wfn.org | Green House Project aims to revolutionize elderly care

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April 23, 2003	News media contact: Tim Tanton7(615)742-54707Nashville, Tenn.
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NOTE: Photographs are available with this story.

By Woody Woodrick*

TUPELO, Miss. (UMNS) - Plants bloom and thrive in the warmth and light of a
greenhouse, and developers of the Green House Project, a groundbreaking
system of care for America's elderly, hope the first-ever Green House is a
place where the aged can also bloom.

United Methodist Senior Services of Mississippi Inc. will open the first
Green House in the nation May 2 on the Traceway Retirement Community campus.

"I'm convinced society is reflected in how we treat our elders," says Steve
McAlilly, president and chief executive officer of UM Senior Services, citing
the commandment to honor father and mother. "The whole country is watching
this project. A lot of organizations are waiting to see how this goes. I'm
grateful our board had the vision and courage to step out."

The Green House Project moves away from the institutional model of nursing
homes and borrows from the highly successful group-home model used with
troubled teens.

The concept revolves around a facility built specifically for elders that
creates a "home" atmosphere. The core of the small homes is a common living
room, complemented by a large, open kitchen, lots of windows and other
amenities. The 10 residents may bring their own furniture, including pieces
for the living room. Meals will be cooked in the home, and all will eat
together around a family-style table. Outside are fenced yards and a small
patio in front.

McAlilly and Dr. Bill Thomas, a United Methodist and founder of the Eden
Alternative, helped develop the Green House Project, along with members of
Thomas' organization. The New York-based Eden Alternative is a system of
elder care designed for retirement communities. UM Senior Services, a
self-supporting agency affiliated with the Mississippi Annual Conference, has
adopted the Eden Alternative for all of its facilities. 

The Eden Alternative is a philosophy that seeks to change the environment of
today's nursing homes and other long-term care institutions by making life
better for those who live and work there. Its core principle is that housing
for the elderly must be habitats for human beings, not sterile medical
institutions. The Eden Alternative is dedicated to eliminating the
loneliness, helplessness and boredom that make life intolerable in many
nursing homes.
 
Those involved in the Green House Project wanted to find a better way to care
for frail elders, or those who need skilled nursing assistance. McAlilly says
the idea grew out of numerous conversations over a period of years.

"We conceived the idea of a small home for elders that provides as much of
the things of a home as possible," he says. "This home will be
state-of-the-art technologically and will provide all the services of a
nursing home but in ways not offered before."

UM Senior Services has four units under construction, with the first
scheduled to start receiving residents May 2-3. Plans call for eventually
moving all 140 residents of the Cedars nursing home on the Traceway
Retirement Community campus into Green Houses, McAlilly says.

Jude Rabig, executive director of the Green House Project, spent a week in
Mississippi training those who will work in the homes. Actively involved in
nursing home reform for many years, Rabig says she's excited about the
possibilities of the Green House Project.

"There are only two groups we consistently institutionalize for life -
murderers and frail elders. Everyone else can eventually get out of an
institution," she says. "There is no reason why frail elders can't live in a
home like this."

Watching the training, the amount of thought that went into how the homes
will operate is evident. Rabig points out to the 10 or so "shahbazim," as the
universal workers of the Green Houses are called, that when they smell
something cooking, they probably get hungry. The same is true for elders. By
cooking the meals in the homes, residents are more likely to become hungry
and eat better. The fact they've helped plan the menus should also be a plus.

All of the workers have experience in nursing homes. Rabig spent time showing
them techniques for dealing with everyday issues that allow the elders to
maintain their dignity, yet still receive the care they need.

For example, while discussing dementia, Rabig had a shahbaz play the role of
an elder trying to communicate a need. Rabig pointed out how traditional
nursing homes usually handle the situation and how it should be handled in a
Green House.

"This is a step in the right direction," says Matt Belue, a shahbaz. "If we
do our jobs, we're both better off. We will have more one-on-one time and be
better able to nurture, sustain and protect (the elders)."

