.

Grand Opening Celebration Takes Place for Colorado’s First Green House Homes – A Story of Partnership and Vision

The beautiful Rocky Mountains provide a wonderful view for Elders that will live in The Green House Homes at Mirasol in Loveland, Colorado.  That view will only be matched by the person-directed living they will experience in this innovative model of skilled nursing care.  Built on the campus of the Mirasol Senior Living Community, there will be six homes with each including: ten private bedrooms and bath, open kitchen, a hearth area along with a variety of other open spaces that will embrace socializing and the ability to live life in a meaningful way.

Sam Betters, Executive Director of the Loveland Housing Authority, said,

From my own personal experience of trying to provide the best care for my parents, I discovered that aging in America presents many challenges.  I knew that there had to be a better option than the traditional institutional models for elder care.  There is.  It’s called The Green House Project.  As we began our vision-quest, we didn’t know how we were going to make this happen.  We just knew it had to be done.

Senior Director for The Green House Project, David Farrell, was on hand for the festivities on October 21st along with a number of other state and local leaders in Colorado.

David said, “These homes will help the Loveland Housing Authority meet a gap in its continuum of care-skilled nursing and allow Mirasol residents to remain a part of their existing community, deriving the benefits of receiving a higher level of care while still living independent and social lives.”

The Green House Project is part of Capital Impact Partners, a certified community development financial institution, which led the financing for this $17 million dollar project.

As a mission driven lender, this project fits well into our larger strategy to build strong, vibrant communities of opportunity for underserved populations. We are not only proud to help bring the Green House model to Colorado, but also the fact that a large percentage of the residents are Medicaid eligible,

said Terry Simonette, CEO of Capital Impact Partners. “It took a number of partners, and use of innovative tools like New Market Tax Credits to make this happen.”

Funding for the project included:  $2 million dollar grant from The Harry and Jeanette Weinberg Foundation, program related investments from the AARP Foundation and the Robert Wood Johnson Foundation, $2.5 million New Market Tax Credits, $3.4 million in tax credit equity from JPMorgan Chase plus a land donation by the Loveland Housing Authority.

We congratulate all who helped in the process of making these homes possible…and welcome everyone to the Green House family!

Click here to read more about this project and why leaders from The Harry and Jeanette Weinberg Foundation and the AARP Foundation were most pleased to make this development a reality!

The Green House Homes at Legacy Village Win Celebrate Arkansas Magazine Award

Congratulations to The Green House Homes at Legacy Village! Celebrate Arkansas Magazine has announced Legacy Village as their winner for “Very BEST Award for Retirement Living.”  This reader’s choice award speaks to the consumer driven demand for quality long term care that offers a real home to elders.  We are so proud to see Legacy Village recognized for the way they are changing elder living for the better, with real home, meaningful life and empowered staff.  You can look for the article announcing The Green House Homes at Legacy Village as the winner of the “Very BEST Award for Retirement Living” in the December issue of Celebrate Arkansas Magazine.

White House Conference on Aging in 2015

2015 marks the 50th anniversary of Medicare, Medicaid, and the Older Americans Act, as well as the 80th anniversary of Social Security. The 2015 White House Conference on Aging (WHCOA) is an opportunity to recognize the importance of these key programs as well as to look ahead to the issues that will help shape the landscape for older Americans for the next decade.  Four major areas of focus are:

Retirement security is a vitally important issue. Financial security in retirement provides essential peace of mind for older Americans, but requires attention during our working lives to ensure that we are well prepared for retirement.

Healthy aging will be all the more important as baby boomers age. As medical advances progress, the opportunities for older Americans to maintain their health and vitality should progress as well and community supports, including housing, are important tools to promote this vitality.

Long-term services and supports remain a priority. Older Americans overwhelmingly prefer to remain independent in the community as they age. They need supports to do so, including a caregiving network and well-supported workforce.

Elder justice is important given that seniors, particularly the oldest older Americans, can be vulnerable to financial exploitation, abuse, and neglect. The Elder Justice Act was enacted as part of the Affordable Care Act, and we need to realize its vision of protecting seniors from scam artists and others seeking to take advantage of them.

Recently, Green House Project, Chief Operating Officer, Susan Frazier, met with WHCOA Executive Director, Nora Super, and Communications Director, Michele Patrick.  During this meeting, they talked about how The Green House model highlights so many of the key areas addressed in the conference objectives, especially, Healthy Aging and Long-term services and supports.  The Green House Project plans to be visible and involved in all of the activities surrounding WHCOA, and will amplify the voice of the elders and staff who are living this innovative model every day.

