Green House Blog

A flexible, diverse vision for eldercare with Jennie Chin Hansen

This week’s podcast episode with Senior Director Susan Ryan featured Jennie Chin Hansen, who has served as the CEO of On Lok, president of AARP, and a stakeholder in California’s Master Plan on Aging.

A happy, peaceful abode

Much of the podcast focused on Chin Hansen’s time as director of On Lok.

On Lok, which loosely translates to “happy, peaceful abode” in English, started out as a community center providing social services to elders in San Francisco’s Chinatown in the 1970s. When Chin Hansen joined in 1980, the organization merged social services with medical services.

In 1984, On Lok received funding from the Robert Wood Johnson Foundation to see if this model – which had nailed the concept of serving the needs of elders without infringing on their autonomy or desire to live in their own homes – could be replicated elsewhere. As Chin Hansen admitted, at the time, the stereotype of On Lok was that it worked only because it served a largely Chinese, tight-knit population. They aimed to upend this conception, and they certainly did: There are currently 250 PACE models based on the On Lok blueprint in 31 states, serving incredibly diverse populations.

An ecosystem, not a transaction

Chin Hansen talks a little about the role of serendipity in paving her path throughout her career. I thought the process of On Lok’s development was a perfect example of what can happen when you choose to seek out opportunity in the face of uncertainty and chance. For example, the eventual merging of social with medical services happened because On Lok took a look around and realized that the needs of elders were not being met with the single-pronged approach that they had started with. Rather than throw in the towel, they chose to rebrand, resulting in an organic merge that has made On Lok the holistic, reliable care model it is today.

Another story Chin Hansen shared was when On Lok ran into a lack of funding when they wanted to build a nursing home. They were forced to build a community without walls, but this flexibility ended up being its strength, especially during COVID-19, when elders that were ill could still be in their homes, surrounded by loved ones.

Having leadership that embodies adaptability, resilience, and flexibility is perhaps what leads On Lok to be what Chin Hansen calls “an ecosystem, not a transaction.”

Chin Hansen’s vision for eldercare

Chin Hansen ends the podcast suggesting that medicine, for all the good it has done, may not be the ultimate solution to our health and wellbeing. We see this in eldercare all the time –when we prescribe anti-psychotics, limit favorite foods if they’re deemed “unhealthy”, time bathroom breaks, and resign elders to tiny clinical rooms in the name of health and safety.

Though this care is often well-intentioned, I resonated with Chin Hansen’s sentiment that it’s the most inexpensive expenditures that lead to wellbeing. In fact, as she further mentions, studies have suggested that clinical medicine accounts for only 15% of our health outcomes. While we still have a while to go in ensuring that all people have access to this 15%, On Lok and the leadership of Jennie Chin Hansen makes me optimistic that around the country, eldercare will start to look less like a pill and more like family, friendship and feelings of home.

An age-friendly vision for America’s capital city: in conversation with Gail Kohn

Gail Kohn was the latest guest on the “Elevate Eldercare” podcast, in conversation with Senior Director Susan Ryan. A powerhouse leader, particularly in pushing for diversity and community, she is the former executive director of Capitol Hill Village and Collington. Now, she leads the Age-Friendly DC initiative, as part of a World Health Organization project to establish a network of cities dedicated to better aging all over the world.

Simple fixes for a more inclusive city

As Kohn describes, the story behind age-friendly cities is an interesting one, involving the popularity of Rio de Janeiro’s Ipanema neighborhood skyrocketing as a residential area for elders after the real-life “Girl from Ipanema” relocated to a high rise there. Dr. Alexandre Kalache noticed that Ipanema was creating a lot of difficulties, particularly for its aging population, and identified several small but impactful fixes the city could make. For one, he noticed that buses would often pass by stops when elders were waiting there, knowing that it would take a while for them to get on the bus. The bus system at the time was touted for being incredibly punctual, leaving bus drivers no leeway to wait for slower customers. So he pushed for a restructuring of the system that put an emphasis on the number of customers a bus could attract – not the exactness of the time in which it arrived and departed. This quick fix made the city far more accessible to elders.

I was struck by the simplicity of this solution, because it raises the question of what other quick, easy, and effective solutions to people’s problems we’re missing simply because we take our circumstances for granted. As someone who is perpetually running late, I would depend heavily on the punctuality of the Ipanema bus system. I’d likely never consider that the very same system may be rendering the city inaccessible to people who can’t get on the bus fast enough. There is incredible power in empathetic leadership – and significant results that can be obtained just by working to better understand the concerns of others.