Samantha Fullilove says she likes the idea of residents having more control
over their own lives. "At a nursing home, they can't make their own
decisions. We have to decide," she says. "Here, we let them make decisions."

Belue says she likes the fact that she will get to know the residents better
than in a traditional nursing home. "We'll take care of them every day," she
says. "We can become a family together."

The shahbazim will have more input into residents' care, she notes,
contrasting that with nursing homes, where nurses usually make all the
decisions. By being in close contact with a small group of elders, a shahbaz
will be able to make better decisions, she says.

The workers will be a mix of current UM Senior Services employees and
newcomers, McAlilly says. UM Senior Services looked for those with a
commitment to elder care, he says. All workers are certified nurses' aides.

The Green House Project has attracted interest from elder care groups around
the United States. Thomas was able to secure a grant that has paid for the
shahbazim training, and leading researchers in the field are already studying
the project.

Dr. Rosalie A. Kane, an expert on quality-of-life issues for the aging, is
leading a team of researchers exploring the concept. She and team member Lois
Cutler visited Tupelo March 6.

The research team will watch the development of Green Houses from various
perspectives, including those of health and social services personnel in the
community and state. In addition, they want to gain knowledge from the
experiences of seniors living in the Green Houses, their families and those
who provide care for the elders. 

The lessons learned from the planning and implementation of the Green House
concept in Tupelo will be applied to similar projects across the nation.
Besides additional Green Houses in Tupelo, others are planned for Nebraska
and Michigan. Tabitha Health Care Services, owned by the Evangelical Lutheran
Church in America, will operate one in Lincoln, Neb., and local government
will operate another one in Powers, Mich.

Each of the initial Green House buildings is about 6,000 square feet and cost
about $480,000 to build. UM Senior Services already owned the land.

"The Green House Project addresses a key problem in the structure of nursing
homes today, providing treatment to people in a setting governed by strict
routines," Kane says. 
"The Green House is designed to provide that same care and treatment for
people in a normal, home-like setting. It will be exciting to see the concept
become a reality."

The Green House developers have been creative in meeting state requirements
without taking away the "homey" feel, McAlilly says. Certain telltale signs
of a nursing home, such as a nurse's station, have been moved behind closed
doors. Lights over each door that signal assistance is needed have been
incorporated into a unique design. 

Each resident will wear a small transmitter that, when pressed, will signal a
nurse. Response time should be no more than five minutes - about standard in
a nursing home, McAlilly says. While shahbazim will serve a single home,
nurses will rotate among several.

Once Senior Services decided to embrace the Green House Project, a
presentation to the Mississippi Department of Health was necessary. McAlilly
says the state requires nursing care facilities to meet 114 criteria. The new
Green House model met 111 criteria immediately. Two items had to be approved
by someone who could not attend the entire meeting, and the third has since
been met. 

Response among Cedars residents and their families has been mostly positive,
McAlilly says. Some are taking a wait-and-see approach, while others are
enthusiastic, he says.

"I've never had anyone call and say they wanted to move into a nursing home
until they had to," McAlilly says. "Every time a story about the Green Houses
is in the paper, we get calls from people asking to move in."

Much of the landscaping is being left to the residents. They will choose
plants for inside and outside, where a fenced patio area has room for a small
flower garden. Those who are able will be encouraged to take part in
planting. Members of the Master Gardener program at Mississippi State
University will assist them.

Standing on the cusp of a groundbreaking project is heady stuff, but McAlilly
hasn't forgotten the first two words in his organization's name - United
Methodist.

"I'm proud of the United Methodist Church because of its support for, honor
and respect of elders, and its ability 35 years ago to see the need to
provide meaning and abundant life to elders," says McAlilly, the son and
brother of United Methodist clergy.

"When we do what we do, it is because of the church. Our organization
believes it is called by God and the church to be at the forefront of
providing meaning and quality of life for elders."

More information on the Green House Project is available at
http://thegreenhouseproject.com/ online.
# # #
*Woodrick is editor of the Mississippi United Methodist Advocate, the
newspaper of the United Methodist Church's Mississippi Annual Conference.

*************************************
United Methodist News Service
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