The Green House Project is an innovative model of skilled nursing care that offers high quality care and saves Medicare and Medicaid dollars. In an era of budget deficits and a growing aging population, our country needs to identify effective models that can save money and yet offer choice, quality and independence to our nation’s seniors. After viewing this short video you will have a sense of the model and how it differs from large, traditional, institutional-style nursing homes. In his recent book, Being Mortal, Dr. Atul Gawande examines the loneliness, helplessness and boredom so often experienced by those living out the end of their lives in long-term care institutions and he argues that this should not be the norm in our country. He writes that Green House homes are “…designed to pursue that idea that a life worth living can be created…by focusing on food, homemaking, and befriending others.”

Nora Super and her team have been invited to visit Green House homes as they travel the country and learn more about the issues that are important to various consumers, policy makers and stakeholders.  To learn more about the local, state, regional and policy events as well as other ways to be involved, visit http://whitehouseconferenceonaging.gov/

A Special Day in New Jersey: Six Green House Homes to be Developed

There was a special kickoff celebration October 14th to highlight the construction of six Green House homes in Lawrenceville, New Jersey.

Darlene Hanley, CEO for the St. Lawrence Rehabilitation Center and Morris Hall (Assisted Living and Skilled Nursing) welcomed local officials and members of the press to review the development plans for the organization.

Susan Frazier, The Green House Project COO, was a featured speaker at the event.  Work is already underway at the site, which will be called Morris Hall Meadows.  The first homes are expected to open late spring 2015.

Welcome to the Green House family and congratulations to all!

Join us at the Leading Age Annual Meeting and Expo

We hope you join us in Nashville at the Leading Age Annual Meeting and Expo October 19-22. The meeting “connects thousands of aging services professionals who are facing the same triumphs and challenges that you face every day.”

Come see us at booth 2331 where you will have a chance to win Atul Gawanded’s new book, Being Mortal, which highlights The Green House model as a place to live a meaningful life. Additionally, we are co-guitar-slider.jpghosting the Reception for Person Centered Care Leaders, along with the Eden Alternative, LifeBio, It’s Never 2 Late and Penner Spas. And on Wednesday, October 22, from 1:30pm – 3:00pm you will have a chance to hear us speak in a breakout session called Green House homes: Challenges and Opportunities.

We look forward to seeing you there as we re-define age.

Favorable Time for Financing in Senior Housing Market According to Provider Magazine

Having come through the recession more intact than many other sectors, the environment for development is especially favorable right now for senior housing, according to experts.

In a recent edition of Provider Magazine, Imran Javaid, managing director, healthcare real estate, commercial and specialty finance, Capital One Financial Corp., explains, “A lot of players recognized that [seniors housing] had performed really well in the recession,” says Javaid. “The demographics are positive, but also important is that it held better in the recession than some other classes they’d typically lend to. They really recognized that it is more resilient to recession and downturns because it’s needs-driven.”

Because of the positive performance over the last 5-6 years, there are more financing options, favorable terms and low interest rates available, but experts predict that the current state is time limited, “If you have a plan that five years from now will be absolutely necessary [to implement], do it now,” says Javaid. “Accelerate the timeline, and do it now. Expand or upgrade a facility now, don’t wait for five years from now when you might have a very different environment.”

 

Financing for Green House homes comes in a variety of forms.  In addition to commercial loans, Green House homes have being developed using bonds and government backed loans, as well as non-traditional loans. Through our partnerships with RWJF, AARP Foundation and The Weinberg Foundation, we are able to provide special financing for organizations serving low income elders.  To learn more about financing opportunities, visit The Green House website

Project Update: Occupancy Faster Than Anticipated for First Green House Homes in Minnesota

It’s the kind of issue that all marketing directors are happy to manage—an unexpected “rush” of Elders that want to move in ASAP to your new Green House homes!  Well that is precisely what happened at Water’s Edge in Mankato, Minnesota.

Since the first Elders moved in this past August…there has been a whirlwind of activity to welcome Elders into their new homes and to make sure that all hiring and training is accomplished on time.  In fact, during the first week of opening their first home, they moved in 9 Elders!  “We certainly hadn’t planned it that way,” said Director of Operations, Brooke Olson, “but it’s not a bad problem to have so many Elders want to move in when you first open your doors!”

Water’s Edge is comprised of three assisted living Green House homes, each with 12 private bedrooms.  They are operated by Grace Senior Services.  The owners, Brad and Heather Bass have long been committed to serving Elders in their community.  They opened their first adult day service in their home more than 18 years ago.  They currently have several senior housing cooperatives, and adult foster care program, two assisted living communities and now the new Green House homes at Water’s Edge.

The second home is nearly full, so training and hiring will begin for the third home very shortly.  The plan for Water’s Edge had always included a position for Marketing and Elder Enrichment, but they were not going to fill it until much later.  However, with the pace of occupancy, they decided that the role was going to be needed much sooner.  In September, they welcomed Rachel Carpenter to their team.

