Managing for Results

What are the differences between a traditional nursing home and the GreenHouse model of service?

 

Traditional GreenHouse
Organized like a hospital –  the goal is to provide care for frail sick individuals No more than 12 people to a house. An intentional community, where primacy is given to quality of life.
Decisions about most issues are made for the elder. Resident Council meetings give input/feedback to the decision makers. House council meetings are held each week and include elders making decisions as possible with the guidance and support of the elder assistant.
Most common is double room, with some single rooms. All single rooms.
Usually shared All rooms have private baths
Long double loaded corridors Short corridors opening on to the hearth, with bedrooms on only one side
Lounges or sitting rooms and dining rooms are usually located at the end of long corridors. The hearth – a living room located at the center of the house. The dining area adjoins the hearth.
Usually in a remote location in the buildings most often quite far from the elders. An open kitchen adjoining the heart
Elders have choices, and may participate in menu planning through food committees. Weekly menus are planned by the elders and the elder assistants. (They are reviewed by the dietitian).
Meals are usually prepared in the central kitchen by dietary staff. Elders almost never have access to the area of meal preparation. Meals are prepared in the Green House kitchen by the elder assistants. Elders can see hear and smell the meal preparation and are free to participate in meal preparation if they choose.
Centrally stored and delivered using a medication cart Stored in locked closets in each elders room. Nurse administer if the elder cannot self administer with prompting. Emphasis on reduction of medications
Managed by rehab staff or specialized workers Planned by the clinical support team and elder assistant, but administered by the elder assistant

The principals at the core of the model are:

  • Maximizing of independence.
  • Resident-centered care.
  • Self-managed direct-care work teams.
  • Small homes focused on creating intentional communities, in which all residents of home are seen as part of a community within the house and within the larger area in which the house is located. This differs from a nursing home where the older adult is a patient and the institution does not represent a community.

 

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