Age-friendly DC

Kohn then transitioned to talking about her experience leading the Age-Friendly DC initiative, which comes up on its 10-year mark in 2023. As she describes, the initiative is positioned on top of three main pillars – the built environment, changing attitudes about growing older, and lifelong health and security. It was remarkable to hear about how the built environment was approached. One example that Kohn gave was of a block-by-block walk taken by politicians, students, and community members alike. The walk allowed them to identify possible hazards – such as unclear intersections, potholes, and cracks in the sidewalk – that were promptly fixed.

As Kohn mentioned, 95% of surveyed elders want to live and grow old at home, but for many people, that is not a reality. Considering the rapid demographic shift that not only the U.S but the world is going to experience in the next few decades, rethinking how our cities cater to the elderly is not just a unique, interesting pursuit but incredibly crucial to the quality of life for everyone, young and old.

On discrimination and diversity

There was comment of Kohn’s, attributed to Susan Donnelly of LeadingAge, that particularly stuck with me:We’re discriminating against our older selves when we dislike older people.

This is why I think Age-Friendly DC, and the network of cities under the WHO, is so powerful. Fixing cracks or potholes in a sidewalk helps those of us that are already nearing older age, but those changes will still be around as the rest of us grow older and require more thoughtful design of our communities. Moreover, potholes and cracks don’t just pose a problem to elders – fixing them would help young parents pushing strollers, or people riding a skateboard.

One of my favorite quotes, from Paul Hunt in A Critical Condition, says “The quality of the relationship the community has with its least fortunate members is a measure of its own health.” As a leader, I think Kohn embodies this sentiment remarkably. Whether it was pushing for diversity and neighbor-to-neighbor relationships with Capitol Hill Village, Collington or now Age-Friendly DC, Kohn proves that as a society, we can be committed to lifting everyone up – we just need leaders courageous enough to push for it.

Green House in Wyoming: A Story of Firsts

In 2007, Doug Osborn and Charles Scott of the Wyoming legislature brought a bill up for consideration. The bill would authorize three pilot projects, in three different communities in Wyoming, to study alternative elderly care homes. 

The passage of the bill was a catalyst for radical change in eldercare in Wyoming. Prior to this bill, Osborn and others had traveled to Tupelo MS to study the Green House model of care. They decided to bring it back to the community of Sheridan. 

Two cottages finished construction at the end of 2011, while two more finished in early 2012. The four cottages at Green House Living for Sheridan opened to residents on January 31 of 2012.

But what is truly remarkable about Green House Living for Sheridan is that it was built not by an established religious organization or nursing home company. Instead, it was conceptualized, funded, and constructed from the ground up by the individuals living in Sheridan. 

When it was built, Sheridan held the audacious title of being the only grassroots Green House community in the nation. 

The Wyoming Life Resource Center 

For a state that set one record with the conception of its first Green House home, it’s no surprise that they’re on track to set another. 

The Wyoming Life Resource Center (WLRC) in Lander, Wyo., is a state-owned Green House community that has long served the needs of the Wyoming population and is being rebuilt as the first Green House home to be established as an Intermediate Care Facility (ICF) for people with intellectual disabilities, in addition to housing cottages established as a traditional skilled nursing facility (SNF). In accordance with federal Medicare and Medicaid regulations, this means that WLRC will serve people who have organic brain syndrome, high medical needs, and those who are “hard to place.”

Construction began in 2018 will host a total of 100 beds in 10 cottages, all built using the Green House model. There are four types of cottages in terms of licensure—ICF Medical Cottages, ICF Behavioral Cottages, SNF Medical Cottages, and SNF Behavioral Cottages. The campus also includes a recreation center with a pool, therapies and gym, an outpatient clinic with a pharmacy and lab, and a kitchen (existing) with a pharmacy and lab. 

Doug Osborn has since passed away, but his legacy lives on in the Green House community he helped to create.

The WLRC is an example of how best to meet the needs of diverse people with diverse needs, all under the Green House core values of Real Home, Meaningful Life, and Empowered Staff. The model of WLRC is innovation at its core. It sets an example that many residential care facilities across the U.S, Green House or not, are looking to replicate and learn from. 

What Is it About Wyoming? 