We congratulate Water’s Edge on their success and wish them only the best moving forward!

7th Annual Green House Conference in November – A Time to Connect

At The Green House Annual Meeting, organizations gain strength from each other around implementing and sustaining this model.  Connecting to share lessons learned and best practices of this paradigm shift in Long Term Care is one of the most valuable parts of being a trademarked Green House home.

This year’s conference for Green House adopters will take place November 17-19, at the historic Peabody Memphis Hotel in Memphis, Tennessee. Our theme, Leading with Heart and Soul, is ideal for this magnificent mecca where musical legends combined soul with talent and passion to become the pioneers for American musical genres…much like The Green House Project has pioneered the transformation of long-term care.

 

TIME FOR A ROAD TRIP!

The Green House Annual Meeting & Celebration can be a wonderful time for a road trip!  That’s right…why not drive to the conference and miss all the hassle of flying these days?  Well, that is exactly the decision that was made by team members last year from the Green House Homes at Willow Ridge in Blufton, Ohio.

 

Their new Guide, Barb Lawrence, shared the following memories from the trip:

Last year, four Shahbazim (Paula, Tammy, Terry, and I), one nurse (Coral), the Guide (Rhonda), and the Fund Development person (Doug) rented a van and drove to Boston for the Green House Annual Conference.

Paula and Terry were from one team, and Tammy and I were from the other team at Willow Ridge.  The 14-hour van ride allowed for much bonding opportunity.  We shared about our personal lives as well as our experiences thus far working in the Green House homes.  We played trivia games that we found on our phones, we enjoyed the beautiful landscapes of Ohio, Pennsylvania, New York, and Massachusetts, and enjoyed one another’s company.  We texted folks back home (we’re not there yet!), we listened to music, and some read books.

Mid-way through the trip, Doug said, “Do you want the good news or the bad news first?  The good news is that we are half-way to Boston!  The bad news is that we are ONLY half way to Boston!”

Once we got to Boston, Doug and Rhonda had to find a parking garage that would be tall enough to fit our 12-passenger van.  Boston buildings are small!

Leaving Boston was equally as challenging.  Since we left in the middle of the night (3:00 AM), many of the exits off of the highway were closed, and there were very few signs giving direction – it took over 45 minutes just to get out of the city!

The team is again taking a road trip to this years conference in Memphis and Barb is quick to point out that “it’s only half the distance to Boston!”

 

Long Term Care Community Coalition Reception Honors Mary Jane Koren

The Green House Project is proud to help support the Long Term Care Community Coalition’s Sixth Annual Reception celebrating the life and work of Mary Jane Koren, M.D., M.P.H. at the Alzheimer’s Association chapter in New York City.

The Coalition is honoring Dr. Koren at a reception on October 22nd for her dedication and passion for improving the lives of seniors in her work and research. Some of her accomplishments include her work as Vice President for LTC Quality Improvement at The Commonwealth Fund and her position as past chair of Advancing Excellence: Long-Term Care Collaborative.

We are excited to celebrate Dr. Koren’s accomplishments and support the Coalition’s mission to improve care, quality of life and dignity for elders and the disabled.

Louis "Lou" DeLucia — a very special Elder who inspired so many

Saying goodbye is never easy.  Saying goodbye to a particularly adventurous soul – one who embodied so much of our vision to lead and inspire a shift in society’s views of elderhood –- is especially difficult.  Louis “Lou” DeLucia was a friend, a wise elder, an independent spirit, an advocate, and a shining example of what is unique and beautiful about the Green House model of skilled nursing care.

Lou challenged staff and fellow residents to “think outside the box.”  Earlier this year, he came to the table at one of St. John’s community-based Green House homes in Penfield, NY and said, “We should get a dog.”  Lou had the insight to see how this pet could enhance their quality of life.  Alexandra, or Lexi, as she’s called, moved in on June 24, and has become a cherished companion. Says elder Dorothy Carcelli, first-time dog owner at age 89, “She (Lexi) brings a lot of joy to everybody.”

Lou insisted on going outside every day, even throughout the winter.  We worried for him, but he wouldn’t have it any other way.  He made friends throughout the adjacent Arbor Ridge community and when they hosted their holiday party, Lou was the elder they invited. After his passing on August 12, they came together to give a gift in his honor.  They wrote, “Lou was a good neighbor and friend, and quite a character as well!  We in Arbor Ridge will miss his presence and remember him fondly.” This gesture is evidence of the community connections and relationships Lou formed because he had the opportunity to be a part of something beyond the traditional nursing home and took advantage of it each and every day.

Lou reminds us to keep celebrating and keep seeking these non-traditional approaches to meaningful days for our elders.

He has left a valuable legacy.