Making the Nursing Home More Like 'Home'

For five years, 95-year-old Mildred Adams lived in a traditional nursing home. By the end of her stay, she had stopped eating and talking.

"She didn't respond to us when she came to visit us," said Becky Adams, her daughter-in-law. "She was totally helpless, and we just felt like she didn't have long to live."

Now, she not only talks -- she sings her favorite songs, like "Amazing Grace," all day long. And she not only eats -- she feeds herself and has gained 20 pounds.

She attributes it all to her new home -- the Green House Project. It's an experiment in reinventing the nursing home.

"I just like the people," she said. "They're friendly. They're nice."

Located in Tupelo, Miss., the Green House Project took 144 people out of a traditional, hospital-like facility and moved them into 10 cozy cottages with 10 residents apiece.

"The very first day, she made a complete turnaround, and it was like she was happy to be here," Becky Adams said. "And she has done just wonderful being here."

More Like Home

The Green House Project's goal is to make a nursing home less like a sterile institution and more like an actual home.

Green House Project residents get family-style meals around an open kitchen. They decide how the house should be decorated. Plus, the care is hands-on. The staff makes the residents' meals and eats with them.

The Green House Project has a much lower turnaround than in a traditional nursing home.

"It's about having the highest possible quality of life despite the fact that you are frail," said Jude Rabig, the national director of the Green House Project.

Rabig says the Green House Project doesn't cost any more to run than a traditional nursing home. In fact, state Medicaid pays the same amount per resident as in a regular nursing home.

"One of our goals was to make this an option for all elders, not just those who have huge resources," Rabig said. "So, if you qualify for nursing home care in your state and there is a 'greenhouse' in your state, you would qualify for the 'greenhouse.' "

Difficult to Replicate?

Skeptics like Dr. Robyn Stone, executive director of the Institute for the Future of Aging, argue that while the Green House Project may be a great idea, replicating it on a national scale presents obstacles.

"I think this model might be challenging in a lot of communities where land is expensive, where it is also difficult to build these small group homes and at the same time have nursing care in close proximity," Stone said.

Green House directors say it can work. They already have commitments for similar projects in 17 states.

It's part of a broadening movement to humanize care for the elderly. People 85 and older are the fastest-growing segment of the population, according to the Census Bureau.

For the few who already have experienced the Green House Project, it's been life-changing.

"We don't feel guilty anymore, because she's in a wonderful place," Becky Adams said.

She added that Mildred Adams' grandchildren and great-grandchildren are much more inclined to visit -- and regularly harmonize with her on favorite old songs.

More Details

Links for further information:

     The Green House Project

     The Robert Wood Johnson Foundation

     Consumers can compare nursing homes by clicking here

     The American Association of Homes and Services

     The American Health Care Association

If you're thinking about sending someone in your family to a nursing home, experts suggest:

     Call the area agency on aging in your community.

     Visit the nursing home unannounced, and speak with residents and their families.

     Consult experts, and get the state survey report posted in the nursing home.