Households for Elder Care Continue U.S. Expansion

When the idea of a nursing home is brought up, a lot of people might frame in their minds the image of a nursing station centred at the convergence of long corridors where elderly people sit quietly, waiting for something they’re not sure about.

Carts are wheeled around teaming with medication and you can set your watch to meal and bedtimes.

But more and more that institutional vision, which is based very much on the reality of elder care for the past 40 or 50 years, is being replaced with a “household” model of care that turns conventional ideas completely around.

On Jan. 15, for example, a new 80-bed home opened for retired officers from United States military braches in San Antonio, Texas, and the home is broken down into six households. A similar home opened in Springfield, Illinois on Jan. 3, broken into households for 16 residents.

Dr. Bill Thomas, who has championed this idea of culture change in aging since he founded the Eden Alternative back in the early ’90s, speaks about the false wisdom in the economies of scale that have long driven the design of nursing homes.

Bigger and more is not always better, and in fact, his Greenhouse Project, which focuses on building “Greenhouses” for nine seniors per household, is the direct opposite of large-scale institutions we’ve long accepted for our elders.

“In the United States, we have pretty much an obsession with economies of scale,” Thomas says.

“That’s why in America everything gets blown up so big, but what we’ve found in long-term care is that there are diseconomies of scale. There are things that when you make it bigger it gets worse, and real care is one of the things that does not scale.”

He says real care involves a small circle of people who are tightly connected and work together for the betterment of each resident and the household as a whole.

The Greenhouse Project has published data verifying that not only does this model translate into better care for residents by team members who are more content in their work environments, but it’s also more economically viable than large-scale operations.

The improved clinical outcomes for residents in household models coupled with the more efficient economics associated with the “diseconomies of scale,” that Thomas describes are strong incentives to move towards culture change.

If you have questions or comments, feel free to post them right here on the site and we’ll follow up. You can also contact 800-294-0051, ext. 24, in Canada, 705-741-4421, ext, 24 in the U.S. or e-mail kristian(at)axiomnews.ca.