Green House Blog

Fast Company, The Green House Project Brings Back Dignity to Aging

Fast Company, is a magazine focused on highlighting the most creative individuals sparking change in the marketplace. By uncovering best and “next” practices, the magazine helps a new breed of leader to work smarter and more effectively. Recently, they  published a piece about The Green House Project.  The article interviews, Jane Lowe, the senior advisor for this program with The Robert Wood Johnson Foundation, and she gives her ultimate endorsement, “”If I am frail and old and need nursing home care, I would be quite comfortable going to a Green House home. I would definitely not say that about going to traditional nursing home.”

The article, complete with beautiful photos of Green House homes, and a short video, highlights the fact that this model is creating real home, whether that is in a rural setting, an urban high rise, or the Veteran’s administration.  By putting the elder at the center of the organizational chart, it is clear that the goal is to deeply know the elder, and to help them live their best life, “Nursing homes are hierarchical, and patient’s needs are at the bottom of the chain. Bill [Thomas] had an idea that you could create these homes that could provide complete care for the elders in a more high-quality way and a way that really supported their lives,” explains Dr. Jane Isaacs Lowe, a senior adviser for program development at the Robert Wood Johnson Foundation. “We were all intrigued, because if you could build these Green House homes so they could be embedded in communities then this would make nursing homes more of a home and community-based service, because in theory someone could move from home to Green House home and still be in that community.”

As The Green House Project celebrates 10 years since the first Green House home opened in Tupelo, MS, the initive looks to the future, and how this model will create a viable and sustainable option for long term care.  Explore www.thegreenhouseproject.org for more information about The Business Case of The Green House model, and to find a Green House project near you! 

 

 

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.

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

Green House model creator, Dr. Bill Thomas, to be honored by The Long Term Care Community Coalition

Green House model creator, Dr. Bill Thomas,”an international authority on geriatric medicine and eldercare”, will be honored by The Long Term Care Coalition in a fundraiser to benefit the coalition. The theme of this year’s fundraiser, “improving the lives of nursing home residents and changing the way we think about the elderly”, is a perfect backdrop to Dr. Thomas’ message that it can be different!

The Long Term Care Community Coalition (LTCCC) is a group devoted to improving care for the elderly and disabled. Their work centers around work to ensure that long term care consumers, who are often very vulnerable, are cared for safely and treated with dignity.

The Green House model, created to be a place where Dr. Thomas’ Eden Alternative Principles can thrive, is a living testement to the goals of the coalition. By simultaneously transforming the philosophy, environment and organizational structures of traditional long term care, real power is shifted to the elder and those working closest to them.

To learn more about the coalition and the fundraiser, click here.

Sneak Peak: Green House 10th Anniversary Trailer– coming to a community near you 2013!

Click here to view The Green House Project 10th Anniversary Trailer. Creating Real Home, Meaningful Lives and Empowered Staff– Coming to a Community Near You– 2013!!

The 5th Annual Green House Meeting and Celebration, a huge success!

“Meaningful Life, Meaningful Engagement” was a most appropriate theme this year for the 5th Annual Green House Meeting and Celebration! Over 160 people representing Green House home adopters from Alaska to Florida spent three days learning, laughing, building relationships, sharing stories and most importantly challenging conventional ways of thinking about elders!

The meeting kicked off to a great start with pre-conference sessions in the critical areas of coaching leadership, reframing activities and leisure, and equipping the Director of Nursing for success in the model. These intensives took important roles and concepts to the next level.

An impassioned keynote by Green House model founder, Dr. Bill Thomas, urged attendees on the opening day of the conference to fill their Green House homes with stories, “a story is not a story until you tell it”. A house is not a home without a story he explained, and this includes the stories of all of the elders who live there and the people who work in the home.

Storytelling became a constant throughout the conference with many venues for elders, Shahbazim, Guides, CEOs, Nurses, Social Workers and Activity Professionals to share their experiences, challenges, and successes with each other.

A highlight of the conference was the involvement of Porter Hills, The Green House project in Grand Rapids, MI. Ingrid Weaver, CEO and family member, Carl Eschels welcomed attendees to the conference, and invited attendees to visit their homes over the course of the meeting. Elders from Porter Hills served on an elder panel to share their experience of living in a Green House home, and wisdom about life. Also, Elders of the Porter Hills singers graced us with beautiful music and entertainment. We are lucky to have four Green House projects in Michigan, and through beautiful photos, and great attendance, they added insights to every aspect of the meeting.

