Kay J. Miller, M.S.W. of Life Care Retirement Communities (LCRC) in Des Moines, IA, recently returned from Kyoto, Japan where she presented the Green House® Project to a global audience. This innovative long-term care potion emphasizes cultural change for residents and staff. Green Houses are part of a broadening movement to humanize care for elderly people with smaller, more domestic settings and a closer sense of community among residents and staff members. Miller traveled to Kyoto, Japan as part of an exchange program hosted by the United States-Japan Training Institute in Care for the Elderly and sponsored by The Center for Global Partnerships, Japan Foundation. The trip gave Americans an opportunity to observe clinics and in-home comprehensive care centers in four unique environments: Irahara Clinic, Kajiwara Clinic of Tokyo, In-home Comprehensive Care Center Moto-Asakusa and Life Care System Suido-bashi Higashi-guchi Clinic.
Japan has pioneered elderly care with a model called “culture change homes” with person-centered efforts from elder choice in meals and a physical environment that includes home-like touches to a way of operating called the “Household or Neighborhood Model.” To achieve this, a nursing home is broken down into “households” of nine seniors who share a family style living room, dinning room and kitchen. Residents make their own decisions about every aspect of their lives. Caregivers are permanently assigned to a household so that consistent care and relationships can form between staff and elders.
“Currently Japan, with the wider availability of LTC insurance, has a more robust system in place than we do in the U.S.” Miller notes. “The relationship between the frontline staff and the residents is exceptional. There appeared an ease that is often unseen in United States nursing homes. The Mitsubishi Group Home mirrored what our profession is trying to achieve by creating a social environment for frail older adults with private rooms, home cooked meals, high staff to resident ration and the ability to remain in the home up until their death. Our industry in the U.S. can learn from the advances in Japan and implement ‘best practices’ in our nursing homes.”
Green Houses bring a culture change in the nursing care industry. People 85 and older are the fastest-growing segment of the population and will continue to be so over the next 30 years, the Census Bureau predicts. As the nation ages, nursing homes are aging, too. Some 16,080 nursing homes house 1.6 million people and many of the homes are outdated. Proponents for change say the “deinstitutionalized” Green House model might help the industry compete with popular alternatives such as assisted living and home health care.
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