Green House Blog

Dr. Bill Thomas: Creating Real Home with Increased Acuity

As Elders living in Green House homes age in place it is important that we resist the urge to revert back to institutional practices to solve the obstacles that may be associated with their changing care needs. During a Peer Network webinar last month, adopters had the opportunity to hear Dr. Bill Thomas discuss the topic of increasing acuity of Elders in Green House homes and his recommendations for sustaining the Green House core value of real home.

Participants on the call were asked to think about Florence Nightingale and the new approach and standard of practice that she brought to the existing institutions of her time. Dr. Thomas believes that we are descendants of her philosophy of care and therefore must be prepared to care for Elders in sickness and in health.

A few recommendations he provided during the conversation included:

– Having a clear understanding of the advanced care directives of Elders living in Green House homes and what they want when their health changes acutely.  It is important to have these conversations in advance of illness and revisit the topic as needed

– To better understand how quality acute care services are provided in a home, have conversations with the hospice and home care agencies in your community

– Understand from Elders and their loved ones whether they want maximum care or maximum treatment at the end of life. It isn’t possible to provide both simultaneously.

In many institutional long-term care settings a person is placed in the “sick role” and then kept there for the remainder of their life. Green House homes are unique in that they are a place of recovery, rejuvenation and a dedication to the belief that all people have the right to live with dignity, autonomy and purpose until their last breath.

Dr. Mary Jane Koren Highlights Dr. Bill Thomas at LTCCC Event

Last month, The Green House Project  helped sponsor the Long Term Care Community Coalition’s Sixth Annual Reception which honored the life and work of Mary Jane Koren, M.D., M.P.H. at the Alzheimer’s Association chapter in New York City.  Dr. Koren’s experience includes 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.

During her acceptance speech, Dr. Koren shared that, “…between 1950 and 2050, there will be a 10-fold increase in the percent of the population over 85, which is exactly the age cohort most dependent on long-term care services and supports.” She argued that the best way to address this need is to move away from a model that “…puts institutional priorities ahead of resident choice…” and instead follow Dr. Bill Thomas’ lead in creating long-term care models that alleviate loneliness, helplessness and boredom. She shared with the audience that, “Bill Thomas’ philosophy, even at that early stage was, for me an epiphany. I suddenly ‘got’ OBRA’87 in a way I never had before.”

You can read Dr. Koren’s full speech here.

Congratulations to Dr. Koren for her work as a thought leader and innovator in the aging field! We appreciate the work you have done to make the Green House model a reality for so many elders nationwide.


Moving Day for St. John’s in Rochester!!

REPOSTED

Visit the original post at ChangingAge.org

“But let there be spaces in your togetherness and let the winds of the heavens dance between you. Love one another but make not a bond of love: let it rather be a moving sea between the shores of your souls.”

Khalil Gibran

The above quote was posted today by Susan Thomas for St. John’s “Eden Quote of the Day”, in honor of the first three Elders moving into our community Green Houses in Penfield, New York. This is the culimination of an incredible journey for St. John’s Home.

It has been exactly a decade since I went to hear Bill Thomas give a talk in Utica about his latest thoughts about Elderhood. At that talk, Bill described his concept of “doing vs. being”, and his visions for “Eldertopia”.

In 2003, the first Green Houses opened in Tupelo, Mississippi. Our CAO, Veronica Barber went to visit them, and on her return she told our CEO, Charlie Runyon, “We have to do this.”

Then about four years ago, with the encouragement of former DOH Dormitory Authority Director Tom Jung and Assistant Health Commissioner Mark Kissinger, we decided to take one more very big step: we decided to bring Elders back to true community engagement, by moving off campus and integrating our Green Houses into residential communities.

This set off a series of twists, turns and setbacks that pushed us back a few years in our timeline, but what we leanred in that process about our vsision, our strengths and challenges, and about our Eden journey was priceless.