New tools such as The Green House Business Case, were introduced at the meeting. Concurrent sessions addressing the diverse interests and needs of the attendees spanned the two day meeting. There were Green House specific sessions about team building, marketing, utilizing data, palliative care, continence care, and other important topics. Information to create successful development as well as sustainability of the model was shared and discussed. An exciting feature is that many sessions were livestreamed and recorded, expanding the reach of these valuable tools and education.

Teepa Snow, a renowned expert in dementia care, shared her energy and expertise with the meeting through interactive sessions and a keynote. These sessions equipped attendees with new ways of being with and learning from people living with dementia. Many people had experiences that they will never forget, as Teepa explained the physical and cognitive changes that a person living with dementia goes through, and how that impacts the ways we can engage effectively.

After a whirlwind of fun, learning, stories and relationship building, The Green House attendees returned to their organizations around the country to share their knowledge and new connections. Building a community of passionate people who are committed to making life better for elders, and those who work closest with them—that is what The Green House Project is all about- the Annual Meeting and Celebration was a joyful time to come together and celebrate how far we have come, and to combine our forces to achieve what is yet to be accomplished.

Michigan NPR Affiliate, WGVU, Interviews Dr. Bill Thomas and Porter Hills at GH Annual Meeting

On September 7, 2012, WGVU a local NPR affiliate in Michigan interviewed Dr. Bill Thomas, and Porter Hills CEO, Ingrid Weaver, about The Green House Project. They discuss how the model transforms the philosophy, organizational design and environment of traditional long term care, radically shifting the paradigm of aging! Additionally, this interview highlights the power of bringing together providers from around the country to celebrate and learn from each other. Porter Hills is a wonderful host, and a great example of what it means to LIVE The Green House brand and mission.  It can be different!!

Listen here:

http://www.wgvu.org/wgvunews/audio/fplayer1.cfm?styid=18041

Tribes of Eden Book Club at Pioneer Network's 2012 National Conference

It’s not often that you get the chance to hear the author read excerpts from their book, but that was the case Tuesday as Dr. Bill Thomas discussed his latest novel, The Tribes of Eden.   The lucky audience was attendees at the Pioneer Network 2012 National Conference.  The book is set in the near future after the utter collapse of society.  It introduces a new vision of old age to counter ageist views that hinder our efforts to improve care for older adults.   

Dr. Thomas had a special message for the culture change group, stating that it is time for them to take the movement one step further.  “We need to become agents of changing our wider culture.”  He believes the novel can be conduit for this broader change.  He challenged the group “to begin framing the work you do to the society as a whole”…it is time to combat declinist and ageist views that do not promote elderhood.

Dr. Thomas is the founder of The Eden Alternative and The Green House Project.

Tribes of Eden Book Club at Pioneer Network’s 2012 National Conference

It’s not often that you get the chance to hear the author read excerpts from their book, but that was the case Tuesday as Dr. Bill Thomas discussed his latest novel, The Tribes of Eden.   The lucky audience was attendees at the Pioneer Network 2012 National Conference.  The book is set in the near future after the utter collapse of society.  It introduces a new vision of old age to counter ageist views that hinder our efforts to improve care for older adults.   

Dr. Thomas had a special message for the culture change group, stating that it is time for them to take the movement one step further.  “We need to become agents of changing our wider culture.”  He believes the novel can be conduit for this broader change.  He challenged the group “to begin framing the work you do to the society as a whole”…it is time to combat declinist and ageist views that do not promote elderhood.

Dr. Thomas is the founder of The Eden Alternative and The Green House Project.

The Green House Annual Meeting and Celebration

The Green House Project is excited to host The Fifth Annual Green House Meeting and Celebration, an exclusive opportunity for organizations who have adopted The Green House Project.  This year’s meeting will be held on September 5-7 in Grand Rapids, Michigan. Building on an important value of The Green House concept, this year’s theme, “Meaningful Life, Meaningful Engagement”, will highlight the impact organizations are having on the lives of the people who are living and working in their Green House homes.  

The Green House Project is eager to use this platform to acknowledge the four Green House Projects that are open and thriving in the great state of Michigan.  From Pinecrest in the Upper Peninsula to Porter Hills, in Grand Rapids, our host city; from the Villages of Redford in Detroit’s outskirts to Resthaven on the the eastern shores of Lake Michigan, we honor all of the homes where elders and persons living with disabilities can live lives of meaning and engagement in homes where they are well known.  

