New nursing home idea more appealing

6/25/2005

AS AN aide at a nursing home one summer a few decades ago, I recall the dwindling dignity and quality of life the residents seemed to experience.

Although I respected old people, I learned in that nursing home to really appreciate them. I was struck by the gratitude of one woman after I used ordinary lotion to massage her frail, bony, arthritic hands. I recall a man who kept motioning for me to shut the door to his room. He seemed aggravated that he had no privacy. A different woman sadly showed me pictures of her family, who seldom visited. And a woman I had to bathe seemed to separate herself from the idea of a strange young woman attending to her private needs.

Personal attention, privacy, and dignity are among the issues being addressed in a new nursing home concept called the Green House Project. Interestingly, it mimics elderly living with their families, which was once the norm in America and still is in many cultures.

Instead of an impersonal, hospital-like setting where old people live in some of the nation's nearly 17,000 nursing homes, these elderly live in a house where communal living is the focus and where home-like dining and living areas are a focus instead of a nurses' station and cafeteria. About 10 residents live in a house, and each has his or her own bedroom and bathroom.

Nearly every trace of a typical nursing home is absent in these houses, started in Tupelo, Miss. Ten residents each already live in four such houses there, and six more are under construction. In Redford Township, Michigan a second set of the nursing homes is expected to open next spring.

The residents are not called patients, but elders.

"A patient is a sick person," geriatrician Dr. Bill Thomas told National Public Radio. "And the people who live here are the elders of this community."

A critic of nursing homes, he and his wife Jude Meyers Thomas, 45-year-old New Yorkers, developed the idea for the project and have de-institutionalized the concept of caring for old people.

There are nurses and aides, but aides are called shahbaz or shahbazim, innovative made-up terms. Visitors don't just walk right in these houses, but must ring a door bell. And loved ones who do visit can stay the night on a sofa-bed.

The Harvard Medical School graduate first tried to de-institutionalize nursing homes with plants, pets, and the like. He called that attempt to humanize nursing-home living Eden, and other nursing homes that have picked up on the idea of a home-like environment have done well with it.

But Dr. Thomas decided to replace the concept with something the residents are more familiar with: home.

These are not homes only for wealthy elders, as it might seem. Medicaid pays for the residents in the Tupelo homes, too.

The homes are under close scrutiny, and so far news about them is positive. Staff turnover is down to around 10 percent instead of the usual 80 or 90 percent. Also, the elders' health speaks volumes about their success. Generally, some appear to improve once they move into a Green House home.

"Results have been astounding," said Mississippi Methodist Senior Services president Steve McAlily. He is moving residents from a nursing home he runs into the new homes. "People who wouldn't eat in the nursing home are eating and gaining weight. Medicine use is down. Family involvement is up."

I don't recall the nursing home I worked in having the horrible odor or the herd-the-residents-along mentality that I've observed in nursing homes since, but apparently their quality has deteriorated. So the thought of a loved one or myself in one isn't pleasant. That's why I was glad to learn about this new concept in nursing homes.

For me and millions of other Baby Boomers, the idea of going to a Green House Project home is far easier to cope with.