Green House Blog

Convivium: Good Food and Good Company leads to Good Outcomes

Mealtime is an important part of The Green House day. We even have a name for it, “convivium”. This term describes good food, good company and good conversation. In every Green House home, there is an open kitchen where food is cooked in the home, and it is served around one large table to create a feeling of belonging. Smells of delicious food waft through the air, and the dining room table is filled with conversation as elders, staff members and visitors sit together and form an intentional community. This normalized environment creates not only a sense of well-being, but also has a positive clinical impact. Watch the below short video to hear what a dietitian from a Green House home says about her experience:

At the Table: Dining and Nutrition in The Green House Model (2 mins 33 secs) from The Green House Project on Vimeo.

According to a recent article in McKnight’s Long Term Care News, “’Undernutrition’ is the most common dietary problem related to dementia… This refers to insufficient intake of calories, protein or other nutrients. It affects up to 30% of residents in long-term care facilities…” The article goes on to talk about how improving the environment and increasing staff education can help to improve elder nutrition. Through intentional design and deep education, Green House homes have seen positive outcomes and stories that demonstrate the value of focusing on food and mealtime.

Dr. Bill Thomas, founder of The Green House model, has always seen food as central to how we connect as human beings. As our physical needs increase to a skilled nursing level—this deep human factor does not change. In this short video below, Dr. Thomas shares his vision for “convivium”. By creating an environment of deep knowing where we honor an elder’s preferences and natural rhythms, issues like “undernutrition” will dissipate.

Convivium from The Green House Project on Vimeo.

Green House Living in Wyoming Prepares To Welcome Elders

Green House Living for Sheridan

The nation’s first grassroots-organized Green House Project homes will open their doors to welcome elders on January 31st in Sheridan, Wyoming.

Nearly five years in the making, Green House Living in Sheridan has completed construction on two of four planned Green House cottages at the newly created Village at Cloud Peak Ranch. Two more cottages will be completed by mid-February, serving a total of 48 elders, and a grand opening celebration is scheduled for March.

Green House Living in Sheridan President Doug Osborn shared the news Dec. 30 and said the community-based initiative would not have been possible without support from volunteers and contributors from every level of local government and walk of life.

“The Scott Cottage, the Watt Cottage, the Whitney Cottage, the Founders Cottage… will introduce this change in nursing home care to the state of Wyoming and help other communities as they consider providing the kind of care and fulfilling lives our elders deserve,” Osborn said.

Green House Living in Sheridan will provide 24/7 skilled nursing care but it is not a nursing home or assisted living facility. Elders have their own private room with bathroom and shower, and each cottage has a spa room near the kitchen. Up to 12 elders share a cottage and a central living and dining area. Each cottage has a household team of Shahbazim who care for, cook for and eat with the elders.

“We have a table where everyone sits together and experiences what we call convivium, which is the experience of eating together, just like in a real home,” said Green House Living administrator Chris Szymanski in an interview with Sheridan Media posted online here.

What really sets the model apart is the philosophy and organizational structure. The Shahbazim and all medical and support staff are trained in a circular organizational structure centered around the elders, creating an environment for them to grow and thrive, like in a “green house.”

The model is designed to transform the experience for both the elders and the staff. Sheridan just completed the first round of training Shahbazim for the Scott and Watt cottages and will begin training the second round later this month.

“Especially gratifying is watching our new employees in training, wrapping their minds and souls around the concepts and methods which define the Green House model,” Osborn said.

Visit SheridanGreenHouse.org for more information, photos and updates on Wyoming’s first Green House Project.

