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The Green House nursing care center for seniors is a relatively new concept in "home-like" care for seniors requiring nursing care. Traditional nursing homes are based on a medical model. The Green House projects are based on a home model -- with a smaller, more homelike building with private space and shared community facilities.

Staffing is also different. Each project is based on 24/7 care, but the duties have shifted from highly specialized care to more family-like care provided by a core team, and supplemented with appropriate medical teams from outside.

Clinical Support Team

The clinical support team is comprised of a Medical Director, Director of Nursing, nurses, therapists, social workers, dietician, and activities coordinator to provide skilled care for the residents as required in the care plan. The Shahbazim are certified nursing assistants with additional Green House training) by developing close relationships with the elders, provide the Clinical Support Team with valuable information to assist in developing the care plan.

Licensed nurses are available to and responsible for clinical care in Green House homes on a 24-hour basis. If the nurse is not in the home and is needed, is available to the Shahbazim and elders via pager and other communication technologies. The Shahbaz

The Shahbaz (plural: Shahbazim) is a universal worker who provides personal care, meal planning and preparation, light housekeeping, and laundry for 7-10 elders. Shahbazim core training as Certified Nursing Assistants receive about 120 additional hours of specialized training to cover The Green House philosophy of care, person-directed care for persons with demenia, household operations, building self-managed work teams, policies and procedures for their project, communication skills, culinary training, safe food handling, and certification in first aid and CPR.

The Guide

The Green House Guide serves as coach and supervisor the the Shahbazim, and is responsible for the overall operations and quality of services in the home. The Guide may be responsible for more than one home, depending on the size of the community.

The Sage

The Green House Sage is a resident elder who acts as a coach or mentor, assists facilitating the development and continued growth of the self-managed work team and to serve as a trusted advisor to the Shahbazim. This is a volunteer position.

Extended Nursing Care Residents

Residents in the Green House are encouraged to participate in shared home activities such as cooking, self care and cleaning, as well as hobby activities and participation in the surrounding community.

Family

Family participation is encouraged and welcomed in The Green House home, from sharing meals to participating in activities and volunteering time and services to help their loved one decorate personal space. Well-behaved family pets are also welcome visitors!

Only projects accepted through the application process and developed in cooperation with The Green House Project team are authorized to provide long-term care services under the licenses service mark: THE GREEN HOUSE®.

A five year pilot project ending in 2010 is reaching its goal of 50 projects across the country. Check the website for locations in your region. These nursing care facilities are often developed by nonprofit groups, churches and even municipalities.

Local food is fresher and tastes better than food shipped long distances from other states or countries. Local farmers can offer produce varieties bred for taste and freshness rather than for shipping and long shelf life.

Shipping food for thousands of miles not only loses freshness and its related health benefits, but it increases use and dependence on petroleum for transportation -- which affects air quality, and soil and habitat health.  Local production of consumables is common sense, and this online local food locator can help you make buying local and fresh food practical.

The Buy Fresh Buy Local Campaign, a project of the Community Alliance with Family Farmers, helps consumers find and choose local products while building relationships between growers, food artisans, farmers' markets retailers, restaurants, and institutions.

Buy Local Buy Fresh:  http://guide.buylocalca.org/

Vision Technology (St. Louis, MO) has an image magnifier system for people with poor vision. Designed to be portable like a laptop, the unit folds into a flat package for easy transport.

• The VIEW features 2x -65x magnification giving one of the largest zoom ranges found on  portable video magnifiers.
• Advanced precision glass optics provide a crisp image with no glare, and works together with monitor features such as 5 ms response time and 16 million color hues, creating a crisp and clear image.
• A high-performance camera is included in its engineered design.

Morning newspapers, magazines, bank statements and a wide variety of documents can be placed on the reading tray and it will autofocus instantly -- reducing eye fatigue and saving  time.

How would you like a coffeehouse or snack bar named for you? 

Vitalize! Wellness Centre, is a state‐of‐the‐art development that opened as part of the Ecumen community Parmly LifePointes in Chicago City, called Ruben's, named for a 94‐year‐old resident, and lifetime swimmer.  Being active in a local community brings many rewards...and a great community will use its own facilities to acknowledge achievements and inspiring people to further their mission -- including naming facilities after key residents!

The Vitalize! Wellness Centre,  features a warm‐water pool, juicing classes and rows of high‐tech exercise machines that boost a goal of helping residents to seize personal responsibility for "aging well." Ruben Berg is a prime example of that accomplishment, says Patricia Montgomery, the center's director.

She defines aging well as "live long, die short."

A 1998 book titled "Successful Aging," based on results of the groundbreaking MacArthur Foundation Study, taught us the powerful role each of us has in shaping our health and well‐being as we age.

Our genes determine only 30% of our destiny! 
The other 70 percent is up to us!

A decade after the book was published, other studies have confirmed and advanced those findings.