What is it about Wyoming that makes it such a hotspot for the sort of tenacious idealism demonstrated by Sheridan and WLRC? Former director of WLRC, Virginia Wright, describes it well: “Because we are a small state, we have a different mindset than some of the larger states. We still look at people as people and not just as numbers. I’ve worked in many states, and I have never seen as high of standards as I have seen here.” 

With Wyoming proving what’s possible in terms of diverse eldercare, it’ll be exciting to see how the eldercare landscape across the country shifts in response. 

An Unlikely Partnership Solves a PPE Issue

At Green House we often say “It’s all about relationships” and that certainly was the case for Green House partner Jewish Senior Life (JSL) in Rochester, N.Y.. Early on in the pandemic, JSL had trouble finding PPE that was accessible and affordable.

An Unlikely Connection

It’s a story of creativity and relationships. The JSL team wondered if the local Amish community might be able to help. This is when JSL Chief Information Officer Travis Masonis stepped up to make a crucial connection. Masonis knew his father had a relationship with the Amish community, so he asked him to make an inquiry about creating cloth PPE.

Travis’ dad reached out to Moes, the general store manager for the Amish, who spread the word about their willingness to sew the gowns in their homes. Twenty women agreed to do so using a pattern created by Travis. The women sewed small, medium, and large gowns on pedal operated sewing machines.

Over a period of several weeks, the community sewed reusable cloth PPE isolation gowns–roughly 10,000 of them. JSL CEO Mike King drove up each Friday to pick up the completed gowns. As it turned out, the low incidence of COVID cases and deaths at JSL meant they didn’t need all of the gowns.

A Pay It Forward Opportunity

This turn of events enabled JSL to make a “pay it forward” contribution to other nursing homes. As a member of a New York non-profit alliance with five other nursing homes, JSL shared the gowns with the other homes dealing with larger coronavirus outbreaks.

We applaud the efforts and hard work by the local Amish community and the creative approaches to meet a practical need at JSL and within their nursing home alliance!

Transforming the elder experience

Resident and caregiver at Jewish Home Assisted Living in River Vale, NJ (Photo: Jewish Home Family)

Following is a repost of a blog by Carol Silver Elliott as it appeared in the Times of Israel on July 8.

What if we viewed elders as individuals with value and purpose? What if we stopped, as a society, seeing older adults as “them,” as people who are “less than” and who have little to contribute? How would that change our perception of older adults and how would that change our view of our own lives as we all, inevitably, age?

That’s the underlying premise of The Green House Project, an organization that’s been in existence for more than 15 years and whose goal is to transform care of older adults. Green House was founded by Dr. Bill Thomas, a geriatrician, who realized early in his career that the care we provide for elders can be radically different and radically improved.

Dr. Thomas began the Eden Alternative, bringing plants and animals into long term care settings, based on a theory that having something to look after and care for would have a positive effect on the residents. It did. But that was not the full answer. Dr. Thomas developed the concept for Green House and today there are hundreds of Green House homes across the United States and internationally.

Green House homes are founded on three core values, real home, meaningful life and empowered staff. Each of these play a role in making the most critical element work—creating a non-institutional, normal environment for elders, an environment that is not “homelike,” rather, it is home.

Last week I had the opportunity to attend a five day educator program provided by Green House. It’s a program called “core training” and it is something that every staff person who works in our organization will receive. The program was held in a new Green House development in Arkansas so we had the gift of both spending the week in an actual home that has not yet opened and visiting elders who live in the homes on that campus that have already opened.

While there was a lot of learning during that week (and a nearly 700 page teacher guide that we will use as we teach it), what really resonated with me is the understanding that this philosophy is not an “add on” or a “tweak” to what we do and what we provide. It is full immersion, it is changing the way we interact, think and approach elders.

To really create normal life for those who live with us, we must always remember to focus on strengths rather than disabilities. When we focus on what someone can do rather than what they can no longer do, it changes the equation dramatically. And that applies in every area from activities to care to dining and so much more. Giving people the opportunity to make choices, express themselves and enabling independence as much as possible, that’s one key elements that creates real home.

This is not an “add water and stir” approach, it’s not easy and it will be a major change in behavior and mindset for many of us. But talking with the elders who live in Green House homes, as well as the staff who work with them, one thing is clear. The results are worth the effort. The elders who live in these settings and can articulate it, told us about quality of life.  They told us about feeling comfortable and at home, about the staff who felt like extended family, about the choices they were able to make about every aspect of their lives, about the family members who came to visit and felt as welcome as if they were still visiting them at home in the community. The staff echoed similar sentiments, the satisfaction of deeply knowing the elders with whom they work, the joy of being able to see and treat people as individuals and not room numbers or diagnoses, the ability to create “normal” every day.  And those elders who can no longer use language as they once could, shared their feedback through the peace in their faces and the comfort they clearly found in the soothing environments of their home.