And today is the payoff as, for the first time in our nation, the first pioneering Elders move to a pair of small houses 11 miles away from the main campus, nestled in the multigenerational Arbor Ridge community. Guide Rebecca Priest has been the lighthouse for this journey and her group of shahbazim, nurses and other supportive care partners is truly incredible. Very soon after, the remaining 17 Elders, people with diverse needs and abilities, will follow.

So many people have put their hearts and souls into this journey that it is impossible to mention them all. In addition to the visionary leaders mentioned above, I must make a special note of Joanne Braunle, our Project Manager, who formerly worked on NASA contracts and showed us that culture change really is rocket science! The builders at Pridemark, architects at SWBR, and our pre-design work with Emi Kiyota all made incredible contributions to the beautiful, warm and functionally versatile houses we open today.

And of course, a huge thank you to The Green House Project, especially Robert Jenkens and Susan Frazier for their guidance and tireless advocacy, and to Bill and Jude Thomas and the Eden Alternative, who have helped shape our new vision of Elderhood that will truly be a game-changer in providing living options for Elders with skilled needs across the nation and beyond.

Way to go, St. John’s; my hat is off to you!!

Moving Day for St. John's in Rochester!!

REPOSTED

Visit the original post at ChangingAge.org

“But let there be spaces in your togetherness and let the winds of the heavens dance between you. Love one another but make not a bond of love: let it rather be a moving sea between the shores of your souls.”

Khalil Gibran

The above quote was posted today by Susan Thomas for St. John’s “Eden Quote of the Day”, in honor of the first three Elders moving into our community Green Houses in Penfield, New York. This is the culimination of an incredible journey for St. John’s Home.

It has been exactly a decade since I went to hear Bill Thomas give a talk in Utica about his latest thoughts about Elderhood. At that talk, Bill described his concept of “doing vs. being”, and his visions for “Eldertopia”.

In 2003, the first Green Houses opened in Tupelo, Mississippi. Our CAO, Veronica Barber went to visit them, and on her return she told our CEO, Charlie Runyon, “We have to do this.”

Then about four years ago, with the encouragement of former DOH Dormitory Authority Director Tom Jung and Assistant Health Commissioner Mark Kissinger, we decided to take one more very big step: we decided to bring Elders back to true community engagement, by moving off campus and integrating our Green Houses into residential communities.

This set off a series of twists, turns and setbacks that pushed us back a few years in our timeline, but what we leanred in that process about our vsision, our strengths and challenges, and about our Eden journey was priceless.

And today is the payoff as, for the first time in our nation, the first pioneering Elders move to a pair of small houses 11 miles away from the main campus, nestled in the multigenerational Arbor Ridge community. Guide Rebecca Priest has been the lighthouse for this journey and her group of shahbazim, nurses and other supportive care partners is truly incredible. Very soon after, the remaining 17 Elders, people with diverse needs and abilities, will follow.

So many people have put their hearts and souls into this journey that it is impossible to mention them all. In addition to the visionary leaders mentioned above, I must make a special note of Joanne Braunle, our Project Manager, who formerly worked on NASA contracts and showed us that culture change really is rocket science! The builders at Pridemark, architects at SWBR, and our pre-design work with Emi Kiyota all made incredible contributions to the beautiful, warm and functionally versatile houses we open today.

And of course, a huge thank you to The Green House Project, especially Robert Jenkens and Susan Frazier for their guidance and tireless advocacy, and to Bill and Jude Thomas and the Eden Alternative, who have helped shape our new vision of Elderhood that will truly be a game-changer in providing living options for Elders with skilled needs across the nation and beyond.

Way to go, St. John’s; my hat is off to you!!

The Power of Choice

I was speaking in Ohio earlier this month and had an experience that reinforced an important lesson for me. I was giving a community talk on dementia and a TV reporter came to interview me before the talk. We put on the microphone and launched into a 10-minute conversation on camera. She asked a lot of good questions, and then as my message became clearer to her, she threw me a curveball. Continue reading “The Power of Choice”