On December 14th, 2009 the four-year effort to create substantive culture change at Green Hill was culminated as Green Hill Inc. broke ground on the first of four Green House® Homes on its 23 acre West Orange, New Jersey campus. Dr. Bill Thomas founder of the Eden Alternative® and the Green House Project®, and many state and local dignitaries were in attendance for the historic event in senior healthcare in the state. The first of its kind in New Jersey, the Green House Home model’s operation and design was crafted to de-institutionalize skilled long-term care, and return dignity and a sense of well-being to residents, their families, and staff. Eight years later, having celebrated the opening of the 100th Green House Home in the US at Green Hill in September 2011, Green Hill innovates the person-centered care model once again by offering subacute rehabilitative care in the Green House setting.
The Green House Home model is a home for 10-12 people, with private rooms/baths that “harmonize with the neighboring community” (Green House Project). The Green House Home creates a familiar home environment with an open kitchen, a great room living space and easy access to the outdoors. The Green House Home structure enables deep relationships between elders and caregivers and turns the organization chart upside down establishing the elder as the center of the care paradigm. This structural change is most evidenced by the flexible routines and personal preferences of elders that are in the forefront of each day. Personal growth and the pursuit of individual passions are encouraged and supported by attentive care providers called Shahbaz, a Persian word referring to a fabled guardian who provides 24/7 care.
“He (Dr. Thomas) believes that his generation, which reinvented what it means to be young, should now be reinventing what it means to grow old. We need to get people out of hospitals, we need to create a rich set of community-based alternatives.’” The Washington Post by Tara Bahrampour 1/23/16.
“One of the many beautiful aspects of the Green House model is its adaptability. When our homes first opened, they were designated for long term care with only two rooms per house designated for short term rehabilitation,” says Stephanie Thomas, Green Hill Green House Educator and Culture Change Coach. “Over time, we not only saw positive results in those elders who were living in our Green House homes for rehab services, but we also realized that it was a growing need in our community. Making the decision to utilize more of our Green House homes for short term rehabilitation seemed like a perfect fit, and we have seen great success for those elders who use our services.”
Studies show that residents of the Green House Homes get 23-31 more minutes of direct care time per elder, per day with 4x’s more staff engagement with elders. Green House elders enjoy improved quality of life in privacy, dignity, meaningful activity, relationship, autonomy, food enjoyment and individuality (Green House Project®). Elders also show Improved quality of care, retention of self-care abilities, and fewer experience depression.
The Green House model at Green Hill focuses three core values of a Real Home, a Meaningful Life, and Empowered Staff. Elders live in the private home setting, and dine together at a family table. They are cared for by Shahbazim who provide one-on-one attention fostering deep relationships. They serve as liaison between the elder and their clinical support team made up of the nurses, therapists, social workers, and other staff involved in the elder’s care. The Shahbazim take the time to individualize the care of each elder, catering to each elder’s preferred routine and choices.
“Research shows that Green House elders are happier and healthier than residents in traditional nursing homes – even though they have similar conditions, such as dementia, post-stroke ailment, Parkinson’s disease and heart disease. They’re less likely to become hospitalized or to experience declines in their ability to eat, dress or go to the bathroom on their own.” Susan B Garland, Kiplinger’s Retirement Report 4/16.
Rehabilitation services are provided within Green Hill’s Green House Home with areas designated for specialized equipment. Therapists work with the elder and the Shahbazim to determine what time of day works best for treatment. An individualized atmosphere promotes a better healing environment. “It can best be described as home care provided in a skilled setting,” continued Ms. Thomas. “Imagine that instead of having therapy in a rehabilitation facility you are having every need catered to in your own home. Family can visit at any time and can even join you for a meal. This setting helps not just the elder but families as well feel comfortable and confident in the care being provided.”
“Both the clinical and emotional experience of providing rehab services in our Green House homes are spoken of very highly by residents and their families,” said Executive Director and President Donna Lazartic MBA, LNHA. “We find that the principals of the Green House Project in rehabilitation provide best case scenarios for an elder’s emotional wellbeing, therapy participation, familial engagement, and rate of positive outcomes.”