This meeting and celebration as always been a time to honor the commitments that Green House organizations have made to the model and the initiative,  and the hard work to make this vision a reality.  We hope this experience provides our network with the opportunities for learning, growth, replenishment and fun!

The opportunity to visit Porter Hills will give adopters a chance to how The Green House model is lived on another campus, and there will be plenty of time for networking and relationship building amongst peers throughout the conference.  This venue will be bustling with best practices, and lessons learned from all phases of Green House development and sustainability.  Education and growth are key features of The Green House model, and there will by thoughtful sessions by Dr. Bill Thomas, founder of The Green House model and international change agent, dementia care expert Teepa Snow OT/R, and many others.   

This meeting brings together Shahbazim, Guides, CEOs, Clinical Support Team members and Elders to share their knowledge and everyday experiences. 

If you can’t attend this year’s meeting, or if you are not a Green House adopter, but are interested in the agenda, don’t worry– there will be interactive opportunities throughout the meeting!  We will be livestreaming from our website: Dr. Thomas’ keynote (9/6/2012, 9:00a), Teepa Snow’s keynote (9/7/2012, 8:30a).  We will also be updating our facebook page throughout the conference and will be using hastag: #GHP12, to tweet exciting news and photos. 

Thank you for your support and energy to further The Green House Project, and our quest to create “Meaningful Engagement and Meaningful Lives

British Parliament Takes a Look at The Green House Project

From the ChangingAging Blogstream

The Green House Project isn’t just making waves in the U.S. The model’s innovative transformation of nursing home care was the the subject of a British Parliamentary hearing this week on the future of caregiving in the UK.

A British researcher who recently visited the United States testified before the Parliament Health Committee Tuesday, Jan. 10, that Britain should look at the Green House model as the future of nursing home care.

Dr. James Mumford, a senior researcher for the Centre for Social Justice, told Parliament that it was “absolutely vital that we dream a different future for residential care, particularly nursing care,” and “The Green House model presents a new way of doing that.” The Centre for Social Justice is a British think tank focused on finding effective solutions to poverty and Mumford leads research focused on low-income older adults in the UK.

“The (Green House) model was invented by Dr Bill Thomas but it is not just a brainchild; it actually exists. There are 127 Green Houses in the U.S. with 250 in development,” Mumford said.

In Britain, policymakers are currently too focused on delivering services that help elders remain in their homes longer, Mumford said. He warned that the growing population of adults with dementia and other chronic conditions means the need for nursing homes (which the British call “care homes”) is not going away and such settings need to be reformed.

The committee called on Mumford to report findings of his visit to the U.S., including a tour of Green House homes at The Eddy in Albany, N.Y. Mumford testified that the key innovations in the Green House model are achieved through reforms in design and staff ethos:

These Green Houses are self-contained buildings for nine to 12 people with about two staff members looking after each home. Their kitchen is not downstairs or siphoned off but is actually at the heart of the home. There are no clinical corridors and the rooms are off the central area.

The design is half of it. The second half of the innovation is around the staffing ethos. Basically, by cutting out middle management, the key thought is this: the staff in the care home context are bigger than the roles that they have.

By empowering the staff to actually take responsibility for the way that that particular Green House is run, and by also allowing them to take charge of cooking the meals and doing the laundry, you make huge staffing efficiencies, so that there is not actually any more hour per resident in terms of the staff labour cost, but it is for the same cost.

“They have seen extraordinary results from what they have achieved because of these two dramatic innovations at the heart of this new form of care,” Mumford testified. “As I said, this is not just a bright idea, it is being backed and rolled out across the US.”

Watch the full Parliament hearing here (Mumford’s Green House testimony begins 28 minutes into the hearing):

You can read the full transcript of Mumford’s testimony after the jump.

Continue reading “British Parliament Takes a Look at The Green House Project”

Summer Call Series for Green House Adopters

This series of calls/webinars will highlight the major goals of our second Robert Wood Johnson Foundation grant, through a dialogue about major initiatives and how you can be involved

We are looking forward to the stimulating discussions, questions, stories and successful practices that will emerge from these conversations. Your feedback is welcomed, appreciated and necessary to make these connection outlets reach their highest potential.

Topics Include:
* Marketing: Utilizing the Blogstream to tell your story and market to your community
*Policy: Activating Green House Projects to advocate for Culture Change
*Finance: Dollars and Sense of The Green House Model, updated findings
*Project Management: Living the Brand and the Mission
*Tool Development: Equipping Green House Projects for Success
*Peer Network: Sustaining our Promise to the Model

For more information, contact your Project Guide!