Maya Angelou wrote “Do the best you can until you know better.  Then when you know better, do better.” Those words have great meaning as we begin this transformational journey. They have great meaning as we think about the care we provide to elders and the possibilities. We can do better as caregivers, as families and as a society to remember that our elders are not “them,” rather that they are still an important part of “us.”

Carol Silver Elliott is president and CEO of The Jewish Home Family, which runs New Jersey’s Jewish Home at Rockleigh, Jewish Home Assisted Living, Jewish Home Foundation and Jewish Home at Home. She joined The Jewish Home Family in 2014. Previously, she served as president and CEO of Cedar Village Retirement Community in Cincinnati, Ohio. She is chair-elect of LeadingAge and past chair of the Association of Jewish Aging Services.

Here is a link to the original blog post: https://blogs.timesofisrael.com/transforming-the-experience/

 








Breakthrough Skilled Nursing Facility Opening In Central Arkansas

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.

Media Inquiries

John Montgomery
Executive Director – The Green House® Cottages of Poplar Grove
johnm@poplargrove.care
501- 454 – 5604

Rick Rogala
CEO- Bespoke Health Media
rrogala@bespokehealthmedia.com
501-765-1841








The Small House Pilot in California, Changing the Face of Aging

Update, 05/18: The Green House Senior Director, Susan Ryan was honored to join Leslie G. Moldow, FAIA, LEED of Perkins Eastman and Mary Muñoz of Ziegler at the LeadingAge California conference to speak about The Small House Pilot, and how providers can seize this moment to enhance the way elders in California age. Collaborating with strong leaders in our field makes our collective voice louder and our impact greater. 

Originally Published 01/18

It is a pivotal moment in California’s history.  The Small House Pilot Program is now live, and it has the potential to clearly demonstrate that there is a better way to deliver skilled nursing care. This profound opportunity requires that nursing home providers across the state, take a stand, and say, NOW IS THE TIME!

The wait has been long, making this moment all the more powerful.  In 2013, through a tenacious journey, Mt. San Antonio Gardens became the first Green House Project in California. The work that they did to make regulatory gains with stakeholders across the state blazed a trail and were codified in late 2012, as Governor Brown signed into law Senate Bill 1228 (introduced by Sen. Elaine Alquist). The bill created The Small House Skilled Nursing Facilities Pilot Program, which authorized the development and operation of 10 pilot projects to deliver skilled nursing care in smaller, residential settings, “It puts the ‘home’ back into nursing home”, said Senator Alquist (D-San Jose). However, it wasn’t until early 2018, that the regulations to support this bill were released, and the request for applications is now open to the public. As a perennial advocate for elder directed, relationship rich living, The Green House Project is eager to support every effort to ensure the success of this opportunity.

The Green House Project has come to be recognized as the leader of the small house movement to create a high-quality, cost-effective, human-scale alternative to the traditional nursing home. Studies of the Green House model have found that:
• Residents have a better quality of life and receive higher-quality care than residents in traditional nursing homes.
• Staff report higher job satisfaction and increased likelihood of remaining in their jobs.
• Family members are willing to drive farther and pay more to have access to a Green House home for a loved one.

Real Home, Meaningful Life, and Empowered Staff: these core values align well with the regulations of the Small House Pilot in California, and they drive change in Green House homes, creating quality outcomes, consumer demand and preferred partnerships in the healthcare system.

With 15 years of expertise in design, education and evaluation, The Green House Project is a strong partner to support the expedited timeline and in-depth requirements of this pilot. The first deadline for submission is June, 2018. Design tools, like The Green House Prototype, along with educational protocols and policy and procedure expertise, will ensure an organization is able to successfully navigate this application. Susan Ryan, Senior Director of The Green House Project says, “The Green House Project specializes in a comprehensive cultural transformation that shifts the beliefs, behaviors, and systems to ensure a lasting investment across an organizational system. It is more than simply a process from ‘this’ to ‘that’; a real transformation unleashes the best of what can be by accessing collective wisdom.” The national initiative stands ready to support nursing home innovators in California, to ensure better lives for elders and those who work closest to them.

