Columnist John Paradis: How a ‘small home’ model might work at Soldiers’ Home

  • This screenshot from a Youtube video produced by The Green House Project, a national nonprofit that promotes a small house design concept with family-like alternatives to traditional institutional care. youtube

Published: 8/13/2020 1:59:22 PM
Modified: 8/13/2020 1:59:12 PM

My father, Neal, a World War II and Korean War veteran, lives in a small assisted living facility in Florida.

Despite his age and a heart attack earlier this year before the pandemic in which our family thought we lost him, he continues to thrive and do amazingly well in the facility where he lives. And so far, despite the spike in COVID-19 in Florida recently, there has not been one incidence of COVID at his facility.

Why?

The best answer I can give you is the small house design of his facility where his living area is contained to his own private room, where he has a small number of fellow residents and where they live essentially in their own autonomous neighborhood that follows strict adherence to infection control protocols.

But is there even greater evidence, research or data that corroborates what my instincts tell me? As a member of the Holyoke Soldiers’ Home Coalition, the grassroots group that stood up in June in response to the Home’s COVID-19 tragedy, that answer is crucially important as our group appeals to the state for a much-improved future Soldiers’ Home.

To answer that question, I recently participated in a national webinar sponsored by The Green House Project, a national nonprofit that promotes a small house design concept with family-like alternatives to traditional institutional care.

The topic was how senior housing designs can reduce the transmission of COVID. A panel of senior living architectural experts looked at how a decentralized small house design and outdoor spaces can reduce the incidence of COVID.

The panelists noted that small home designs are much better equipped to deal with the pandemic than larger environments and have fared much better than their counterparts in the mitigation of COVID.

The Green House — a small house model — is a concept that appeals to me greatly. Conceived in 2003 by Dr. William Thomas, a Harvard-trained geriatrician, the focus is on providing elders with more autonomy and deeper social interactions but within a close-knit family-style, household setting. The Green House also has its own private entrances, like you’d find with your own home, and doesn’t have the foot traffic, open floors and corridors you find in traditional nursing homes with all the touchpoints that can spread disease.

The model also results in higher satisfaction levels and there are fewer health problems such as depression, a big factor when you are working with the veteran community, which has higher incident rates.

When our coalition recently conducted a “reimagining” exercise to jot down what we would like to see in a new Soldiers’ Home in Holyoke, we noted the necessity for a small house model with private rooms, private bathrooms, homestyle features and amenities that appeal to a diverse veteran population.

Constructing a new Soldiers’ Home will not be an easy feat, considering the scope of services needed for a veteran population that today predominately ranges from an aging legion of Vietnam-era baby boomers to future generations of post 9/11 veterans, many of whom have experienced multiple combat deployments.

A design put forth in 2012 by Paul Barabani, the former superintendent of the Soldiers’ Home, used many of the Green House concepts. Our coalition has asked the state to now upgrade that design to leverage today’s latest Green House trends, along with an enabling outdoor environment and an adult day health care program.

Green House homes come in many different styles to fit either rural, suburban or urban design settings. The key is a small home concept where residents live in “homes” or “neighborhoods,” each with their own living accommodations with unfettered access to outdoor space. Each “home” comprises, on average, 10 private bedrooms and bathrooms clustered around an airy and open-style kitchen and dining and living areas.

Here is the rub, though. As you might expect, the designs cost exponentially more than traditional facilities. Cost nationwide has been the number one reason why more Green Houses are not built. Once you get past the building costs, however, operational costs for Green Houses are comparable to those of traditional nursing homes.

At my Dad’s place, dinner is freshly cooked and dished up family style. These days he eats in a dining room, socially distanced from other residents. He goes outside often to a beautiful environment with flowers, trees and bird houses. He has attentive care providers and medical experts who know him as intimately as any of his children. He is safely enjoying his golden years, even if in isolation due to the greatest pandemic in our lifetimes.

But my father has the means to pay for such care. Like many from his Great Depression generation, he was frugal throughout his entire life, and he made sure to save up for the day when he would need extra help and skilled nursing. Never wanting to be “institutionalized” in a nursing home, he saved every penny for this day. Every senior citizen should get the same quality of care my dad receives.

Over the years, government funding has been dismal for nursing home construction and although there has been some support in Congress for loan programs for the development and construction of a small home design concept, the support from taxpayers has not been there.

Coalition members fear the state likewise will not hear our voices when it comes to conceptualizing and then constructing the kind of long-term care facility that our veterans and truly all senior citizens deserve. And my biggest question is the one hardest to answer: Will our fellow citizens be willing to do what it takes financially to reach our vision?

John Paradis, a retired U.S. Air Force lieutenant colonel, lives in Florence and writes a monthly column for the Gazette. He can be reached at columnists@gazettenet.com.


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