NEW TRENDS IN NURSING HOMES

NURSING HOMES vs GREENHOUSES

Dr. Bill Thomas

And The “Greenhouse” Concept

of Nursing Home Care For Our Elders


In the U.S. a few nursing homes are beginning to change the way they are managed and organized to create a more resident-centered environment, so they are more "home-like" and less institutional or "hospital-like."   Sometimes this kind of nursing home is called a "greenhouse."

In these homes, units are replaced with “households,” a small set of rooms surrounding a common kitchen and living room. The staff giving care is assigned to only one of these households at a time.
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In Greenhouse-style Nursing Home living environments, the residents are the heart and focus of the home.  Compared to traditional nursing homes, individual residents have more choices about when they wake up, when they eat and what they want to do during the day. In many cases, they can even have companion animals and pets.

NEW TRENDS IN LIVING ENVIRONMENTS

FOR NURSING HOMES

AND SKILLED NURSING FACILITIES


Resident-Oriented Care vs. Task-Oriented Care

A new approach in nursing homes and skilled nursing facilities is resident-oriented care.  This method of care involves nurses and aides being assigned to focus on and work with a small group of patients (perhaps 10 or 12) as a team, rather than being assigned to perform one or two tasks for a much larger number of residents.   

With resident-oriented care, nurses and certified nurses aides (CNAs) are encouraged to interact and develop relationships with their ‘family’ of patients and residents as they see to their daily care and comfort.  

  1.   Patients are treated more as family, as opposed to a check-off list of names in an institution.

  2.   Using resident-oriented care, nurses are encouraged to become familiar with each patient and develop schedules and routines that better meet each individual’s specific medical, emotional and/or physical needs.

  3.   A growing number of studies about resident-oriented care demonstrates that this method of care is not only a more positive, satisfying experience for nursing home residents and patients, but also for the staff members.
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In contrast, traditional or institutional care tends to be staff and task-oriented.  This means that staff members are trained to perform nursing or care “tasks” rather than take time to interact and develop relationships with patients as they attend to their daily needs.

In resident-centered facilities, the staff works to create a personal, more home-like environments; in more traditional, institutional environments, managers and employees may identify residents by room number, diagnosis, or patient-related tasks (like "feeders" for residents who need assistance eating their meals).


Traditional institutional methods focus on completing assignments:

  1.   Delivering services to residents in the most cost-efficient way

  2.   Maximizing the number of tasks each staff member performs

  3.   Increasing the number of residents each staff member can service

  4.   Task scheduling is designed to optimize the efficiency of the staff - not to address the comfort, convenience or personal needs of individual patients or residents.
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If given a choice, nursing home and skilled nursing facility residents would choose a resident-oriented environment over a task-oriented environment nearly every time.

 

Some staff members may even identify residents by room number, diagnosis, or patient-related tasks (like "feeders" for residents who need assistance eating their meals).

In resident-centered facilities, the staff works to create a personal, more home-like environment.

In institutional-style nursing homes, managers and employees are task-focused.

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New Trends In Nursing Homes

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