Adviser Spring 2016 April 2016 | Page 14

Feature Where Commune Meets Kibbutz The New Jewish Home’s embrace of the Green House model is creating small-scale caring communities and large-scale cultural change. By Audrey Weiner, DSW, MPH; president and CEO, The New Jewish Home W alk down the hall of the Pavilion wing of The New Jewish Home’s Westchester campus and you will find tantalizing smells wafting your way. Paprika, lemon and nutmeg. Coq Au Vin, Spaghetti Bolognese and Chicken Tikka Masala. The freshest of vegetables and the ripest of fruits. Freshly made coffee and orange juice. This ain’t your grandmother’s nursing home. Ring the doorbell, go through the private front door, and you’ll find yourself inside the world of our “Small Houses” (three are currently up and running, with four more to follow). A world within a world, the Small Houses operate according to the Green House® philosophy of elder care. As a recent New York Times article explained, in a Green House setting, the impersonal, hospital-like feel of an old-school nursing home gives way to the intimate, homey feel of a small-group household. Each elder has a comfortable bedroom and bathroom (“There’s plenty of space. It’s ideal,” says Frances Russillo, 99) and everyone shares a “great room” — a big living room that flows into a large dining area adjacent to an oversized open kitchen. It’s all beautifully designed just as such spaces would be in a private house. There’s even a fireplace to create a feeling of hearth and home. (See photos below.) In a Small House, a personal approach to life complements the homey interior design. Instead of each day’s schedule being determined by what is operationally efficient for the institution, the elders themselves choose the day’s activities, meals and mealtimes. Caregivers, whom we call adirim (ah-dee-REEM), the Hebrew word for nobles, to signify the nobility of the nurturing and sustaining care they offer, work in flexible, self-managed teams. (See Where Commune Meets on page 14) Where Commune Meets ... (continued from page 13) Visit a Small House and you’ll find elders doing a variety of things — and why not, since there are no set schedules to which everyone has to conform. Some residents might be in the living room talking, listening to music, doing an art project — even participating in a drumming circle. Others might be in their bedrooms reading, watching TV. Some might be outside in the garden, soaking up the sun or visiting with friends. Still others could be sitting down to a meal together at the large, beautiful communal table just steps away from the huge, open kitchen, where the foods each person likes are prepared the way each person likes them, no matter how many individual dishes that means at any given meal. “We see the ingredients, we move them around in the pan,” says Small House resident Marilyn Weiss, 87. “Food is more tasteful because it’s being prepared in our own kitchen.” Like other residences based on geriatrician Bill Thomas’s groundbreaking approach to elder care, The New Jewish Home’s Small Houses represent a completely new way of caring for, and thinking about, elders. Instead of seeing them as collections of physical problems to be managed, we see them for what they are — people who, while old and sometimes fragile, deserve to be treated with the respect and dignity every human being deserves; to experience joy and fulfillment; and to have their wishes honored about how they wish to live each day of the rest of their lives. Our goal as stewards of the Small Houses is to learn about and honor our elders’ lives and the rich experiences that comprise them. Just some of the benefits of the Green House approach can be seen in the reduced rates of pressure ulcers (30 percent less), incontinence (62 percent less) and falls resulting in a major injury (35 percent less) among elders living in the Small Houses versus those living in the traditional part of our Westchester skilled nursing facility. But the Small Houses – Westchester’s first Green House-style skilled nursing option – are just the tip of the iceberg. We are working hard to break ground on New York City’s first Green House residence and the first to be built in a major urban environment. To be called The Living Center in Manhattan, the 20-story high-rise will offer 11 floors with a total of 22 Green House homes, each with 12 private bedrooms and baths clustered around an inviting a great room like the ones in the Westchester Small Houses. There will be several kosher households and, in another first for New York City, The Living Center will offer at least one all-LGBTQ household for those who wish to live there, although LGTBQ residents will be welcome in every household. The rest of the facility will comprise five floors of rehabilitation facilities serving up to 150 patients; a café, a spa and a library; a lobby with welcoming indoor and outdoor public spaces; and a 4,000-square-foot rooftop complete with landscaped gardens, an urban farm and areas for strolling, relaxation and horticulture therapy. Cultural Change An integral part of the move to the Green House model is the cultural change that comes with it. More than a year ago, we kicked off a training program for the entire Jewish Home staff in the core Green House values of “meaningful life,” “real home” and “empowered workforce.” Eventually, every single employee, from senior administrators to maintenance engineers, will have undergone training. The reaction of Physical Therapist Supervisor Zofia Tryjanski is representative of those who have been through the program. “There is so much different [in my approach to my work],” she says. “I try to practice more understanding and patience now. Class was like a Zen experience; I hope to take that experience and energy to the elders.” (See Where Commune Meets on page 16) 13 Adviser a publication of LeadingAge New York | Spring 2016 leadingageny.org 14