Most people can recite the wisdom of regular exercise, keeping weight within limits and that smoking is bad for your health, says Robert Kahn, co‐author of "Successful Aging"

He sees progress in Americans' understanding of aging well, he says. But it shows up more in what they know than what they do.  Like obesity -- it's increasing rather than decreasing.

Kahn sees too little about why people are living longer and what longer life means, he adds. "Or what a longer and productive and happy life can be."

He wants to see more information circulated about other findings, too, such as the need to challenge our brains often and in new ways to stay mentally sharp. And he'd like to see more about learning and productivity in older people's lives and less about leisure.

We get the hint :-)  So in this blog ... "Solutions for Senior Health" we're focusing on learning and productivity and healthful living!  Good behavior!

Dr. Roger Landry travels the country to educate audiences about aging well and to promote and train care providers in the how‐to of masterpiece living, a plan for successful living inspired by the MacArthur Foundation Study.

Questions remain about how to make it happen. "One is how to engage older adults. They're smart people with interesting lives." But our broader society tends to push them aside. Changing that, he says, would be a "win‐win" for people of every age.

IDEAS:  crossword puzzles and Sudoko and software such as  [m]Power cognitive fitness technology

Spirituality and Social Connectedness -- Solution for Isolation

Understanding of the value of both spirituality and social connectedness is growing, he says. "If we stay in our homes, almost by definition we stay more and 3
more isolated." Studies show that isolation heightens the risk of cancer, cardiovascular disease, dementia, falling and fractures.

"Alzheimer's disease still terrifies people," Landry says, and many aren't aware there are ways to ward it off.

Americans need to replace high levels of stress, which he calls "our national sickness," with more serenity and soulfulness.

States Are Developing Senior Communities

Cleveland (Ohio) Foundation Successful Aging Initiative (http://www.successfulaging.org), which is developing a three‐year, $4 million plan to create and maintain elder‐friendly communities in the city. Goals include creating lifelong learning and development centers and promoting employment and volunteer opportunities for older people.

Colorado,  (www.silverprintcolorado.org) is developing an independent coalition of individuals, organizations and businesses with a vision  to establish a culture for positive aging and addressing needs, contributions and opportunities for people age 60‐plus.

6 Dimensions of Wellness

• physical
• emotional
• intellectual
• social
• vocational
• spiritual

The hope is that individuals will hold onto an independent spirit. That can mean living one's passion, whether it's a long‐held one, something they've always wanted to try or a new discovery.

SOURCE:  Ecumen, "Senior Housing and Successful Aging in the 21st Century"

This news story about a family coping with Alzheimer's notes features of senior housing designed with apartments for Alzheimer's patients, including senior stoves, emergency sensors and community exercise programs.

During a patient stay in a hospital, nursing home, or other health care setting, the staff will work with you to plan for the patient discharge. The patient and their caregiver are important members of the planning team. This is a checklist of important things you should know to plan for a safe discharge. To view the checklist, click here.

Examples of the items in the checklist include:

1.  Who will you contact to get care after you are discharged?

2. Do you understand your health condition(s)?

3. Do you know what problems to watch for...and how to handle them?

Check the checklist for more details.

Public agencies have resources available such as home-delivered meals and rides to appointments. Ask a social worker at your health care provider for more information about the local community services and support available in your area.

Area Agencies on Aging (AAAs)
Assist adults age 60 and older and their caregivers.  Call the Eldercare Locator at 800-677-1116 weekdays or visit their website at www.ElderCare.gov

Aging and Disability Resource Centers (ADRCs)
Assist people of all incomes and ages in 43 states.  Check the website to see if your area is served:  www.adrc-tae.org

Centers for Independent Living (CILs)
Assist people with disabilities. A state directory can be found at www.ilru.org

State Technology  Assistance Project
Information on medical equipment and assistive technology.  Contact the RESNA - Rehabilitation Engineering and Assistive Technology Society of North America to get contact info for your state.  www.resna.org

State Medicaid Agency
Information about Medicaid. To find your local office visit www.nasmd.org/links/links.asp. It has a clickable map of the US.

Medicare
Call 1-800-Medicare (800-633-4227) or visit www.medicare.gov/LongTermCare/Static?Counseling.asp

 

Additional resources for learning about options or finding help (nationally) include:

• http://www.ioaging.org/ - Institute on Aging.
• http://www.apsnetwork.org/ - National Adult Protective Services Association (NAPSA).
• http://www.ncea.aoa.gov/ncearoot/Main_Site/index.aspx - National Center on Elder Abuse-Administration on Aging.
• ACF: Administration for Children & Families; http://www.acf.hhs.gov/; The ACF, within the Department of Health and Human Services (HHS) is responsible for federal programs that promote the economic and social well-being of families, children, individuals, and communities.
• ADCRC: The Alzheimer's Day Care Resource Center program's primary purpose is to provide quality daycare for persons with dementia, while giving respite to their caregivers.
• Administration on Aging; http://www.aoa.gov; The Administration on Aging funds the largest U.S. community nutrition program for older persons, and works closely with its network of state and area agencies on aging, tribal organizations and service providers to provide adequate nutrition for the elderly. In addition to Nutrition information you will find information on Alzheimer's; Senior Medicare Patrols; the Eldercare Locator. Information that can be found on the AoA website:
• Grants; http://www.grants.gov/; Grant information.
• Statistics on Older Americans; http://www.aoa.gov/prof/Statistics/statistics.asp.
• Aging Network Resource; http://www.aoa.gov/prof/agingnet/agingnet.asp.
• About the Older Americans Act; http://www.aoa.gov/about/legbudg/oaa/legbudg_oaa.asp;
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Human beings love nature!  There's no question about it -- when you look at the amount of time we spend as a species admiring sunsets, planting gardens, exchanging flowers, and taking long leisurely walks.  But healthcare has become an indoor activity -- sequestered from nature's healing embrace.