With California’s number of individuals 85 and older expected to triple by 2030, the market for Green House homes and others like them is rapidly growing. Consumer demand for the kind and quality of care that The Green House model provides has long existed, but until recently, California’s regulatory and approval process had been unable to accommodate non-traditional models of care. In fact, it took almost seven years for Mt. San Antonio Gardens to gain the approval it needed from multiple local and state agencies. Inspired by their lessons learned, Senate Bill 1228, and the newly released regulations, will enable innovation without obstacle. The Green House Project calls every organization interested in creating a real home, meaningful life and empowered work opportunities for the citizens of California to contact us, and together we will forge a trail to a brighter future.








Age In America Begins Their Series on John Knox Village

For our next series, we visited Pompano Beach, Fla., where a retirement community known as John Knox Village is located–about 10 miles north of Fort Lauderdale. On the campus are 12 Green House homes, which are small, resident-centered homes designed intentionally to counter the institutional feel of traditional nursing homes. A key feature of a Green House home is that staff and residents are empowered to live and work together as a team. Helping to make this team operate smoothly are Sages, who hold an esteemed position within the home. For this series, we interviewed Sages, all of whom have a lifetime of experience from which to draw upon to assist elders and others within the home. We will let our first interviewee, Diane, explain the purpose of a Sage: “As part of structure of this place they look for volunteers to act as Sages, because we’re old and wise and we’ve had experience working with groups, mentoring people, and problem solving with people. There is a screening process and we were trained. There are homes in this building, and there is at least one Sage assigned to each home. We come in on a volunteer basis and our function is to council, mentor, encourage the shabazim, who are the trained CNAs, within the home, to help them create a self-managed work team. And we are also there to provide contact between the elders and the shabazim and to enable them to get to know each other better. We come in on a fairly regular basis to visit in the home, we attend team meetings, if we’re invited, and hopefully give them the support they need.” . . How often do you come to the home? “It varies. I try to come two or three times a week, and that’s hard because I’m involved in other things. But I try to make it two or three times a week. I’m a resident of John Knox Village, as all the Sages are. We are lucky that we have that volunteer base to work with because everyone is on the property.” . . . . . #changingaging #agewoke #disruptaging #agepositive #greenhousehomes #sages #wisewords @johnknoxvillage #florida #pompanobeach #johnknoxvillage #ageinamerica #oldandwise #olderandwiser

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A Grandaughter’s Externship Provides Insight into The Green House Model

Breanna with her grandparents, Twylah and David Haun

The Green House model has added passion and purpose to my family in many ways. My grandparents, David and Twylah Haun, are Independent Living residents at John Knox Village (JKV) and they were instrumental in bringing The Green House model to their community. We have had many great conversations about the model’s potential over the years, and it has become close to my heart as well. Currently, I am pursuing my doctorate in Occupational Therapy at the University of Southern California (USC). When a professor challenged us to seek out opportunities and learn what it means to be a leader in healthcare, I immediately thought of my grandparents. This led to an exciting externship at The Woodlands at JKV. Before I stepped foot on the grounds at JKV, I was already destined to have valuable experiences simply based on the leadership skills I could learn from my grandparents.

John Knox Village, Pompano Beach, FL

I can still remember back in 2011 when bringing The Green House model to JKV became the main topic of our Thanksgiving meal ; My grandmother was interested and my grandfather was doubtful. Never ones to be easily convinced or to skimp on their research, they decided to take a road trip to eight different Green House homes to see this model in action. After visiting four homes, Grandfather was sold on the idea and came home to put their research into action. In the years since this initial exploratory trip, my grandparents have stayed very involved in The Green House initiative at JKV and also at a national level. They have spoken at the national Green House Meeting, contributed to The Green House blog, and helped with every aspect of creating and opening The Woodlands at JKV (including selecting paintings for the walls and dishes for the dining rooms, pictured right). Grandma has continued her active role in The Green House homes by becoming a Sage, a volunteer role that allows her to mentor and support the self managed work team to become a cohesive team and help create a real home for and with the elders.

In my program, we were discussing different models of care, and my professor brought up The Green House Project. It was something USC knew little about, but were excited to see how it could change the future. I was thrilled to be able to share my grandparents’ experiences with my 150 classmates and professors. I couldn’t wait to see the model in action! The Woodlands at JKV represents the first Green House homes in Florida, and they also offer homes dedicated to short term rehabilitation. Providing meaningful therapy in a natural environment is the ideal for an occupational therapist, and an exciting reality in the Green House homes.

