Courtesy of Susan Hindman

Warmth, relationships, caring, home, nurturing, happiness, quality of life. These are some of the words and phrases that come out consistently when watching videos and reading comments about the Green House Project, small homes where elders live as a community with each other and the staff, with a sense of place, dignity, and control over their lives—much the opposite of what has been the experience in traditional nursing homes. And Dr. Bill Thomas, founder of the Green House Project, has thrown down the gauntlet on the issue.

“Many nursing homes are in buildings that are increasingly outdated,” he told the Chicago Tribune in 2005. “Are we going to create a whole new generation of institutional long-term-care facilities, or are we going to stop it here?”

Thomas has worked to stop it. As far back as 2001, his message was that “nursing homes need to be taken out of business,” according to an article in the Wall Street Journal. His goal was to establish small houses for long-term care needs, and he envisioned places that felt like home, where elderly residents could gather, dine together, and sit before a blazing fire.

Everything about the Green House homes is different—the size, interior design, staffing patterns, and methods of delivering skilled services to residents. The houses, which look like any other home in the neighborhood, have seven to 10 bedrooms, and residents get their own rooms and bathrooms. A shared living room, dining room, and kitchen facilities make up the common living space and the heart of the house. Every night, the residents, staff, caregivers, family, and friends sit down to dinner together at one large table.

“The Green House is based on deep relationships, nurturing, sustaining and protecting each person,” Joyce Ebmeier, a “guide” for a nine-person home in Nebraska, said in an article. “Excellent medical treatment is a key component of life in a Green House, but it is delivered discretely and supportively, with respect to the rhythm of each elder’s life.”

The first Green House was opened in Tupelo, Mississippi, in 2003. The Robert Wood Johnson Foundation (RWJF) provided the first grant and now is contributing millions to build more. The foundation directs the money to NCB Capital Impact, a Washington, D.C.–based nonprofit that offers consulting, education, architectural, and other help to those interested in operating a Green House.

An early goal was to develop 50 Green Houses by 2010, but the 50th one opened in December 2008. That same year, the Senate Finance Committee named the Green House Project a program “that should be piloted.” Fifty homes have opened in 12 states, and 130 are under development, according to the Dallas Morning News.

The project has received a tremendous amount of attention from the national media. For an in-depth look at the issue of green houses in a nursing home society, read the Wall Street Journal article. You can watch a video about the Green House Project at the RWJF Web site, or listen to a National Public Radio interview. Finally, view pictures of some of the homes—many of which look like bed and breakfasts—at NCB’s site.