Not a nursing home, but a nurturing home

Serving dessert

Sherri Rohr, a "shazbaz," gets dessert for resident George Hess. The large kitchen and dining table are central to the Green House. (Sun photo by Lloyd Fox / February 14, 2008)


By Tanika White | Sun reporter
February 24, 2008

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PALMYRA, Pa. - Instead of a nursing station, the focus of activity at Castagna House is a homelike kitchen with double ovens and a long wooden dining room table.

The people who live here aren't called residents or patients, but "elders." Those who care for them are not nurse's assistants or aides; each is called a shahbaz, a Persian word that means "royal falcon." And antiseptic corridors are replaced with short, sunlit passageways leading to private bedrooms, a whirlpool bath, a living room with a fireplace and landscaped outdoor areas.

It doesn't sound like a nursing home, and for good reason. This unusual living arrangement is called a Green House - a progressive new way to care for the elderly in their last years of life. While licensed as nursing homes, Green Houses provide care in a home, not an institutional, setting.

"I've been in different places, and this is the first place I felt like I wasn't in jail. I'm not kidding," said George Hess, 90, who uses a wheelchair to move freely throughout Hostetter House, a neighboring Green House on the campus of Lebanon Valley Brethren Home. "The way they treat me, you would think I'm the only guy here."

Now the concept could be headed to Baltimore. This spring, a Baltimore nonprofit expects to receive approval from the Maryland Health Care Commission to start designing and planning four Green Houses, to be built at Stadium Place in Waverly.

The Green House is the brainchild of Dr. William Thomas, a professor at UMBC's Erickson School. He believes that elderly people who require 24-hour care should live in a homelike environment, where their very basic needs - happiness, privacy, relationships - come first.

New priorities
"That might seem strange for a doctor to say that love comes first, then comes medicine," said Thomas, widely regarded as a leader in the quest to change how nursing homes operate. "But if you really want to make a difference in people's lives, love has to come first."

The first Green Houses opened in 2004 in Tupelo, Miss. Since then, 35 others have opened, and, with funding from the Robert Wood Johnson Foundation, groups are planning additional models in 20 states - including the four in Northeast Baltimore.

Mitch Posner, executive director of Govans Ecumenical Development Corp., the nonprofit organization that plans to open the Baltimore Green Houses by 2011, called the concept "the gold standard" in long-term care.

"It's the most cutting-edge, 21st-century thinking when it comes to providing a housing, service-enriched environment for the frail elderly," Posner said.

Green Houses - so named because of their airy, sunlight-filled atmosphere - don't just feel different. They look different, too.

Many traditional nursing homes are set up like hospital wards, with long corridors of residents' rooms on either side of a nursing station. There are often 20 to 40 people on a ward; residents usually share a room and bathroom with a roommate.

The Green House model calls for no more than 10 elders living in the house. Each elder has a private room and bathroom; the rooms are situated around a large open kitchen, a living room and the dining room.

Eyes and ears
The elders eat together, assemble puzzles together and lounge in the living room together. Staffers who care for them act as housekeepers, cooks and friends. Nurses come in and out, assisting the staff, but not running the house as they do in traditional nursing homes.

As they cook meals or help elders with dressing or bathing, staffers keep a watchful eye and a trained ear for distress calls - or even more mundane needs such as a second cup of coffee or a better book to read.

Another key difference: Elders are not corralled to meals and activities if they choose not to be. If they crave a snack, elders - as well as their children and spouses - are free to grab one from the refrigerator, or from a fruit bowl or muffin tin sitting on a counter.

"You can eat your breakfast whenever you want to," said Leroy Patches, 77, who lives at Hostetter House with his wife, Caroline, in the one adjoining spousal suite each Green House offers.

"Down there," said Caroline Patches, 78, pointing to the traditional nursing home on the Lebanon Valley Brethren Home campus, "they bring it to you at 6:30 a.m." She grimaced at the thought.

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Copyright © 2008, The Baltimore Sun

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