Green Houses

One of the most innovative projects in the culture change field is the Green House -  radical vision of deinstitutionalised nursing homes.

In Green Houses, seniors enjoy privacy, community, and, perhaps most important, an environment designed to look and feel like a real home. In a study comparing health outcomes and quality of life for Green House residents with residents at two traditional nursing homes, Green House residents were found to experience better quality of life, with the same or better quality of care than those in the comparison homes.

• Green Houses are self-contained dwellings for seven to 10 residents requiring nursing home levels of care.
• They incorporate physical design changes such as private rooms and bathrooms, a residential-style kitchen, a communal dining area, and accessible outdoor space.
• Institutional elements, like medication carts, public address systems, and nurses' stations, are avoided.
• The model also transforms the hierarchy of the institutional staff, giving wider responsibilities to certified nursing assistants who are supervised by an administrator, or "guide."
• A visiting clinical team comprises all other professional staff members, such as nurses, doctors, physical therapists, social workers, and others.

The study, "Resident Outcomes in Small-House Nursing Homes: A Longitudinal Evaluation of the Initial Green House Program," (Journal of the American Geriatrics Society, June 2007), was led by researcher Rosalie A. Kane, Ph.D., of the University of Minnesota School of Public Health, and supported by The Commonwealth Fund and the Robert Wood Johnson Foundation.