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A Future Without Nursing Homes?

November 23, 2004
There is a future without nursing homes says Dr. William Thomas, a physician who has established new small group homes for elders called “Green Houses.”

At a congressional briefing on Capitol Hill, research findings presented by an independent team from the University of Minnesota led by Dr. Rosalie Kane reported statistically significant improvements in how the elderly responded in Green Houses compared to a control group of two other traditional institutional-type nursing homes.

In a time of growing concern about the cost of caring for the elderly, the Green House model delivers this high-quality at the same or lower cost, Thomas said.

“America has a choice. With the nation's nursing homes deteriorating from age and the baby boom generation moving into the later chapter of their lives, should we build many new traditional institutions or replace them with an alternative that deinstitutionalizes the frail elderly and truly celebrates elderhood?” Thomas asked.

America's obsession with youth harms young and old alike, says Thomas, who argues in his new book What Are Old People For? that the 77 million aging baby boomers will change society one more time.

“Creating a new old age will be the baby boomers’ last act on the public stage,” says Thomas.

The focus of the Green House model is the quality of life experience in a living space for eight to ten elders. The preliminary findings from the ongoing study found that the seniors, the people who take care of them, and even the friends and family that come to visit were extremely satisfied with the quality of life offered by Green Houses.

The Green Houses, which look and feel like a house, respect what Dr. Thomas calls the “rhythm of life” and the well-being of the people who live there. This rhythm is created by, and evolves through, household decisions made jointly by the seniors and the staff trained to care for them.

At the Green House, there is no bureaucracy. Says Dr. Thomas, “Bosses upon bosses upon bosses have been removed.” The research indicates that this may be a solution to the critical problem of high staff turnover in traditional nursing homes.

In research at the world’s first Green Houses in Tupelo, Mississippi, which opened in May 2003, answers to open-ended questions show that elderly people thrive far more than in regular nursing homes.

“Seniors who were in wheel chairs are walking, seniors who were not talking are talking, seniors who were not eating are eating,” states Tupelo director Steve McAlilly. “Through something as simple as enabling Green House residents to smell the bacon cooking, the small pleasures of life are restored.”

Additional Green House projects are in development nationwide in Michigan, Nebraska, Georgia, Florida, and North Carolina.

More detailed findings of the research sponsored by The Commonwealth Fund are available on the project’s web site at www.thegreenhouseproject.com.

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