Senator Bob Casey (D-PA) is on the right track in proposing introducing the “Promoting Small House Nursing Homes” bill to the United States Senate. Senator Casey is absolutely right in trying to promote a culture change in the Long Term Care industry.
Nursing homes have become complacent with providing “quality care”, a definition that is used very loosely, in a hospital-like setting. Imagine making the shift from a cozy household to a facility with florescent lights. Instead of waking up and having breakfast at your leisure, you are awakened at 5:45 am in order to eat at 6:30. This sudden loss of freedom is absolutely debilitating and can cause serious depression, a fact of life for about 20% of the elderly. Change however is approaching. A very innovative idea to integrate quality care with freedom as well as a cozy home-like atmosphere is called the “Green House Movement”.
An average of ten residents would live in one structure, each with their own private bedroom and bathroom. This would be connected to a common area as well as a kitchen. Instead of florescent lighting, the common area would have incandescent bulbs, just like those found in our homes. The smells from the kitchen would permeate into the living room, making the act of eating much more enjoyable and expanding a sometimes meager appetite. Board games and casual conversation would become commonplace in the living room, bringing residents out of their isolated rooms and into a community of peers.
The staffing would be done by two or three committed individuals for every home who are trained in cooking, washing of clothes, and daily care. This allows the staff to get to know the residents on a very personal level, and the residents can form their own routine with the staff. For example, if someone likes to sleep late, it wouldn’t be any extra burden for the staff member to wake someone up at 10 am rather than 6 am. If a resident doesn’t like pancakes, fine, she can eat eggs. Doctors and Registered Nurses would make the same type of rounds they do in conventional homes.
What I thought when I first heard this idea was that it would be insanely expensive to change nursing homes into “Green Houses”. Yes, building new structures would be very expensive. The costs would remain the same in almost every other category. Staffing levels would not increase and staff turnover would likely decline when CNAs would build stronger relationships with the residents.
There is anecdotal evidence to suggest that Green Houses would save nursing homes costs from illness’s that stem from immobility. Residents would be able to walk around more and integrate themselves in a community which would reduce pressure ulcers and depression. So why hasn’t the industry taken this step? It takes a tremendous amount of capital to build these new, smaller structures.
And that is where the honorable Senator from Pennsylvania comes in. He has proposed that the Department of Health and Human Services gives a low interest loan to nursing homes who want to build these structures. They would need to fulfill the criterion that ensures they are creating person centered care, of which the Green Houses is just one strategy. With a little nudge from the federal government, nursing homes would be able to take a step in the right direction that would not only improve the quality of care but also save taxpayers money in the future by reducing needless ailment brought on by the current institutionalized conditions. Contact your senator today and tell him/her that you support the “Promoting Small House Nursing Homes” bill.
