Essay on Green House Project

Published: 2022/01/10
Number of words: 954

This essay will discuss the Green House Project and explain how it was developed, as well as its significance to the overall healthcare system.

The Green House Project, created by physician Dr. Bill Thomas, is an innovative approach to elder care and assisted living for older patients. The project seeks to shift the elderly care model away from an institutional model to a personalized model, and to remove the stigma of aging while humanizing elderly care. It involves the creation of tight-knit, intensive communities for elders, facilitated by dedicated staff. At present, the Green House project has seen significant success, with over 100 Green House Projects in over 30 states. The Green House project is intended to be an alternative elder living and elder care model, with elderly residents given private baths and rooms, free movement throughout the nursing home, and community in the form of communal meal preparation and communal activities through tight-knit groups of up to 10 residents.

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Green House Project homes are also equipped with communal areas such as living rooms, kitchens and dining rooms, and are designed to integrate well with the surrounding look of a residential neighborhood, to reduce the stigma traditionally associated with living in a ‘nursing home’. To engage Green House Project residents, Green House Project staff also encourage residents to perform chores, interact with other community members, and entertain visitors such as family members. Specialized roles within the Green House Project staff team, such as Shahbazes, Guides and Sages, also allow for the efficient and effective delivery of different nursing home roles, such as meal preparation, housekeeping, operations, mentorship, dietary services and healthcare. (Rabig et al, 2006) The Green House Project residency fees are also kept highly competitive, and are on par with prevailing nursing home costs, alongside being Medicaid eligible. The program has been shown to be highly effective, with Green House Project participants demonstrating increased social interaction, lower rates of weight loss, decreased rates of depression, and greater happiness and satisfaction with life. A study by Loe et al (2012) also reported that Green House Project participants experienced greater autonomy, dignity, privacy, relationship satisfaction, and empowerment, and reported lower feelings of guilt at their aging condition that peers in traditional nursing homes. (Loe et al, 2012).

The development of the Green House Project is as follows. The program was first created by Bill Thomas, a geriatric specialist doctor, and Steve McAlilly, the Mississippi Methodist Senior Services CEO, in 2003. The two founders saw a need for the transformation of elder care, where elderly residents were often housed in cramped living conditions, isolated rooms and industrial settings, and often suffered high rates of weight loss, depression and social isolation. McAlilly and Thomas were also concerned about the quality of life for a rapidly aging population, and wanted the elderly population to be able to live fulfilled and happy lives till the end of their lives. (Sharkey, 2011) The two founders eventually secured funding from the Robert Wood Johnson Foundation in 2005 (to the tune of $10 million), and started operations in Mississippi. (Loe, 2012) As of 2015, there are over 100 Green House Projects in over 30 states. The government has also been keen to support the Green House Project as an innovative typology for elder care, and has invested in support and Medicaid funding to fuel the expansion of the Green House Project nationwide. However, as the program has expanded, some studies, such as one by Zimmerman et al (2010), have found that implementation of the Green House Project has been inconsistent, with different project homes showing different rates of resident satisfaction and health outcomes. (Zimmerman et al, 2010).

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The Green House Project is highly significant to the overall U.S. healthcare system, as it showcases an innovative, personal and humanized approach to the elder care system, distinct from earlier institutional models that dehumanized elder care. As the U.S. population ages, the Green House Project could signal a cultural shift toward more personalized healthcare for the elderly, in a way that preserves their dignity and autonomy, and allows them to better cope with the challenges associated with aging. Studies such as those by Kane et al (2007) have also provided statistically significant findings to back the potential of the Green House Project to improve the quality of life for nursing home residents, as well as to enhance the job satisfaction for healthcare providers and nursing home staff, who spend more time in direct care and interaction with residents in small-scale contexts.

In conclusion, the Green House Project represents a highly significant development in elder care in the U.S., and has the potential to transform the way in which the challenges of an aging population are dealt with.


Kane, R. A., Lum, T. Y., Cutler, L. J., Degenholtz, H. B., & Yu, T. C. (2007). Resident outcomes in small‐house nursing homes: A longitudinal evaluation of the initial green house program. Journal of the American Geriatrics Society55(6), 832-839.

Loe, M., & Moore, C. D. (2012). From nursing home to green house: Changing contexts of elder care in the United States. Journal of Applied Gerontology31(6), 755-763.

Rabig, J., Thomas, W., Kane, R. A., Cutler, L. J., & McAlilly, S. (2006). Radical redesign of nursing homes: applying the green house concept in Tupelo, Mississippi. The Gerontologist46(4), 533-539.

Sharkey, S. S., Hudak, S., Horn, S. D., James, B., & Howes, J. (2011). Frontline caregiver daily practices: a comparison study of traditional nursing homes and the green house project sites. Journal of the American Geriatrics Society59(1), 126-131.

Zimmerman, S., & Cohen, L. W. (2010). Evidence behind The Green House and similar models of nursing home care. Aging Health6(6), 717-737.

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