Green House Blog

Green House homes in Florida are Supporting Elders to Live their Best Life

Anne Ellett is a certified Nurse Practitioner (NP) with more than 20 years of experience in elder living and memory care, and served as Sr. Vice President with Silverado Senior Living, an award-winning Assisted Living company specializing in dementia care.  Currently, Anne is owner/CEO of Memory Care Support, LLC, a consulting agency working with senior housing professionals as they develop state-of-the-art health and wellness and memory care programs.

The Green House Project recognizes that providing a life affirming, dignified environment for elders living with dementia (ELWD) is imperative, especially given that over 80% of people living in long term care have some form of cognitive change.   Supporting these elders to thrive is a multifaceted process, and involves culture change.  Best Life is a new initiative, designed to support Green House teams, by building on the core values of Real Home, Meaningful Life and Empowered Staff, and providing enhanced education that focus on principles such as:

  • Power of Normal – normalizing programs and environments
  • Integration with greater community
  • Celebrating retained abilities
  • Dignity of Risk
  • Age-appropriate interactions
  • Elder-directed, relationship-rich living
  • Advocacy

 I had the pleasure of delivering this guided process of implementation at The Woodlands at John Knox Village (JKV) in Pompano Beach, Fl.  JKV is a wonderful location incorporating independent living, assisted living, a nursing community and 12 Green House homes onto one campus!  Their 12 homes have barely been open a few months but the leadership at JKV has the desire to strive for excellence in helping those with dementia thrive.  Educator, Dolores Hughes said, “We feel equipped with tools to implement immediately, and also challenged to see people living with dementia in a new way. Best Life is an eye-opening experience.”

BEST LIFE supports elders living with dementia (ELWD) to have choice and dignity, while living in the least restrictive environment possible.  Often, restrictions are due to our own perceptions of the capabilities and interests of ELWD.  Typically, we are trained to see the diagnosis first rather than the whole person, which can limit the experiences and choices we offer to the ELWD.  For example, as a nurse, I was trained to label “patients” by their diagnosis, i.e., the hip fracture in Room ###, or the patient with Alzheimer’s in Room ##.

When we use labels to identify someone, that prevents us from seeing the whole person and instead we focus on their loss of abilities,   “they’re not able to ______ (fill in the blank) because they are living with dementia, they would not be interested in doing ______ (fill in the blank) because they are living with dementia.”  In BEST LIFE, we learn to look beyond losses and inabilities toward retained capabilities and emerging talents.

As professionals, it’s important to examine our own training in the traditional model which emphasizes the diagnosis rather than the person.  Are we limiting the experiences we offer to ELWD?  For example, are we restricting them, perhaps from our own bias and belief that we need to segregate ELWD for their own safety?  New research shows that there is value in offering ELWD frequent experiences with the larger community and with younger generations.

BEST LIFE has three areas of focus: Culture, Meaningful Engagements, and Health and Well-being.  An entire day is devoted to each of these topics, looking both at our own biases and misperceptions of ELWD, and also examining new research from around the globe on new techniques that are beneficial and increase choice and dignity for ELWD.

During the BEST LIFE workshop at JKV, one of the most poignant experiences was when the participants shared what they would want the shahbazim to know about them if they were living with dementia.  Aside from details such as their favorite foods or activities, the participants overwhelmingly requested that they be enabled to continue to have fun and laughter, and opportunities to try new things, and also to continue to contribute and “give back”.

There are already stories of elders connecting with life in new ways, as a result of this new focus on retained abilities and strengths. There is an elder in The Woodlands who plays dominoes every day after lunch and loves to teach anyone else, and an individual who recovering in short term rehab and plays his harmonica.  Knowing him is a priority,  and his full personality shines!    There is a new garden growing in another one of the homes—it is amazing how nature, growth and learning enhances well-being for everyone.

 

 

 

GREEN HOUSE® PROJECT CONTINUES TO LEAD LONG-TERM CARE TRANSFORMATION WITH NEW $650,000 ROBERT WOOD JOHNSON FOUNDATION GRANT

 

 

For more information, contact:  Susan Ryan
sryan@thegreenhouseproject.org or 703.615.2359

 

 

GREEN HOUSE® PROJECT CONTINUES TO LEAD LONG-TERM CARE TRANSFORMATION WITH NEW $650,000 ROBERT WOOD JOHNSON FOUNDATION GRANT

BALTIMORE, MDThe Green House® Project has received a two-year, $650,000 grant from the Robert Wood Johnson Foundation (RWJF) to fulfill its mission of redefining—and humanizing—long-term care in the United States.

The Green House Project aims to end the institutionalization of older adults in America. Under this vision, all elders will have the opportunity to live in small, welcoming homes with dignity, autonomy, choice, and the best quality of life possible, while receiving the care they need.