I spent my externship running from meeting to meeting, soaking up as many experiences as possible, and asking questions about everything. From the staff in the homes to the people working across the whole community, I was continually impressed by the way they put the needs of the elder first, and balanced that with the success of the organization.

Some of my most meaningful interactions occurred with the elders, sharing stories of joy, belonging, and feeling safe in The Green House homes. In the end, this is why we do what we do, and it filled my heart with pride to be able to see this vision that my grandparents helped to carry forward, being lived out in such a beautiful way.

My time at JKV was a wonderful learning experience, and one that I will never forget. The Green House model is truly making a difference in the lives of the elders and those who are passionate about working with them. As a leader and therapist, I know that one of the greatest gifts I can give a client is to remind them that they are a unique individual who matters. From talking to the elders and listening to their stories, watching the direct care staff prepare meals in their home, participating in leadership meetings, and delivering mail to the homes with my grandmother, every experience taught me something valuable, and I am incredibly grateful.








The Visionary Leadership Behind the First PACE Green House homes

Green House homes are dynamic and able to impact innovation in many different settings.  The first Green House homes to be incorporated with a PACE community have opened as part of The Thome Rivertown Neighborhood in Detroit.  It is an honor to be able to open the doors of accessibility for low income elders through this partnership. 

PACE is the acronym of the Program of All-inclusive Care for the Elderly.  PACE programs are government-funded managed care health plans that also provide comprehensive health services for individuals age 55 and over who have health needs classified as “nursing home eligible” by their state’s Medicaid program.  The goal is to keep chronically ill elders independent for as long as possible –preventing avoidable  hospitalizations, emergency visits and stays in nursing homes.

Roger Myers is CEO of Presbyterian Villages of Michigan, and Mary Naber is President/CEO of PACE Southeast Michigan.  They are the leaders behind this innovation, and hold the belief in this partnership to evolve the healthcare system.  “This is the future.  Health is about more than medical care.  To meet the needs of elders, the focus must be holistic, accessible and home based,” Naber says.

The goal of PACE is to keep people as independent as possible and to avoid nursing home stays.  Despite that, nationally 7% of PACE participants still end up spending some time in long term care, according to Naber, “less because of a need for skilled care, and more because they are not safe to stay in their homes.”

“As we know, even the best traditional nursing home does not provide the greatest living experience, and now, for at least 21 people, The Rivertown Neighborhood is able to offer an alternative.  The Weinberg Green House homes meet their needs, support them to thrive and enable them to remain in the community,” says Naber.  “It’s very gratifying to be able to offer this option.  I wish I had 10 Green House homes for people!”

The Green House homes are licensed as Homes for the Aged, a distinction that provides flexibility and enables elders with a high level of need to live in the least restrictive environment possible.   As it happens, many of the people living in these homes have moved there from nursing homes.  The PACE program provides a “wrap-around” so that elders receive all the services they need, enabling The Green House home will be their home for life.

“The great thing about the co-location of the Weinberg Green House homes to the PACE center is that the elders receive all the same benefits as if they were living in their own homes, which they are- Green House homes.  Being right on the PACE campus will keep elders more mobile and socially engaged.  It will also help PACE clinicians stay in touch, and we know that frequent interactions can help prevent ER visits and other medical concerns.” explains Myers.

“Health is not just about medical care, especially when you’re dealing with chronic illness,” declares Naber.  By leveraging an interdisciplinary team rather than the typical doctor-driven model, the team at the Weinberg Green Houses are able to care for the WHOLE person: body, mind and spirit.

PACE Southeast Michigan is a 501c3 not-for profit government funded unique health plan and comprehensive care provider.   It is a jointly owned by Henry Ford Health System, one of the early PACE innovators, and Presbyterian Villages of Michigan.

The Thome Rivertown Neighborhood includes Independent Living, Assisted Living, the PACE Center and now The Green House homes.  Not everyone who lives on the campus is a part of PACE, but it is built as a continuum to enable low income and highly frail people to stay in their community as their health status changes.

Integrating residential living with PACE is proving to be an effective development that will hopefully spread throughout the country.  PVM led the development effort for this supportive neighborhood during the recession, and the idea was so compelling that they were able to achieve their goals.  A $2 million grant from the Baltimore-based Harry and Jeanette Weinberg Foundation provided much of the support to make their vision to add Green House homes to the community a reality.