 

 

Convivium, the particular pleasure that accompanies sharing good food with the people we know well


By, Dr. Bill Thomas

Some people eat to live. Others live to eat. Those in the first group regard food as fuel; those in the second group know better than that. Good food has always offered people much more than just calories, fat, carbohydrates, and protein. At its best, food nourishes us – body and soul. A meal can embody powerful symbols of love and acceptance. The bond between comfort and food, which begins at the breast, is fortified throughout childhood and gains renewed strength in the late decades of life. Properly prepared, the meals we cook and serve to our elders should be drenched in memory, ritual, and culture.
Reacting to case reports of actual starvation among nursing home residents, the government has established significant penalties for facilities that allow residents to lose weight “unexpectedly.” As a result, nursing homes struggle constantly to increase the dietary intake of their residents. Just how challenging a task they have undertaken becomes obvious when you look at how these facilities prepare and serve food.
They shop from industrial food catalogues and unload the groceries from a tractor-trailer parked at the loading dock. Meals are prepared in vast industrial kitchens that are deliberately isolated from the people who will eat what they produce. Some long-term care facilities, like airlines, outsource food production entirely and take delivery of dinners by the truckload. In a down-to-the-minute ballet, food is rushed upstairs in huge rumbling carts. Staff members distribute it to waiting residents as quickly as they can. It is a never-ending challenge to serve hot food when it is still hot and cold food when it is still cold.
The people involved do their best. The realities of large-scale food service demand, however, that the material characteristics of the food – its color, viscosity, temperature, and nutritional content- become its most important descriptors. The emphasis on consistency and low cost is constant. Food is shorn of meaning, leaving only numerical measurements. The lifelong rhythm of good food shared within the circle of family life is absent. It is just not possible to imbue six hundred meals a day with the essence of love.
The Romans had a special term for the particular pleasure that accompanies sharing good food with the people we know well. They called this experience convivium. The word has enjoyed a revival recently. The “slow food” (an alternative to fast food) movement has seized on the word as a way of describing dining experiences that are rich in meaning. Fresh, local ingredients prepared according to authentic regional recipes are served to people eager to share. They use smell, taste, and texture as a springboard to good conversation and vital relationships. The shahbazim foster a convivium that enriched the lives of elder and shahbaz alike.
The relationship between people and the food that sustains them begins with the planning that by necessity must precede each meal. The idea that meals can and should be planned with loving care and then prepared with loving hands will strike the typical food service manager as little more than wishful thinking. For the rest of us, it is simple common sense confirmed by our own experiences in our own homes. The suffering created by the industrialization of food in long-term care institutions deserves more than passing attention. Nursing homes are canaries in the mine, warning us of the assembly-line approach to food that is spreading across our social landscape. We are all losing our grip on convivium. Institutions may be able to blame their mechanical approach to food on their own gigantic size, but we can see the erosion of convivium all around us, even in our own lives.
The ability to create and maintain convivium demands an appreciation of the long, languorous meal and is one of the core competencies of a shahbaz. Time must be taken because food tastes better when it is soaked in anticipation. Elsewhere, soup may be purchased in bulk, heated, and then served. The shahbaz insists that the soup be made fresh and allowed to simmer all morning long with ingredients added slowly as the hours pass. In an institution, mealtime is a mad rush. For the shahbaz it is an opportunity to create and then deepen meaning. The spirit of convivium calls upon us to linger, to savor, and to draw strength not just from the food we are blessed to eat but also from the people with whom we are blessed to share our meal.

Building an Evidence Base for Enjoyable Dining

“All great change in America begins at the dinner table.” -Ronald Reagan

Eating at a dinner table with friends and family is not only the quintessential portrait of Thanksgiving, but also an activity that can promote significant positive change.

In this month’s LeadingAge Magazine, the article, Enjoyable Dining: Can We Build an Evidence Base? , speaks volumes about how creating a dining environment that looks and feels more like home can have a tremendously positive impact on elders- boosting overall morale, without significant cost increases.

“We have had better intake. We’ve reduced the use of supplements. They are eating real food. Our meals are part of a concerted period when the residents are up and active, which then has a positive effect…We have less weight loss, and residents have fewer complaints about food service. They are better nourished, and there’s an increase in family involvement. And it doesn’t add to the cost, because residents are getting what they like. There is less waste.”

The article also highlighted recent research conducted by The Pioneer Network to develop great evidence-based food and dining standards for long-term care facilities. These best-practices contain sections that concentrate on the liberalization and honoring of choice when it comes to diet as related to diabetic and calorie controlled, low sodium, cardiac and altered-consistency diets. The new dining standards of practice can be found here.

Click here to read the full article.