Three years ago, we introduced readers to Dr. Bill Thomas ("[Not] the Same Old Story," February 2002), a dynamic doctor in upstate New York who is determined to fix the nursing-home industry. His nonprofit company, Eden Alternative, "deinstitutionalizes" dreary facilities by introducing pets, plants, children, and dramatic cultural change to create a warmer environment. Thomas also hoped to build his own "Green Houses," small group homes designed around the Eden philosophy.
In spring 2003, the first Green Houses opened in Tupelo, Mississippi. Forty people moved into four single-story wood-and-brick homes built by Mississippi Methodist Senior Services. Each resident has a private room and bath, a rarity at traditional facilities. Overhead lifts help staff members move residents in and out of bed, greatly reducing the risk of injury. And an open kitchen lets residents enjoy the sights, sounds, and smells of home cooking. The idea is not only to create a welcoming home but also to celebrate "elderhood," explains Thomas.
Rosalie Kane, a public-health professor at the University of Minnesota, is conducting a two-year study comparing the Green Houses with two conventional facilities in Mississippi. Preliminary findings suggest that Green House residents are, in fact, healthier and happier. Their family members and the staff are happier, too. Turnover is about one-tenth the typical rate.
These early results bolster the business case for Green Houses, says Thomas. They cost less to build and no more to operate. The time for an alternative is ripe. Many nursing homes in the United States are deteriorating. "America has a choice," Thomas told lawmakers last November in a briefing on Capitol Hill and writes in What Are Old People For? (Vanderwyk & Burnham, 2004). "Green Houses or nursing homes." His vision is taking root: Six more sites are scheduled to break ground this year.