Growing Old, Living Fully

There's a fascinating story in today's Wall Street Journal (try the link but a subscription is required to see most stories) on green houses. No, not the kind where you grow exotic orchids, but rather small group homes for the elderly that proponents will someday replace nursing homes. Each home houses 10 - 12 residents in what looks and feels like a traditional home yet provides advanced medical care.

The Robert Wood Johnson Foundation is putting some serious cash behind a plan developed by Dr. Bill Thomas to try to reach critical mass -- green houses operating in all 50 states -- in hopes that the movement will gain enough traction to be self-sustaining. He's just one proponent of this alternative to traditional nursing homes.

I think that this all sounds wonderful. One of my grandmothers spent her final three years in a nursing home and I can't recall ever being to a more depressing place. I hope to secure the right pill so that I can end things before I get to that state but might reconsider that chilling option if something like green houses are available.

One challenge is keeping this within the reach of average people. Current "assisted living" options are pretty darn expensive. I would hope that the group setting would encourage mutual care that might lower some costs. One study mentioned in the WSJ showed that the costs in a green house can be lower than in a traditional nursing home despite the scale advantages of the larger institution.

The capital costs of building the facilities is one thing that makes the green houses difficult financially. I wonder, however, if existing urban building stock could be adapted and repurposed for use as green houses. The density of urban areas lessens the need for cars, offers greater opportunities for social interaction, and may offer amenities such as movie theaters, drug stores, etc. I can even imagine several green house "condos" in relatively close proximity that could benefit from some centralized back office efficiencies.

The population is aging and we need to rethink how the elderly live their final years. There are enormous opporunities that can come from rethinking current approaches and being bold enough to try new ideas. It is heartening to hear about efforts such as this one. Please, build a green house in my backyard.