Dr. William Thomas is the generative spirit behind the Green House Project. This long-time nursing home reformer brought together a group that recently received a grant for almost $10 million from the Robert Wood Johnson Foundation with this purpose:

promote the diffusion of the green house model as a higher quality alternative to institutional skilled nursing care. Green houses are small, self-contained houses for 10 elders with substantial disabilities that operate under a state skilled nursing home license. They represent a radical departure from traditional nursing home practices and physical environments. Each element of the green house operation and design is crafted to deinstitutionalize skilled long-term care practices and return control, dignity, and a sense of well being to residents and direct care staff. The small scale of each home and the resident-directed philosophy are core elements of the model. Under a previous grant, the Foundation helped demonstrate the green house model and develop a business plan for how it could be replicated commercially. The green house replication initiative is structured to jump-start development of over 100 green houses nationally through a mix of grant-supported and fee-for-service activities that would create a self-sustaining enterprise and would continue to refine and promote the model.

The Green House is a trademarked model. Any nursing care facility bearing that label must meet certain standards for construction, living arrangements, care, and other features. Dr. Thomas was interviewed on the Lehrer News Hour (hear the podcast) about his notion that, "The American nursing home is finished."

There's a video on YouTube showing what a Green House looks like and how the elders who live there react to the living arrangements.

And take a look at this Green House Project building in the Birmingham, AL, area.

Photo credit: cottagesatstmartins.blogspot.com

Seeking Solutions with Suzanne is a seniors-focused show with a senior host, Suzanne Roberts. On Suzanne.tv, she commented on the program and pointed out some statistics,

There are 20 active Green Houses in 16 states across the US.

She's a bit behind the count according to the interview, where it said there were 35 green houses.

The transcript of the Lehrer News Hour from Jan. 23, 2008 is reprinted in part at Providence Women, and explains the concept of shahbazim, which is an integral part of the Green Home concept that is mentioned in the YouTube video. The Shabaz is referred to on the video as the midwife of elderhood. According to Providence Women,

The twelve-minute story highlights two primary characteristics of the Green House concept – characteristics of all transformative nursing homes. The first, making the nursing home HOME, with all the implications that follow. The residents interviewed testify to that. So do the front line workers in a more indirect but compelling way. From the transcript:

Ebmeier, Nursing Home Administrator, and the shahbazim, (plural for shahbaz, name for traditional certified nurse assistants), tell the story of one former Green House elder, Mary Valentine, who celebrated her 101st birthday in the Green House.

Providence Women's story gives the details from the transcript about Mary Valentine, and then a personal comment:

At this point in the story, I experienced a strong resonance with Dr. Thomas’ differentiation between home and the institution. I was remembering the death of a friend in a nursing home early one morning just a couple of years ago. When the mortuary personnel came to remove the body, I accompanied them as they rolled the body-laden gurney down the long hall to the exit. My action was a conscious effort to form a kind of honor guard. As we passed the nurses station, the two employees sitting there, kept their heads down, apparently engrossed in paper work. Neither even looked up. Neither acknowledged the sacredness of the moment. Neither acted in a way that would indicate there had been a personal relationship with this person. I remember my feelings of shock and sadness. That is an example of “institution.” Institutions can’t love. Institutions that hold our elders need to be transformed into HOME.

Beth Baker visited a Green House in Tupelo, MIssissippi. She wrote about it in the AARP Bulletin back in 2005.

At first glance, there's nothing unconventional about the house. A curbside mailbox on a cul-de-sac in a new Tupelo, Miss., development marks the single-story residence, painted cream with blue shutters. A tall picket fence encloses a tidy yard with a barbecue grill, wind chimes and beds of flowers and tomato plants.

To enter, you ring the front doorbell and wait to be greeted by Cynthia Dunn. "This is my home," says the cheerful woman, who gets around in a wheelchair.

Behind her opens a bright interior every bit as welcoming as the exterior. The living room has a fireplace, a sofa and easy chairs. Family photos decorate the bookshelves and the walls. In the adjoining dining area a long wooden table can seat a large family gathering. From the kitchen drift smells of ham and biscuits.

It feels like home, a comfortable place to live, and this very ordinariness is precisely what makes the house exceptional. As part of the first wave of residences from the Green House Project, it's a reinvented nursing home—or more accurately, a new way of living for people who need long-term care.

I don't know about you, but I desperately want to be able to move into a situation like this if I ever need long-term nursing care in a setting outside my own home. Many of you may want to find something like this for your parents. I hope this project spreads rapidly.

Learn how to apply for funding and replicate the Green House Project in your area at NCB Capital.

A tip of the hat to Changing Aging, where I first learned about Green House Communities.