June 27, 2005

Nursing Homes Get a New Look

As National Public Radio (NPR) reported here last week, several nursing home reformers are pushing for a new look for nursing homes, one that emphasizes a home-like atmosphere over institutional efficiency. One project that is receiving praise is the Green House Project, lead by Dr. William Thomas. His hope is that older people will thrive and live happier lives in smaller facilities that resemble the homes they lived in their whole lives. While others in the past have tried to make existing facilities more home-like, Thomas believes that we need to start over from scratch.

Thomas is in favor of nursing homes that are individual units, that blend into the community that surrounds them, whether it be high rise apartment buildings or suburban neighborhoods. Each unit would have 6-10 residents each with a private bedroom, a common area and a kitchen dining area where they would share their meals. The design is intended to give residents more privacy and control of their lives, where they decide when and what to eat and how to decorate their living areas. The focus of the new homes will be to improve the quality of life of elders by restoring their dignity and individuality.

One of the focuses of the new projects is to make the homes blend in with the surrounding community. Current nursing homes have been designed and built to maximize their efficiency at providing medical services to large groups of people. The fact that the long-term health care system is currently stretched to capacity has only served to reinforce their emphasis on institutional efficiency. Green Houses would be furnished by the residents with items from their old homes. They would all have private rooms, to promote privacy. The center of the residence would be a common area where residents would share their meals. There would be no central nursing station, since the residents would keep their pills in their own rooms. Nurses would come by as needed but would not have a permanent presence in the home.

Another core element in a Green House would be an emphasis on meal time as an opportunity for residents to bond and nourish their bodies as well as their souls. Current facilities must struggle with the logistical difficulties of large scale food service, which often depersonalizes the dining experience. A meal in the Green House would take much longer, but would be intended to be a social as well as nutritional experience.

All of the changes proposed by Dr. Thomas would serve to increase the amount of affection that elders receive. Thomas believes that aging should not be viewed as a medical problem, to be treated with professional distance, but rather a stage of life to be embraced. He believes that the residents should be allowed to befriend those who care for them, and that that affection will increase their quality of life.