Jan Cassidy Wood and her siblings knew that if their older brother Jack Cassidy ever needed long-term nursing care, it would fall to them to find it. He was unmarried and lived alone, and since childhood has had serious health issues. After a stroke this past January, the 68-year-old retired mail clerk could no longer take care of himself in his home.
So Wood, a former high school teacher, researched 32 long-term care facilities in the Boston area. Finding up to four residents to a room on her visits, Wood found the places far from warm and fuzzy. The staff at short-term rehabilitation, where Jack landed after the hospital, kept asking her if she had found a bed.
"But that grated on me," Wood says. "I wasn't looking for a bed for Jack. I was looking for a home."
Then, last February, Wood toured the Leonard Florence Center for Living, a new six-story high-rise in the industrial city of Chelsea outside Boston. Jack now lives there with nine other residents in what is called a "Green House," an innovative and growing alternative to long-term skilled care that looks, feels and operates more like a person's own house than a traditional nursing home.
A home that promotes growth
Say goodbye to long corridors, central nursing stations and multiple roommates. In the Green House model, each of the 10 to 12 residents has a private bedroom and bathroom connected to a common dining room, an open country kitchen where all the meals are prepared, a living room, and an indoor porch or backyard. Natural light, plants and freshly baked cookies abound. Everyone eats together at a long wooden table (unless they're unable), and in the living room cozy sofas and a fireplace invite residents, their families and staff to gather.
"Just as a greenhouse for plants is a place that is intentional about the environment to create optimal growth, we want to make sure we create that environment to promote growth for elders," says Susan Frazier, a staff project consultant at the national Green House Project and a former nurse. "It is reframing the whole way we view aging. While there are physical and mental losses, we are going to find those areas where there is still an opportunity to grow."
Maintaining control, making new connections
After a fall last winter, Jean Moore, 84, moved to Eddy Village Green near Albany, New York state's first Green House project. She and two women in her house like to do crossword puzzles together, sit next to one another at meals, read the same kind of books, and even take afternoon naps at the same time. Moore loved talking sports on the back patio with her housemate Harold. He died last month, but his daughter still visits Moore.
"I'm never lonely or bored, and if I don't feel right, someone is always there," says 90-year-old Ruth Birnbaum, a housemate of Jack's in Massachusetts. A neck pendant summons help wherever a resident — called an "elder" in Green House lingo — happens to be. Other discreet technology, such as an electronic lift in each room, easily transports residents who need assistance from their bed to their bathroom.
"When you walk into a Green House, there's a calmness," says Betsy Mullen, vice president of clinical operations for Chelsea Jewish Foundation, which oversees the Leonard Florence Center for Living. "It's more like you're walking into a home where they just happen to be getting treatment."
Green House residents call the shots as much as possible. At a time of life when so many things feel out of their control, they wake up and go to bed when they want, and there are no set visiting hours. "Somewhere along the line, when you have institutionalized care, it becomes what's easiest for the staff rather than what does the elder prefer," says Jaimy Farnan, administrator of Eddy Village Green. Farnan oversaw the large nursing home on the property before it was torn down to make room for 16 ranch-style Green House homes. Today, 12 people live in each house, a total of 192 residents.