There is a large and growing body of evidence over the past decade that demonstrate the role of the physical environment in achieving healthcare quality and safety. A recent analysis of more than 600 primarily peer-reviewed studies found associations between the physical environment and patient and staff outcomes in four areas:

• Reduced staff stress and fatigue and increased effectiveness in delivering care
• Improved patient safety
• Reduced patient stress and improved health outcomes
• Improved overall healthcare quality (Ulrich, 2004)

Hospitals are complex systems in which it is difficult to isolate the impacts of individual factors and suggest that design-based evidence parallels evidence-based medicine for improving health care.

Green Healthcare Solutions

A green healthcare agenda that includes ecological health on multiple scales -- individual, staff, facilities, and global impact -- can incorporate environmental initiatives such as reduced resource use, and it can aim for improved patient outcomes.

A responsible green agenda does not guarantee that recycled floor surfaces or less outgassing of chemicals from products will result in better care or more rapid recovery, but reinventing hospitals and transforming their design becomes a tool to improve quality, safety, and experience.  Green touches everything...food, cleansers, buildings, and even transportation choices.

Seniors are probably the most vocal and highest financial supporters of healthcare institutions.  Seniors' own need for quality care creates some of that focus...but their concern for their communities, the desire to give back to their communities and their concern for following generations lead them to contribute time, talent, resources and a voice to healthcare policies.

Learning about green healthcare and sustinable communities can be a powerful tool to accomplish these altruistic goals.  The information is available through new green healthcare associations, the Institute for Medicine, etc.  Now, what's needed is for individuals with a seat at the table of local organizations to bring their concerns into the light of discussions. 

To help shape a more sustainable future based on solid environmental support systems, not based on the manmade, pharmaceutical and toxic approaches to healthcare that has been developed over the past fifty years, but to look at healthcare as a system of people caring for one another in healthful environments, using healthful products and services...and taking that new approach to clean air and water, non-toxic solutions and reduced impact on the environment home with us.

That's our challenge today.  Understanding how global systems affect our own immediate ability to breathe easily, keep our bodies free of pollutants, and thrive for the long term! 

The Principles of the Ethical Practice of Public Health begins with a statement that, prima facie, supports green health care:

"Public health should address principally the fundamental causes of disease and
requirements for health, aiming to prevent adverse health outcomes."

We are learning that many of today's diseases are being caused or exacerbated by environmental pollutants.  Asthma and heart disease are greatly impacted by exposure to pollutants, especially those from vehicular exhaust.  Allergies and sensitivities are increasing as the chemical soup in which we live increase.  Children tested for resident toxins are showing significant increases in toxin levels.

Public health is one of our vehicles for a more sustianable way of life.  If "green" will improve public health, it will also improve individual health levels for our children, our neighbors, our more vulnerable seniors and even our productivity level on the job.

Climate change brings another kind of health impact.  Severe heat kills.  Droughts kill.  Floods kill.  Those public health threats are environmental, and can only be solved with environmental solutions.  Our role as citizens in those solutions is first and foremost to reduce our impact on the global natural infrastructurel.  By wasting less.  By using less.  By selecting non-toxic products and solutions.  Even by driving less -- by using public transportation and walking.

We can make a difference in the pubic health arena, with our personal choices.  We CAN make a difference, every day. 

Green solutions aren't always common sense -- but frequently are.  But in the healthcare environment when our bodies' immune systems are delicate, special circumstances can exist.  We must reflect on history, however, and remember that patients were once kept in closed, stuffy, hot rooms with no ventilation and it was a visionary nurse who opened the windows and curtains and improved health care.  Those same innovative strategies are part of advancing our concept of green healthcare.

Craig Zimring of the Georgia Institute of Technology,  warns of the "fallacy of generalized goodness"; not all green decisions are all good.

For example, in green building, there's a delicate balance between space and the infrastructure: although wide hallways, large rooms, and oversize windows that provide natural
daylighting may create pleasant environments for staff and patients, they may also
increase energy demand and costs.

The presence of plants may pose challenges for infection control.

Thoughtful analysis, supported by empirical data and a culture of continuous improvement, is necessary to make green healthcare a smarter approach to healthful living and caring for one another.