 

 








A Sage’s Testimonial of Short Stay Rehabilitation in a Green House home

For the last few years, I have served as a Sage (volunteer who supports and advises the self managed work team) at The Green House homes of Mirasol.  Recently, my role was reversed, when I moved in to recover after an extremely taxing and debilitating surgery.  These homes are listed as 5 Star by Medicare and Medicaid, a wonderful professional endorsement.  I can tell you, however, that the essence of what I experienced, goes far beyond that checklist, and their stellar outcomes reflect something much deeper and more comprehensive.

The Green House homes were the only attractive option for rehab within 20 minutes from my home.  Because I know how popular The Green House homes are, I was worried that there would not be space for me.  I was delighted to be able recover in a Real Home. I knew that being a volunteer would be very different from being a guest in the community, but I couldn’t have predicted how impressed I would be, or the gratitude I would feel.

The Green House team ensured that the process was smooth and dignified from the very beginning.  They managed all the hospital paperwork, follow-up appointments and coordination, which in my mind already goes leagues above 5 stars!  The driver’s vehicle enabled me to sit comfortably up front, and he even offered me clip-on sunglasses, my choice of music and a warm blanket (an important touch on a freezing Colorado day).  We quickly fell into a comfortable chat and discovered many things that we had in common.

When I arrived, I was greeted warmly, like a long-lost, favorite uncle!  The Shahbazim (direct care staff) offered me the choice of going to my room for a rest, or staying at the table for a meal.  Having already having discovered my dietary preferences, they offered to make something special, just for me.  The whole home smelled scrumptious when I came in the front door! Just being there made me feel better, and I had a renewed appreciation for the airiness of the dining area, the good smells of the kitchen, and the warm, inviting fireplace area.

We went to my room – private room with private bathroom, thank goodness.  As I was oriented, I was reminded that no room is more than six doors from the hearth, and this was confirmed the next morning by the aroma of breakfast wafting into my bedroom.  How refreshing to recover without the long and disorienting corridors lined with carts of stale food or unmentionables waiting to be taken out back.  At no stage
was I “parked” anywhere in the house, as I have seen in other nursing homes, left alone to wait.  To be treated like a person, rather than an object; what this did for my well-being, I can’t begin to measure.

Dinner was a very communal event, and I felt very welcomed by my fellow elders at the table.  Some required help with eating, which the Shahbazim did casually and warmly with considerable skill and NO DEMEANING BIBS.  It immediately felt like the elders were interested in me as a fellow member of the house and its extended family of elders, staff and family members. The feeling of family was beautifully illustrated, as one elder spontaneously went over to another elder, who seemed unhappy, and simply gave him a hug.  It was then that I was brought to tears, so moved by the atmosphere of support and caring. The elders are empowered to care and support each other, creating a community of reciprocity, where everyone has something to offer.

The hearth in the center of the house is a place where elders and Shahbazim could naturally get to know each other more deeply, creating mutually supportive relationships as our stories are shared. What a realization to know that the more deeply we know each other, the more we are valued.  These relationships enable the elders and Shahbazim to go beyond medical needs, and become connected, helping each other to live the best life possible.

The staff appeared to be encouraged to stop over each day and chat for a while just to get to know me better.  I felt understood, and like the things that were important to me, were important to them.  If I had a visitor (like my wife of 51 years) or was engaged elsewhere, my nurse would ask if I would prefer she come back later. She put me in the driver seat of my care, and made me feel like she honored my privacy and dignity. The Shahbazim seemed to anticipate my needs, incorporating what they learned about me from our conversations, and providing personalized care that went well beyond my physical needs.  Team members would stop by at the end of their shift to just chat about their plans for the rest of the day, to ask advice, or to ask me about my life stories.  This genuine caring, was something that I hadn’t experienced in other nursing home/rehab settings, and it was so gratifying and replenishing.  To be known and truly valued, this is better than the best medicine.

What a phenomenal rehabilitation experience, delivered by wonderful people who love their
job, love the people they work with and the elders they serve.  The Green House homes provide opportunities for these open-hearted people to grow and develop their already extraordinary gifts.  I am honored to be able to share my experience as a testimonial to others who are seeking a place where they can recover, not only physically, but holistically.  It is because of this experience that I healed so rapidly, with caring and the preservation of my dignity.

Learn more about The Green House homes at Mirasol>>