The new RWJF grant will enable Green House Project leaders at the nonprofit Center for Innovation, which recently acquired the Green House trademark and intellectual property, to continue spearheading this movement. They will work with the leading Green House adopters to further refine the model while spreading it across the country.

Additionally, the national initiative plans to expand the impact of the Green House model through a specialized focus on people living with dementia, people in need of short-term rehabilitation services, and other areas of innovation. The Green House Project, the pioneer of the small house model, offers proven clinical and financial outcomes through a comprehensive cultural transformation across the entire organizational system.

“The Green House Project is a dynamic model that continues to evolve as an agile leader in the field,” said Scott Townsley, president of the Center for Innovation. “The success of the Green House Project has catalyzed a community of thought leaders who are discovering new ways to improve the lives of elders. We’re excited to work in partnership with them to change the way people age.”

The Center for Innovation, where the Green House Project is based, was founded by three members of the faculty at The Erickson School, University of Maryland Baltimore County. The Erickson School is the only program in the country offering both undergraduate and graduate degrees in the management of aging services.

The Green House Project launched more than a dozen years ago with the shared vision of its founder, William Thomas, M.D., and RWJF, for transforming long-term care. Today, 231 Green House homes are open and operating, serving elders in 32 states across the country, and another 150 are in the works.

“We owe a debt of gratitude to Dr. Thomas for his role in helping to get the Green House Project to where it is today,” said Susan Ryan, senior director of The Green House Project.  “We wish him well in his future endeavors to move the field forward.”

The Green House Project has a solid evidence base. Supported by RWJF, the THRIVE Research Collaborative conducted a comprehensive and rigorous evaluation of the Green House model.  A team of leading health care and long-term researchers conducted a half-dozen studies that addressed workforce issues, quality of care, cost savings, and culture change.  These studies, all published in the journal Health Services Research, found that:

  • Elders in Green House homes were less likely to be readmitted to the hospital, to be bedridden, to need catheters, or to have pressure sores than those in non-Green House homes.
  • Annual inpatient and skilled nursing facility Medicare costs were significantly lower for elders in Green House homes.
  • Caregiving staff in Green House homes spent more time per day with elders than caregiving staff in non-Green House homes.

“The Green House Project is what people want—for themselves and for their loved ones,” said Nancy Barrand, senior adviser for program development at RWJF.  “We want to ensure that every community has a Green House home and that the Green House Project becomes the standard of quality for all nursing care.”

 To learn more about The Green House Project, visit:  thegreenhouseproject.org

 

 

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Green House Model Fidelity Tool Ensures Sustainability

The Green House (GH) model is a valuable investment of time and resources, and can yield incredible results.  As the only evidence based culture change initiative, it has been proven, and together with Green House adopters around the country, there is a responsibility to protect it.   The Model Enrichment Resource & Integrity Tool (MERIT) was developed in response to insights gained through research.  It is used as a tool to assess model integrity across all Green House homes.

MERIT Assessments

The term MERIT  (Model Enrichment Resource and Integrity Tool) is used to describe the GH model integrity process. However, MERIT is an umbrella term for several GH evaluation and assessment tools.

 MERIT Staff Assessment

  • The MERIT Staff Assessment is designed to evaluate the application of the core values of Real Home, Meaningful Life, and Empowered Staff in Green House homes. The MERIT Staff Assessment launched in 2015 and has been administered to open Green House homes in 2015 and 2016. It is used to measure how model fidelity manifests in practice.

MERIT Organizational Outcomes Assessment (new for 2017)

  • This tool gathers quality outcomes from Green House organizations including key clinical and financial indicators. These clinical and financial benchmarks will provide a valuable comparison to the MERIT Staff Assessment data, and parallels an organization’s data collection through its QI and QM processes.

MERIT Staff Assessment for Legacy Homes (new for 2017)

  • This online tool assesses the application of The Green House core values in a legacy environment. Green House organizations interested in assessing the level of alignment to the core values in their legacy environment and understanding the level of cultural transformation across the organization may contract with GHP for the delivery of the assessment tool. Participation is voluntary. The administration of this assessment tool follows the same process as the GH MERIT Staff Assessment.

More Information

The Green House model is based on three fundamental core values: Meaningful Life, Empowered Staff, and Real Home.  These values play an important role in successfully implementing and sustaining the integrity of the Green House model, as evidenced by:

  • Consistent care delivery and shared goals among Green House adopters
  • The most comprehensive approach to holistic culture change grounded in elder-centered values and essential practices
  • Standards that protect the integrity of The Green House brand and investment of organizations who have committed to the model
  • On-going opportunities for Green House peer support and accountability
  • Impact on a national scale with emphasis on research and growth of the model

The design and administration of the MERIT online assessment and database management process is managed by the Center for Social Research (CSR) at Calvin College in Grand Rapids, Michigan.  CSR conducts social-scientific research on behalf of Calvin faculty and a wide array of local, national, and international organizations.  Each year, the tool evolves and is refined.