From our house to “God’s house”

Over the last decade, the medical practice of elder care has come to recognize the importance of well-designed housing as foundational to the well-being of the elderly. Leading geriatrics doctors such as Dr. Bill Thomas have founded initiatives such as the Eden Alternative and the Green House Project which recognize that “human well-being” encompasses more than what is clinically measurable. These initiatives have brought a semblance of autonomy and a sense of “home” back to these elderly facilities. The concept of de-clinicalizing end-of-life care and understanding the need for elderly residences to have a home have become a driving vision for recent work in geriatrics and hospice care.

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  • “A small but growing group of nursing homes are already implementing these changes. Collectively called ‘household models,’ these nursing homes have generated enthusiasm among diverse stakeholders and long-term care experts. Because of its scale and consistency across homes, the Green House approach has been the most frequently studied household model.”

  • “Alternatives to traditional nursing homes for older adults who cannot remain in their own homes has prompted interest in smaller, community-style facilities such as the Green House model. Staff are used more flexibly in the Green House model, and work with small clusters of residents; the model’s success, especially during the COVID-19 pandemic, has attracted interest as an alternative to traditional nursing homes.

  • “The Center for Innovation and its Green House Project is promoting government incentives that support construction of modern, person-directed facilities through targeted grants or Medicaid rate increases. Providers in Arkansas and soon Ohio, for instance, receive Medicaid rate add-ons for private room nursing care.”

  • “Some suggestions included increasing state investment in home care, incentivizing a transition toward fewer-occupant rooms and Green House-style facilities, standardizing the Medicaid reimbursement system with data-based adjustments over time, increasing audits and financial transparency requirements for nursing homes, and building workforce pipelines into the sector through scholarships and more flexible training programs.”